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Inspiratory flow limitation in children with bronchopulmonary dysplasia
H Sadeghi1, D B Lowenthal, A J Dozor
1Department of Pediatrics, New York Medical College, Valhalla 10595, USA.
Insights
Children with bronchopulmonary dysplasia (BPD) show lower pulmonary function and significant inspiratory flow limitations compared to those with asthma. This study highlights key differences in lung function for symptomatic BPD patients.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Child Health
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in infants, often leading to long-term respiratory issues.
- Asthma is a common chronic respiratory condition in children.
- Comparing lung function in children with BPD and asthma is crucial for understanding disease progression and management.
Purpose of the Study:
- To compare pulmonary function tests (PFTs) in children diagnosed with BPD and asthma.
- To evaluate children with BPD for evidence of upper airway obstruction.
Main Methods:
- A retrospective case-control study involving 11 children with BPD and 32 age- and height-matched children with asthma.
- Pulmonary function tests (PFTs) were analyzed, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and thoracic gas volume.
- Ratios such as FEF50%/FIF50% and FEV1/PEF were used to assess upper airway obstruction.
Main Results:
- Children with BPD exhibited significantly lower FVC, FEV1, and PEF compared to children with asthma.
- Both groups showed similar degrees of hyperinflation and reduced air-trapping after bronchodilator use.
- Children with BPD demonstrated higher FEF50%/FIF50% and FEV1/PEF ratios, indicating significant inspiratory flow limitations and potential upper airway obstruction.
Conclusions:
- Pulmonary function in symptomatic children with BPD differs significantly from that of age-matched children with asthma.
- Children with BPD, even after 5 years of age, show distinct patterns of lung function impairment, including inspiratory flow limitations.
- These findings underscore the need for targeted respiratory management strategies for children with BPD.
Abstract:
The objective of this study was to compare pulmonary function tests of children with bronchopulmonary dysplasia (BPD) and asthma, and to evaluate children with BPD for evidence of upper airway obstruction. This is a case-control retrospective study of pulmonary function tests (PFTs) of 11 children with BPD between 5 and 8 years of age who were followed by pediatric pulmonologists, and of 32 age- and height-matched children with asthma. The median forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF) were significantly lower in the BPD group (0.86 L, 0.79 L, 120 L/min) than in the asthmatic group (1.34 L, 1.21 L, 155 L/min; P = 0.002, P = 0.007, P = 0.004, respectively). Both groups were equally hyperinflated (median thoracic gas volume 155% of predicted values in the BPD compared to 152% predicted in the asthma group; P = 0.67), and both groups showed decreases in air-trapping after a bronchodilator. The ratios of forced expiratory flow at 50% of the FVC to forced inspiratory flow at 50% of the FVC (FEF50%/FIF50%) and FEV1 to PEF (FEV1/PEF) were used to assess upper airway obstruction and were higher in children with BPD than asthma (P = 0.0001 and P = 0.035, respectively). We conclude that pulmonary function of children with BPD who are still symptomatic after 5 years of age is different from age-matched children with asthma, and the children with BPD demonstrate significant inspiratory flow limitations.