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Diffusing capacity of the lung in school-aged children born very preterm, with and without bronchopulmonary dysplasia
A L Hakulinen1, A L Järvenpää, M Turpeinen
1Children's Hospital, Helsinki University Central Hospital, Finland.
Insights
Bronchopulmonary dysplasia (BPD) did not significantly impact diffusing lung capacity in children. However, very preterm infants, with or without BPD, showed reduced lung function compared to full-term controls.
Area of Science:
- Pediatric Pulmonology
- Neonatal Medicine
- Respiratory Physiology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
- Long-term respiratory sequelae in survivors of extreme prematurity require further investigation.
Purpose of the Study:
- To assess the impact of BPD on diffusing lung capacity in childhood.
- To compare lung function in very preterm children with and without BPD to healthy term-born children.
Main Methods:
- Pulmonary function tests, including diffusing capacity for carbon monoxide (DLCO), lung volumes (body plethysmography), and expiratory flow rates (spirometry), were performed.
- Study included 31 very preterm children (birth weight < 1250 g) aged 7-11 years (20 with BPD, 11 without), and 20 healthy term-born controls.
Main Results:
- DLCO was significantly lower in both preterm groups (with and without BPD) compared to term-born controls.
- No significant difference in DLCO was observed between preterm children with and without BPD.
- Reduced expiratory flow rates were noted in both preterm groups, while thoracic gas volumes were similar across all groups.
Conclusions:
- Very preterm birth, irrespective of BPD diagnosis, is associated with persistent structural changes and reduced lung function into childhood.
- These findings highlight the long-term respiratory challenges faced by survivors of extreme prematurity.
Abstract:
The aim of this study was to determine the extent to which bronchopulmonary dysplasia (BPD) affects the diffusing properties of lung tissue in childhood. Pulmonary function in 31 prematurely born children (BW. < 1250 g) was examined at ages 7-11 years. Twenty out of 31 prematurely born children met the criteria for BPD. The remaining 11 children had milder forms of neonatal lung disease. Twenty healthy children of the same age and born at term served as a control group. The diffusing capacity of the lung for carbon monoxide (DLCO) was measured by the single breath method. Lung volumes were determined in a body plethysmograph and expiratory flow rates with a flow/volume spirometer. DLCO values of children with histories of BPD did not differ significantly from those of the prematurely born children without BPD. However, DLCO values in both prematurely born study groups were significantly lower than those in controls born at term. Thoracic gas volumes measured with a body plethysmograph were similar in all groups. Spirometry demonstrated reduced flow rates in both BPD and non-BPD prematurely born children. The results suggest that some structural changes in lung tissues and airways persist for years in children who are born very preterm regardless of whether they develop BPD or not.