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Intra-breath respiratory mechanics of prematurity-associated lung disease phenotypes in school-aged children

Michael Cousins1,2, Kylie Hart1,2, Bence Radics3

  • 1Department of Child Health, Cardiff University School of Medicine, Cardiff, UK.

ERJ Open Research
|April 1, 2025
PubMed

Insights

Preterm-born children with obstructive lung disease show distinct intra-breath oscillometry patterns, revealing greater airway resistance and reactance. These findings help differentiate lung disease phenotypes in this population.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Physiology
  • Medical Technology

Background:

  • Intra-breath oscillometry offers insights into airway function, with potential links to obstructive airway disease.
  • Specific respiratory mechanics in preterm-born children using this method are not well understood.
  • Investigating intra-breath oscillometry features in different spirometry phenotypes of prematurity-associated lung disease (PLD) is crucial.

Purpose of the Study:

  • To investigate specific intra-breath oscillometry features in preterm-born children with different spirometry phenotypes of PLD.
  • To compare respiratory mechanics between children with prematurity-associated obstructive lung disease (POLD), prematurity-associated preserved ratio impaired spirometry (pPRISm), preterm controls, and term controls.

Main Methods:

  • 167 school-aged children (7-12 years) were studied, including groups with POLD, pPRISm, preterm controls, and term controls.
  • Intra-breath oscillometry was performed at baseline, post-exercise, and post-bronchodilation.
  • Spirometry phenotypes were defined by forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) relative to the lower limit of normal (LLN).

Main Results:

  • Children with POLD exhibited greater resistance and more negative reactance throughout the respiratory cycle.
  • The difference in resistance and reactance between end-expiration and end-inspiration, when corrected for tidal volume, was approximately two-fold greater in children with POLD and pPRISm compared to controls.
  • Children with POLD showed a significantly greater magnitude of reactance difference compared to preterm and term controls.

Conclusions:

  • Preterm-born children with an obstructive lung phenotype display distinct intra-breath respiratory mechanics, characterized by increased impedance.
  • These oscillometry features differ from those observed in other wheeze phenotypes, such as preschool wheeze and asthma.
  • Intra-breath oscillometry can help characterize specific respiratory phenotypes in children with a history of prematurity.
Abstract

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