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Multimodal longitudinal respiratory function assessment in very low birth weight 7-year-old children
Wojciech Durlak1, Małgorzata Klimek1, Michał Wroński1
1Jagiellonian University Medical College, Department of Pediatrics, Krakow, Poland.
Insights
Very low birth weight (VLBW) children show persistent lung function deficits and respiratory issues at age 7. Electrical impedance segmentography (EIS) may help assess lung function in these children, especially those with bronchopulmonary dysplasia (BPD).
Area of Science:
- Pediatric Pulmonology
- Neonatology
- Respiratory Medicine
Background:
- Preterm birth is a significant risk factor for adverse pulmonary outcomes.
- Very low birth weight (VLBW) infants are particularly susceptible to long-term respiratory complications.
- Understanding the persistent effects of prematurity on lung function is crucial for effective management.
Purpose of the Study:
- To evaluate respiratory morbidities and lung function in 7-year-old Polish children born with VLBW.
- To compare current lung function with previous electrical impedance segmentography (EIS) results from age 4.
- To identify specific pulmonary challenges in VLBW children, particularly those with a history of bronchopulmonary dysplasia (BPD).
Main Methods:
- Comparison of VLBW children (n=40) with term-born controls (n=30) using spirometry and impulse oscillometry.
- Analysis of perinatal data and current respiratory morbidities.
- Correlation of 7-year-old pulmonary function test results with prior EIS data.
Main Results:
- VLBW children exhibited higher prevalence of elevated total airway resistance (15%) and reduced forced expiratory volume in the first second (18%) compared to controls.
- A positive bronchodilator response was more frequent in VLBW children, indicating airway hyperresponsiveness.
- Children with BPD showed significantly higher airway resistance (total, large, and small airways) and a strong correlation between BPD and bronchodilator response in EIS.
Conclusions:
- School-aged VLBW children, especially those with BPD, experience substantial and persistent respiratory morbidity with reduced lung function affecting both small and large airways.
- EIS demonstrates potential as a valuable tool for assessing lung function in children with BPD, complementing traditional methods.
Purpose:
Preterm birth is associated with adverse pulmonary outcomes. We aimed to evaluate respiratory morbidities and lung function of very low birth weight (VLBW) Polish children followed up at the age of 7 years old, and to compare with electrical impedance segmentography (EIS) results recorded at 4 years of age.
Materials And Methods:
VLBW children were compared with term controls using impulse oscillometry and spirometry. Perinatal data and current respiratory morbidities were analyzed and pulmonary function test results were compared with previous EIS results.
Results:
We included 40 VLBW children and 30 controls in the analysis. Elevated total airway resistance and forced expiratory volume in the first second below the lower limit of normal were more prevalent in VLBW children compared with term controls (15 vs 0%; 18 vs 0%). A positive bronchodilator response was more common in VLBW children (R5 Hz: 46 vs 13.3%; R5-20 Hz: 65 vs 36.7%). Children with bronchopulmonary dysplasia (BPD) had higher total airway resistance (R5 Hz/R5 Hz pred: 1.35 vs 0.95; p < 0.001), large airway resistance (R20 Hz/R20 Hz pred: 0.89 vs 0.66; p = 0.001), small airway resistance (R5-20 Hz: 0.57 vs 0.34 kPa L-1 s-1; p = 0.009), than controls. Strong correlation between BDR in EIS and R5 Hz/R5 Hz pred was observed in children with BPD (r = 0.7).
Conclusion:
VLBW school-aged children with BPD presented with substantial respiratory morbidity and persistent reduction of lung function, affecting small and large airways and lung parenchyma. EIS may be an alternative tool for lung function assessment in children with BPD.
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