Ventilation inhomogeneity and NO and CO diffusing capacity in ex-premature school children

Jesper Kiehn Sørensen; Frederik Buchvald; Anna Korsgaard Berg; Paul D Robinson; Kim Gjerum Nielsen

doi:10.1016/j.rmed.2018.06.006

Ventilation inhomogeneity and NO and CO diffusing capacity in ex-premature school children

Jesper Kiehn Sørensen, Frederik Buchvald, Anna Korsgaard Berg, Paul D Robinson, Kim Gjerum Nielsen

Institut for Klinisk Medicin

8 Citationer (Scopus)

Abstract

Aim: Ex-premature school children show mild-to-moderate airway obstruction and decreased CO diffusing capacity. Multiple breath nitrogen washout (N2MBW) and NO diffusing capacity (DLNO) measurements may provide new insight into long-term pulmonary and vascular impairment in bronchopulmonary dysplasia (BPD). Methods: We examined a randomly selected group of 70 ex-premature children (gestational age <28 weeks or birth weight <1500 g; 42 with and 28 without BPD) and 38 term-born healthy controls of 8–13 years of age. Subjects performed N2MBW (lung clearance index, LCI; Sacin, and Scond), DLNO (membrane related diffusing capacity, Dm and pulmonary capillary volume, Vc), Fractional exhaled NO, CO diffusing capacity, conventional spirometry (FEV1, FVC, FEF25-75) and plethysmography (RV, TLC). Respiratory symptoms were assessed by questionnaire. Results: Compared to healthy controls, the BPD group had higher z-scores for lung clearance index (P = 0.003), Sacin (P = 0.005), lower CO diffusing capacity (P = 0.025), DLNO (P = 0.022), DLNO/VA z-scores (P = 0.025) and a significant larger proportion had respiratory complaints. Amongst ex-premature children, the BPD group did not differ from the non-BPD group except for a decreased Dm (P = 0.023). Ex-premature with BPD showed predominantly airway obstruction (FEV1/FVC; P < 0.0001), signs of hyperinflation (RV/TLC-ratio; P = 0.028), and 25% had a positive bronchodilator response (>12% in FEV1). Conclusion: Ex-premature school children exhibited relatively mild but significant long-term respiratory symptoms and pulmonary peripheral impairment judged by N2MBW and DLNO measurements along with well-known airway obstruction. Larger longitudinal studies are needed to assess the clinical use of these advanced methods of assessing ventilation inhomogeneity and DLNO.

Originalsprog	Engelsk
Tidsskrift	Respiratory Medicine
Vol/bind	140
Sider (fra-til)	94-100
ISSN	0954-6111
DOI	https://doi.org/10.1016/j.rmed.2018.06.006
Status	Udgivet - jul. 2018

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10.1016/j.rmed.2018.06.006

http://www.resmedjournal.com/article/S0954611118301975/pdf

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@article{ecc92b96643442c084d42570dc3922c9,

title = "Ventilation inhomogeneity and NO and CO diffusing capacity in ex-premature school children",

abstract = "Aim: Ex-premature school children show mild-to-moderate airway obstruction and decreased CO diffusing capacity. Multiple breath nitrogen washout (N2MBW) and NO diffusing capacity (DLNO) measurements may provide new insight into long-term pulmonary and vascular impairment in bronchopulmonary dysplasia (BPD). Methods: We examined a randomly selected group of 70 ex-premature children (gestational age <28 weeks or birth weight <1500 g; 42 with and 28 without BPD) and 38 term-born healthy controls of 8–13 years of age. Subjects performed N2MBW (lung clearance index, LCI; Sacin, and Scond), DLNO (membrane related diffusing capacity, Dm and pulmonary capillary volume, Vc), Fractional exhaled NO, CO diffusing capacity, conventional spirometry (FEV1, FVC, FEF25-75) and plethysmography (RV, TLC). Respiratory symptoms were assessed by questionnaire. Results: Compared to healthy controls, the BPD group had higher z-scores for lung clearance index (P = 0.003), Sacin (P = 0.005), lower CO diffusing capacity (P = 0.025), DLNO (P = 0.022), DLNO/VA z-scores (P = 0.025) and a significant larger proportion had respiratory complaints. Amongst ex-premature children, the BPD group did not differ from the non-BPD group except for a decreased Dm (P = 0.023). Ex-premature with BPD showed predominantly airway obstruction (FEV1/FVC; P < 0.0001), signs of hyperinflation (RV/TLC-ratio; P = 0.028), and 25% had a positive bronchodilator response (>12% in FEV1). Conclusion: Ex-premature school children exhibited relatively mild but significant long-term respiratory symptoms and pulmonary peripheral impairment judged by N2MBW and DLNO measurements along with well-known airway obstruction. Larger longitudinal studies are needed to assess the clinical use of these advanced methods of assessing ventilation inhomogeneity and DLNO.",

keywords = "Adolescent, Birth Weight/physiology, Bronchodilator Agents/therapeutic use, Bronchopulmonary Dysplasia/drug therapy, Carbon Monoxide, Case-Control Studies, Child, Female, Follow-Up Studies, Gestational Age, Humans, Infant, Newborn, Infant, Premature/physiology, Male, Nitric Oxide, Premature Birth/physiopathology, Pulmonary Diffusing Capacity/drug effects, Spirometry/methods",

author = "S{\o}rensen, {Jesper Kiehn} and Frederik Buchvald and Berg, {Anna Korsgaard} and Robinson, {Paul D} and Nielsen, {Kim Gjerum}",

year = "2018",

month = jul,

doi = "10.1016/j.rmed.2018.06.006",

language = "English",

volume = "140",

pages = "94--100",

journal = "Respiratory Medicine",

issn = "0954-6111",

publisher = "Elsevier",

}

TY - JOUR

T1 - Ventilation inhomogeneity and NO and CO diffusing capacity in ex-premature school children

