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Differential effects of immaturity and neonatal lung disease on the lung function of very low birth weight infants at 48-52 postconceptional weeks.
MedLine Citation:
PMID:  23401477     Owner:  NLM     Status:  Publisher    
BACKGROUND: The pathogenesis of chronic lung disease of prematurity involves maturational arrest and neonatal lung disease (NLD) followed by mechanical ventilation (MV). However, the effect of these factors on postnatal lung function is not well established. Therefore, the aim of this study was to examine the differential effects of immaturity and NLD requiring MV on lung function test (LFT) parameters within 4 months after discharge. PATIENTS AND METHODS: A total of 386 very low birth weight (VLBW) infants (birth weight <1,500 g) were examined at a median postmenstrual age of 49 weeks. Two hundred twenty-six infants (59%) were born before the 28th week of gestation, and 247 infants (64%) had NLD requiring invasive MV. LFTs included tidal breathing measurements, measurement of respiratory mechanics assessed by occlusion test, body plethysmography, SF6 multiple breath washout, forced expiratory flow (${\rm V}_{{\rm max}_{{\rm FRC}} }^{\prime } $) by rapid thoraco-abdominal compression technique, end-expiratory CO(2) (P(et) CO(2) ), exhaled NO (FeNO), and arterialized capillary blood gas analysis. MAIN RESULTS: Multivariate analysis indicated that severe immaturity was mainly associated with changes in the breathing pattern (reduced tidal volume (P = 0.003) and increased respiratory rate (P = 0.03)), a reduced ${\rm V}_{{\rm max}_{{\rm FRC}} }^{\prime } $ (P = 0.004) and lower respiratory compliance (P < 0.001). NLD requiring MV, but not immaturity, was significantly and independently associated with increased respiratory and airway resistances (both P = 0.003), reduced FRC(SF6) (P = 0.03), increased P(et) CO(2) (P = 0.019) and lower FeNO (P < 0.001). Both immaturity and NLD requiring MV caused a lower paO(2) (P < 0.001) and higher a paCO(2) . CONCLUSIONS: Lung function after discharge of VLBW infants is differentially affected by both immaturity and NLD requiring MV. With increasing prematurity, intubated and mechanically ventilated infants are at increased risk of developing impaired lung function which can be detected by LFT. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc.
Gerd Schmalisch; Silke Wilitzki; Charles C Roehr; Hans Proquitté; Christoph Bührer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-8
Journal Detail:
Title:  Pediatric pulmonology     Volume:  -     ISSN:  1099-0496     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Wiley Periodicals, Inc.
Department of Neonatology, Charité University Medical Center, Berlin, Germany.
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