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

Department of Clinical Medicine

8 Citations (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.

Original language	English
Journal	Respiratory Medicine
Volume	140
Pages (from-to)	94-100
ISSN	0954-6111
DOIs	https://doi.org/10.1016/j.rmed.2018.06.006
Publication status	Published - Jul 2018

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

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10.1016/j.rmed.2018.06.006

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

Cite this

@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

Keywords

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