Multiple-breath washout at 12 months of age reveals lung function impairments in preterm infants with

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Isabell Ricklefs1,2, Elisa Grützner3,4, Hannah Wedman3,5

  • 1Department of Pediatrics, University of Lübeck, Campus Lübeck Ratzeburger Allee 160, Lübeck, 23538, Germany. Isabell.Ricklefs@uksh.de.

Molecular and Cellular Pediatrics
|July 28, 2026
PubMed

Insights

Lung clearance index (LCI) measured by multiple-breath washout (MBW) in preterm infants at 12 months corrected age can detect early lung function impairment. Higher LCI values in infants with bronchopulmonary dysplasia (BPD) indicate long-term respiratory vulnerability.

Area of Science:

  • Neonatal respiratory medicine
  • Pediatric pulmonology
  • Respiratory physiology

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant complication of preterm birth, leading to long-term respiratory issues.
  • Early detection of impaired lung function is crucial for developing preventive strategies in preterm infants.
  • This study evaluates the utility of multiple-breath washout (MBW) parameters for early lung function assessment in preterm infants.

Purpose of the Study:

  • To assess the feasibility of using MBW-derived parameters in preterm infants at 12 months corrected age.
  • To identify early lung function impairment in preterm infants with and without BPD.
  • To correlate lung function parameters with clinical factors and long-term respiratory outcomes.

Main Methods:

  • A single-centre study involving preterm infants at 12 months corrected age.
  • Sulfur hexafluoride MBW and Tidal Breathing Flow Volume Loops (TBFVL) were used during spontaneous sleep.
  • Infants were stratified into severe BPD, mild BPD, and no BPD groups.

Main Results:

  • MBW measurements were feasible in 40% of infants, including those with BPD.
  • Infants with BPD showed significantly higher lung clearance index (LCI) and lower tidal volume to functional residual capacity ratios.
  • LCI positively correlated with duration of CPAP support, oxygen supplementation, and antibiotic treatment, and was linked to increased respiratory infection readmissions.

Conclusions:

  • MBW measurements during sleep can reveal impaired lung function in preterm infants with BPD at 12 months corrected age.
  • LCI is a potential early indicator of lung function impairment and long-term respiratory vulnerability.
  • LCI's correlation with modifiable clinical factors suggests potential for targeted interventions.
Abstract

Keywords:
Bronchopulmonary dysplasiaLung functionMultiple breath washout

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