Ventilation inhomogeneity and NO and CO diffusing capacity in ex-premature school children

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine
• Neonatology

Background:

• Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting ex-premature infants.
• Long-term pulmonary sequelae in BPD survivors often include airway obstruction and impaired gas exchange.
• Novel methods are needed to assess subtle, long-term respiratory impairment in this population.

Purpose of the Study:

• To evaluate the utility of multiple breath nitrogen washout (N2MBW) and diffusing capacity for nitric oxide (DLNO) in assessing long-term pulmonary and vascular function in ex-premature children with BPD.
• To compare lung function parameters between ex-premature children with and without BPD, and healthy term-born controls.

Main Methods:

• A cohort of 70 ex-premature children (8-13 years) and 38 term-born controls underwent spirometry, plethysmography, N2MBW (LCI, Sacin, Scond), DLNO (Dm, Vc), fractional exhaled nitric oxide, and CO diffusing capacity.
• Respiratory symptoms were assessed via questionnaire.

Main Results:

• Ex-premature children with BPD exhibited significantly higher lung clearance index (LCI) and Sacin, and lower CO diffusing capacity and DLNO compared to controls.
• The BPD group also reported more respiratory complaints and showed signs of airway obstruction and hyperinflation.
• Among ex-premature children, BPD was associated with decreased membrane diffusing capacity (Dm).

Conclusions:

• Ex-premature school children, particularly those with BPD, experience significant long-term respiratory symptoms and peripheral lung impairment.
• N2MBW and DLNO measurements are valuable tools for detecting ventilation inhomogeneity and vascular impairment in BPD survivors.
• Further longitudinal studies are warranted to establish the clinical utility of these advanced lung function assessment methods.