Tidal Breathing Analysis as a Prognostic Index for Airway Obstruction Trajectory and Asthma in Preterm Infants.

IF 4.6 2区 医学 Q1 RESPIRATORY SYSTEM Lung Pub Date : 2024-12-01 Epub Date: 2024-09-26 DOI:10.1007/s00408-024-00750-x
Yoon Hee Kim, Mireu Park, Soo Yeon Kim, Yun Young Roh, Jong Deok Kim, Min Jung Kim, Yong Ju Lee, Kyung Won Kim, Myung Hyun Sohn
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Abstract

Introduction: An easy-to-implement and accurate lung function assessment tool for preterm infants is crucial to manage lifelong respiratory morbidities. We aimed to determine which pulmonary function parameters in preterm infants can predict the trajectory of airway obstruction and asthma development after 4 years of age.

Methods: We evaluated 52 preterm infants who had undergone both tidal breathing flow-volume loop (TBFVL) and multiple-breath washout (MBW) analyses in infancy and spirometry after the age of 4 years. We evaluated the association between pulmonary function parameters in infancy and childhood and the pulmonary function trajectory until 13 years of age and compared the changes in this trajectory according to pulmonary function parameters in infancy.

Results: Time to peak expiratory flow/expiratory time (TPEF/TE) in infancy was associated with FEV1, FEF25-75, and dysanapsis ratio in childhood and differed according to level of airway obstruction assessed by FEV1, FEV1/FVC, and FEF25-75, an asthma development. TPEF/TE was a significant predictive factor for airway obstruction and asthma after 4 years of age, after adjusting for sex, extreme prematurity, duration of supplementary oxygen and mechanical ventilation, and recurrent wheezing during infancy. In premature infants with lower TPEF/TE, subsequent pulmonary function parameters remained low until 13 years of age.

Conclusion: In preterm infants, TPEF/TE could be useful to predict airway obstruction and asthma after 4 years of age and even a lower pulmonary function trajectory until 13 years of age. This information may help clinicians to provide lifelong care for pulmonary morbidity in children and adolescents born preterm.

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潮汐呼吸分析作为早产儿气道阻塞轨迹和哮喘的预后指标
简介:早产儿肺功能评估工具简便易行且准确无误,这对于管理终生呼吸系统疾病至关重要。我们旨在确定早产儿的哪些肺功能参数可预测其 4 岁后气道阻塞和哮喘的发展轨迹:我们对 52 名早产儿进行了评估,这些早产儿在婴儿期接受了潮气呼吸流量-容积循环(TBFVL)和多次呼吸冲洗(MBW)分析,并在 4 岁后接受了肺活量测定。我们评估了婴儿期和儿童期肺功能参数与 13 岁前肺功能轨迹之间的关联,并根据婴儿期肺功能参数比较了这一轨迹的变化:结果:婴儿期的呼气流量峰值/呼气时间(TPEF/TE)与儿童期的 FEV1、FEF25-75 和呼吸困难比率相关,并且根据 FEV1、FEV1/FVC 和 FEF25-75 评估的气道阻塞程度不同,哮喘的发展也不同。在对性别、极度早产、补充氧气和机械通气持续时间以及婴儿期反复喘息进行调整后,TPEF/TE 是预测 4 岁后气道阻塞和哮喘的重要因素。在 TPEF/TE 较低的早产儿中,随后的肺功能参数在 13 岁前一直较低:在早产儿中,TPEF/TE 可用于预测 4 岁后的气道阻塞和哮喘,甚至预测 13 岁前较低的肺功能轨迹。这些信息有助于临床医生为早产儿童和青少年的肺部疾病提供终身护理。
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来源期刊
Lung
Lung 医学-呼吸系统
CiteScore
9.10
自引率
10.00%
发文量
95
审稿时长
6-12 weeks
期刊介绍: Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.
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