Functional evidence for continued alveolarisation in former preterms at school age?
Prematurity is the most common disruptor of lung development. The aim of our study was to examine the function of the more vulnerable peripheral airways in former preterm children by multiple-breath washout (MBW) measurements.86 school-aged children, born between 24 and 35 weeks of gestation and 49 term-born children performed nitrogen MBW. Lung clearance index (LCI), and slope III-derived Scond and Sacin were assessed as markers for global, convection-dependent and diffusion-convection-dependent ventilation inhomogeneity, respectively.We analysed the data of 77 former preterm (mean (range) age 9.5 (7.2-12.8) years) and 46 term-born children (mean age 9.9 (6.0-15.9) years). LCI and Sacin did not differ between preterm and term-born children. Scond was significantly elevated in preterm compared to term-born participants (mean difference z-score 1.74, 95% CI 1.17-2.30; p<0.001), with 54% of former preterm children showing elevated Scond. In multivariable regression analysis Scond was significantly related only to gestational age (R(2)=0.37).Normal Sacin provides evidence for a functionally normal alveolar compartment, while elevated Scond indicates impaired function of more proximal conducting airways. Together, our findings support the concept of continued alveolarisation, albeit with "dysanaptic" lung growth in former preterm children.
University Children's Hospital of Basel (UKBB), Basel, Switzerland Division of Respiratory Medicine, Department of Paediatrics, University Children's Hospital Bern, Bern, Switzerland.
Sophie
S
Yammine
University Children's Hospital of Basel (UKBB), Basel, Switzerland Division of Respiratory Medicine, Department of Paediatrics, University Children's Hospital Bern, Bern, Switzerland.
Anne
A
Schmidt
Division of Respiratory Medicine, Department of Paediatrics, University Children's Hospital Bern, Bern, Switzerland.
Oliver
O
Sutter
Paediatric Respiratory Unit, University Hospital of Patras, Patras, Greece.
Sotirios
S
Fouzas
Division of Respiratory Medicine, Department of Paediatrics, University Children's Hospital Bern, Bern, Switzerland University Children's Hospital Zurich, Zurich, Switzerland.
Florian
F
Singer
University Children's Hospital of Basel (UKBB), Basel, Switzerland.
Urs
U
Frey
University Children's Hospital of Basel (UKBB), Basel, Switzerland Division of Respiratory Medicine, Department of Paediatrics, University Children's Hospital Bern, Bern, Switzerland philipp.latzin@ukbb.ch.
Philipp
P
Latzin
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology / Q000503:physiopathology*; D001724:Birth Weight; D001944:Breath Tests; D055745:Bronchioles / Q000502:physiology / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D011650:Pulmonary Alveoli / Q000502:physiology / Q000503:physiopathology*; D012123:Pulmonary Ventilation / Q000502:physiology*; D012044:Regression Analysis; D012135:Respiratory Sounds / Q000503:physiopathology*