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Lung volume measurements in infants with and without chronic lung disease
V Kavvadia1, A Greenough, G Dimitriou
1Dept. of Child Health, King's College Hospital, London, UK.
Insights
Infants with chronic lung disease (CLD) have lower functional residual capacity (FRC) lung volumes compared to healthy infants. This highlights the need for appropriate control groups in neonatal research and lung volume assessment for CLD therapies.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Infants born prematurely are at risk for developing chronic lung disease (CLD).
- Airway obstruction in CLD can lead to reduced lung volumes.
- The impact of control group selection on FRC measurements in CLD infants is not fully understood.
Purpose of the Study:
- To test the hypothesis that infants with CLD have lower lung volumes (FRC).
- To determine if the choice of control group influences the observed differences in FRC.
- To investigate the correlation between FRC and clinical parameters in CLD infants.
Main Methods:
- Functional residual capacity (FRC) was measured in 16 oxygen-dependent infants with CLD and 8 infants without CLD at 14 and 28 days.
- CLD infants were stratified by gestational age (<27 weeks: Group A; >26 weeks: Group B).
- Group B infants were matched for gestational age and gender with control infants (Group C).
Main Results:
- Group A (very preterm CLD) had significantly lower FRC than controls (Group C) at both 14 and 28 days.
- Group B (later preterm CLD) showed lower FRC than matched controls (Group C) only at 28 days.
- FRC correlated significantly with oxygen and ventilator dependence duration, and weakly with gestational age.
Conclusions:
- Neonatal FRC measurements are lower in infants with CLD compared to non-CLD infants.
- The selection of an appropriate control group is crucial for accurate FRC comparisons.
- Lung volume measurements may aid in evaluating treatment efficacy for CLD.
Unlabelled:
Infants born prematurely who develop chronic lung disease (CLD) have airways obstruction and hence may have low lung volume. The aim of this study was to test that hypothesis and ascertain whether the nature of the comparison control group influenced the results. Sixteen infants who were oxygen dependent for more than 28 days (CLD) and eight infants without CLD had measurements of functional residual capacity (FRC) at 14 and 28 days. The 16 CLD infants consisted of eight less than 27 weeks gestational age (group A) and eight greater than 26 weeks gestational age (group B). The eight infants without CLD (group C) were each matched for gestational age and gender to infants in group B. Group A compared to group C had lower FRCs both at 14 days (median 18 ml/kg vs 27 ml/kg, P < 0.01) and 28 days (median 20 ml/kg vs 26 ml/kg, P < 0.05), but group A differed from group C with respect to both gestational age (P < 0.01) and birth weight (P < 0.01). The FRC results of group B were lower than those of their matched controls (group C) only at 28 days (median 22 vs 26 ml/kg, P < 0.05). Overall, the FRC results at 14 and 28 days correlated significantly with the duration of oxygen and ventilator dependence and weakly with gestational age.
Conclusion:
These results support the hypothesis that FRC results are lower in infants with CLD compared to those without CLD when measured in the neonatal period and emphasize the importance of an appropriate control group. Measurement of lung volume may facilitate assessment of the response to therapies for CLD.