婴儿早产和出院后呼吸道疾病的生理肺表型
Robert S Tepper1, Brandie D Wagner2, Jeffrey Bjerregaard3
1Section of Pediatric Pulmonology, Allergy and Sleep Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN; Department of Pediatrics, H.B. Wells Center for Pediatric Research, Indianapolis, IN.
The Journal of pediatrics
|January 24, 2025
概括
肺功能测试根据呼吸道和肺功能确定了早产婴儿的四个子组. 这些表型更好地预测了婴儿期的呼吸系统疾病和喘息,而不是妊娠年龄或支气管肺功能失调的诊断.
科学领域:
- 儿科肺病学 儿科肺病学
- 新生儿科学 新生儿科学
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 过早出生的婴儿患呼吸道疾病的风险增加.
- 早产婴儿的肺病理生理学可能是异质的.
- 确定不同的子组对于有针对性的干预至关重要.
研究的目的:
- 根据肺病理生理学来确定呼吸道和辅酶功能是否可以识别早产婴儿的子组.
- 评估这些子组是否有婴儿期呼吸道疾病的不同风险.
主要方法:
- 125名早产婴儿的前景队列.早产婴儿.
- 关于喘息和呼吸系统疾病的每月问卷.
- 在5个月的婴儿肺功能测试时,校正年龄 (强迫呼气流,气泡体积[VA],肺的扩散能力[DL]/VA).
- 使用先验定义和k-means集群的表型分类.
主要成果:
- 确定了四种肺生理表型,其特征是呼吸道和/或神经膜功能下降.
- 更糟糕的表型与较低的妊娠年龄有关.
- 相比于妊娠年龄,性别或支气管肺功能失调诊断,表型显示出更好的呼吸道发病率 (AUC=0.71) 和喘息 (AUC=0.69) 的预测.
结论:
- 早产婴儿的生理肺表型与呼吸道疾病的不同风险有关.
- 这些表型可能有助于识别长期呼吸系统序列的异质风险.
- 基于这些独特的风险,可以制定个性化的治疗策略.
相关概念视频
Pulmonary Cycle: Exhalation
1.3K
In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
1.3K
Pulmonary Function Tests
297
Pulmonary Function Tests (PFTs)
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
297
Physical Assessment of the Respiratory Tract II: Inspection
226
Physical assessment of the respiratory tract through inspection is a crucial step in understanding the patient's respiratory health. It provides insights into the functioning of the respiratory system, the musculoskeletal structure, and even the patient's nutritional status. This comprehensive approach involves observing several vital aspects: chest configuration, breathing patterns, respiratory rates, skin color, and use of accessory muscles.
Chest Configuration
The chest configuration...
Chest Configuration
The chest configuration...
226
Respiratory System Abnormal Finding I: Inspection and Percussion
201
Respiratory system abnormalities are a significant concern in healthcare due to their potential to indicate underlying severe conditions like Chronic Obstructive Pulmonary Disease (COPD), asthma, and pneumonia. These abnormalities can often be detected through physical examination methods like inspection and percussion.
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...
201
Acute Respiratory Failure-II
168
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
168
Breathing
58.3K
The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs...
58.3K