AU - Sørensen, Jesper Kiehn

AU - Buchvald, Frederik

AU - Berg, Anna Korsgaard

AU - Robinson, Paul D

AU - Nielsen, Kim Gjerum

PY - 2018/7

Y1 - 2018/7

N2 - Aim: Ex-premature school children show mild-to-moderate airway obstruction and decreased CO diffusing capacity. Multiple breath nitrogen washout (N2MBW) and NO diffusing capacity (DLNO) measurements may provide new insight into long-term pulmonary and vascular impairment in bronchopulmonary dysplasia (BPD). Methods: We examined a randomly selected group of 70 ex-premature children (gestational age <28 weeks or birth weight <1500 g; 42 with and 28 without BPD) and 38 term-born healthy controls of 8–13 years of age. Subjects performed N2MBW (lung clearance index, LCI; Sacin, and Scond), DLNO (membrane related diffusing capacity, Dm and pulmonary capillary volume, Vc), Fractional exhaled NO, CO diffusing capacity, conventional spirometry (FEV1, FVC, FEF25-75) and plethysmography (RV, TLC). Respiratory symptoms were assessed by questionnaire. Results: Compared to healthy controls, the BPD group had higher z-scores for lung clearance index (P = 0.003), Sacin (P = 0.005), lower CO diffusing capacity (P = 0.025), DLNO (P = 0.022), DLNO/VA z-scores (P = 0.025) and a significant larger proportion had respiratory complaints. Amongst ex-premature children, the BPD group did not differ from the non-BPD group except for a decreased Dm (P = 0.023). Ex-premature with BPD showed predominantly airway obstruction (FEV1/FVC; P < 0.0001), signs of hyperinflation (RV/TLC-ratio; P = 0.028), and 25% had a positive bronchodilator response (>12% in FEV1). Conclusion: Ex-premature school children exhibited relatively mild but significant long-term respiratory symptoms and pulmonary peripheral impairment judged by N2MBW and DLNO measurements along with well-known airway obstruction. Larger longitudinal studies are needed to assess the clinical use of these advanced methods of assessing ventilation inhomogeneity and DLNO.

AB - Aim: Ex-premature school children show mild-to-moderate airway obstruction and decreased CO diffusing capacity. Multiple breath nitrogen washout (N2MBW) and NO diffusing capacity (DLNO) measurements may provide new insight into long-term pulmonary and vascular impairment in bronchopulmonary dysplasia (BPD). Methods: We examined a randomly selected group of 70 ex-premature children (gestational age <28 weeks or birth weight <1500 g; 42 with and 28 without BPD) and 38 term-born healthy controls of 8–13 years of age. Subjects performed N2MBW (lung clearance index, LCI; Sacin, and Scond), DLNO (membrane related diffusing capacity, Dm and pulmonary capillary volume, Vc), Fractional exhaled NO, CO diffusing capacity, conventional spirometry (FEV1, FVC, FEF25-75) and plethysmography (RV, TLC). Respiratory symptoms were assessed by questionnaire. Results: Compared to healthy controls, the BPD group had higher z-scores for lung clearance index (P = 0.003), Sacin (P = 0.005), lower CO diffusing capacity (P = 0.025), DLNO (P = 0.022), DLNO/VA z-scores (P = 0.025) and a significant larger proportion had respiratory complaints. Amongst ex-premature children, the BPD group did not differ from the non-BPD group except for a decreased Dm (P = 0.023). Ex-premature with BPD showed predominantly airway obstruction (FEV1/FVC; P < 0.0001), signs of hyperinflation (RV/TLC-ratio; P = 0.028), and 25% had a positive bronchodilator response (>12% in FEV1). Conclusion: Ex-premature school children exhibited relatively mild but significant long-term respiratory symptoms and pulmonary peripheral impairment judged by N2MBW and DLNO measurements along with well-known airway obstruction. Larger longitudinal studies are needed to assess the clinical use of these advanced methods of assessing ventilation inhomogeneity and DLNO.

KW - Adolescent

KW - Birth Weight/physiology

KW - Bronchodilator Agents/therapeutic use

KW - Bronchopulmonary Dysplasia/drug therapy

KW - Carbon Monoxide

KW - Case-Control Studies

KW - Child

KW - Female

KW - Follow-Up Studies

KW - Gestational Age

KW - Humans

KW - Infant, Newborn

KW - Infant, Premature/physiology

KW - Male

KW - Nitric Oxide

KW - Premature Birth/physiopathology

KW - Pulmonary Diffusing Capacity/drug effects

KW - Spirometry/methods

U2 - 10.1016/j.rmed.2018.06.006

DO - 10.1016/j.rmed.2018.06.006

M3 - Journal article

C2 - 29957288

SN - 0954-6111

VL - 140

SP - 94

EP - 100

JO - Respiratory Medicine

JF - Respiratory Medicine

ER -

Ventilation inhomogeneity and NO and CO diffusing capacity in ex-premature school children

Abstract

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