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Exercise Capacity and Ventilatory Response in Children Who Were Born Preterm, With and Without Bronchopulmonary
Eleana Kouroukli1, Kosmas Sarafidis2, John Tsanakas1
1Pediatric Pulmonology and Cystic Fibrosis Unit, 3rd Department of Paediatrics, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Insights
Children with bronchopulmonary dysplasia (BPD) show normal lung function but have reduced exercise capacity and impaired ventilatory efficiency during exertion. This impacts their long-term respiratory health following preterm birth.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Exercise Physiology
Background:
- Bronchopulmonary dysplasia (BPD) is a common complication of preterm birth, leading to chronic respiratory issues.
- Understanding the long-term effects of BPD on lung function and exercise is crucial for affected children.
Purpose of the Study:
- To evaluate lung function and exercise capacity in school-aged children with a history of prematurity and/or BPD.
- To compare exertional respiratory patterns and ventilatory/gas exchange responses between children with BPD, preterm children without BPD, and healthy controls.
Main Methods:
- A prospective observational study involving three groups: preterm-born with BPD, preterm-born without BPD, and healthy term-born controls.
- Participants underwent spirometry and cardiopulmonary exercise testing (CPET) to assess lung function and exercise performance.
Main Results:
- While spirometry (FVC, FEV1, FEF25-75%, FEV1/FVC) was comparable across all groups, peak oxygen consumption (V̇O2peak%) was reduced in the BPD group compared to controls.
- The BPD group exhibited significantly higher ventilatory equivalents for carbon dioxide (VE/VCO2), indicating decreased ventilatory efficiency during exercise.
- No significant differences were observed in most CPET parameters when adjusted for height, except for VE/VCO2.
Conclusions:
- Children with BPD maintain normal lung function as measured by spirometry.
- However, they experience reduced exercise capacity and diminished ventilatory efficiency during physical exertion.
- These findings highlight the persistent impact of BPD on respiratory health and physical performance into childhood.
Background:
Bronchopulmonary dysplasia is one of the most common complications of preterm birth and has lifelong repercussions in respiratory health.
Objective:
To examine lung function and exercise capacity and assess potential differences in exertional respiratory pattern and ventilatory and gas exchange responses in school-aged children with a history of prematurity and/or BPD.
Methods:
Prospective observational study including children and adolescents born preterm, with and without BPD, and healthy term-born controls without a known history of asthma. Participants performed spirometry and cardiopulmonary exercise testing.
Results:
Eighty-two children aged 6-18 years (mean: 11.9 years, SD: 3.1) were enrolled and examined in three groups: preterm-born with BPD (gestational age < 32 weeks), preterm-born without BPD (GA < 37 weeks), and term-born controls (GA ≥ 37 weeks). FVC, FEV1, FEF25% -75%, and FEV1/FVC were normal and comparable among the three groups. V̇O2peak% was reduced in the BPD group and was significantly lower than the control group (mean difference: -14.4, CI: -28 to -0.7, adjusted p = 0.04), but the difference was not significant when adjusting for height. The BPD group had the highest mean VE/VCO2 adjusted for height (32.7), followed by the preterm (30.3) and the control group (29.5), and the difference between the BPD and control group was statistically significant (p = 0.015). Moreover, BPD status was significantly associated with increased VE/VCO2 (β = +3.2, CI: 1-5.4, p = 0.005). The rest of the CPET parameters were within normal limits and comparable among groups.
Conclusions:
Children with BPD have normal lung function but reduced exercise capacity and decreased ventilatory efficiency during exercise.
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