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Pulmonary function in infancy and in childhood following mechanical ventilation in the neonatal period
F Lebourges1, G Moriette, M Boulé
1Physiology Laboratories, Trousseau Hospital, Paris, France.
Insights
Premature infants requiring mechanical ventilation show persistent lung resistance and decreased lung compliance into childhood. These pulmonary function deficits may not resolve after the neonatal period, impacting long-term respiratory health.
Area of Science:
- Pediatric Pulmonology
- Neonatal Intensive Care
- Respiratory Physiology
Background:
- Premature birth and neonatal mechanical ventilation (MV) are associated with altered pulmonary function.
- Long-term respiratory outcomes in infants who received MV are not fully understood.
Purpose of the Study:
- To evaluate pulmonary function in prematurely born infants who required mechanical ventilation during the neonatal period.
- To compare pulmonary function from infancy to childhood in the same cohort of patients.
Main Methods:
- Longitudinal evaluation of pulmonary function in 19 prematurely born infants who required neonatal mechanical ventilation.
- Comparison of lung resistance (RL), dynamic lung compliance (CLdyn), maximum flow at functional residual capacity, and pulmonary diffusing capacity for carbon monoxide with control subjects.
Main Results:
- Significantly elevated lung resistance (RL) was observed in infancy and persisted into childhood (P < 0.01).
- A significant decrease in dynamic lung compliance (CLdyn) became apparent in childhood (P < 0.05).
- Maximum flow at functional residual capacity was significantly reduced (P < 0.01), while diffusing capacity for carbon monoxide remained similar to controls.
Conclusions:
- Pulmonary dysfunction following premature birth and prolonged mechanical ventilation may persist from infancy to childhood.
- These findings suggest that respiratory sequelae from neonatal respiratory distress and MV may not fully resolve.
- Further research is needed to understand the long-term impact and potential interventions for respiratory health in this population.
Abstract:
Pulmonary function was evaluated in both infancy and childhood in the same 19 prematurely born infants, who required mechanical ventilation (MV) during the neonatal period. Results of our patients were compared with those of control subjects. Upon first evaluation, we found that lung resistance (RL) was significantly elevated (24.85 +/- 6.06 vs. 17.77 +/- 2.39 cmH2O/L/s; P less than 0.01). The mean value of dynamic lung compliance (CLdyn) was low, but the difference compared to controls did not reach significance. From infancy to childhood, elevated RL persisted (9.33 +/- 2.51 vs. 6.52 +/- 1.52 cm H2O/L/s; P less than 0.01), and the decrease of CLdyn became significant (46.86 +/- 12.84 vs. 59.34 +/- 15.68 mL/cmH2O; P less than 0.05). In addition, maximum flow at functional residual capacity was significantly decreased (0.824 +/- 0.284 vs. 1.215 +/- 0.358 L/s; P less than 0.01); whereas pulmonary diffusing capacity for carbon monoxide was similar in the patients (7.62 +/- 2.16 mL/min/mm Hg) and in the controls (8.38 +/- 1.6). Pulmonary dysfunction following premature birth, respiratory distress, and prolonged MV may not resolve from infancy to childhood.