Design and implementation of a multicenter protocol to obtain impulse oscillometry data in preterm children

Area of Science:

• Pediatric Pulmonology
• Neonatology
• Respiratory Physiology

Background:

• Objective lung function measures are crucial for assessing respiratory outcomes in premature infants.
• Extremely low gestational age neonates (ELGANs) often experience neurodevelopmental impairments that can complicate traditional lung function testing.
• Impulse oscillometry (IOS) offers a noninvasive alternative, not requiring forced exhalation.

Purpose of the Study:

• To detail the multicenter study design for respiratory follow-up using IOS in a cohort with a high prevalence of extreme prematurity.
• To evaluate the feasibility and success rates of IOS in school-aged children with a history of ELGANs.

Main Methods:

• School-aged children from two prior trials, including ELGANs and term controls, underwent IOS testing across five centers.
• Participants were categorized into three groups: prematurity with bronchopulmonary dysplasia, prematurity with minimal lung disease, and healthy term controls.
• A centralized review ensured technical acceptability of all IOS tests.

Main Results:

• Out of 243 recruited children, 239 (98%) attempted IOS.
• High technical acceptability was observed across all cohorts (85%-90%) and centers (80%-94%).
• Factors associated with testing failure included prolonged neonatal ventilation, severe intraventricular hemorrhage, and gross motor functional impairment.

Conclusions:

• IOS demonstrates high feasibility and success rates in a large, multicenter ELGAN population.
• Neurological and developmental comorbidities can influence IOS test outcomes but do not preclude its successful application.
• IOS is a viable tool for assessing respiratory mechanics in high-risk preterm populations.