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Functional evidence for continued alveolarisation in former preterms at school age?
Sophie Yammine1, Anne Schmidt1, Oliver Sutter2
1University Children's Hospital of Basel (UKBB), Basel, Switzerland Division of Respiratory Medicine, Department of Paediatrics, University Children's Hospital Bern, Bern, Switzerland.
The European Respiratory Journal
|October 24, 2015
Summary
Former preterm children show impaired function in proximal conducting airways, indicated by elevated Scond, despite normal alveolar function. This suggests dysanaptic lung growth following prematurity.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Developmental Pediatrics
Background:
- Prematurity significantly disrupts lung development, particularly peripheral airways.
- Understanding long-term respiratory consequences in former preterm children is crucial.
Purpose of the Study:
- To assess peripheral airway function in school-aged children born preterm using multiple-breath washout (MBW).
- To identify ventilation inhomogeneity markers in former preterm children compared to term-born controls.
Main Methods:
- Nitrogen multiple-breath washout (MBW) performed on 77 former preterm and 46 term-born children (ages 6-16).
- Assessed Lung Clearance Index (LCI), Scond (convection-dependent inhomogeneity), and Sacin (diffusion-convection-dependent inhomogeneity).
Main Results:
- No significant differences in LCI or Sacin between preterm and term-born groups.
- Scond was significantly elevated in former preterm children (p<0.001), with 54% showing impairment.
- Elevated Scond correlated significantly with lower gestational age.
Conclusions:
- Former preterm children exhibit preserved alveolar function (normal Sacin) but impaired proximal conducting airway function (elevated Scond).
- Findings support "dysanaptic" lung growth in preterm survivors, where alveolarization continues but conducting airways develop disproportionately.
- MBW is a valuable tool for detecting subtle airway dysfunction in former preterm individuals.
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