Lung Function Assessment in Very Preterm Children at 5 and 10 Years: A Longitudinal Study Using Interruption Technique, Forced Oscillatory Technique, and Spirometry

Le résumé fourni par la source

Abstract RATIONALE: Lung function studies in very preterm patients frequently report reduced respiratory function across different ages and techniques; however, these studies generally focus on subjects with bronchopulmonary dysplasia (BPD) or are confined to single neonatal intensive care units (NICUs). This study aimed to assess lung function at 10 years in a cohort of children born very preterm, comparing results with data collected at age 5 (1). Lung function was evaluated at both ages using the interrupter technique and respiratory oscillometry at 8 Hz, with spirometry added at the 10-year follow-up. METHODS: The ACTION Project is a multicenter cohort study conducted in six Italian regions to investigate the link between pregnancy complications and preterm birth. In Tuscany, a respiratory follow-up was conducted (1). Initial data from this cohort of 198 very preterm preschoolers (<32 weeks gestational age) from all Tuscan NICUs showed reduced lung function at age 5, with elevated interrupter resistance (Rint) and lower reactance values; 12% of these children had BPD (1). At age 10, follow-up testing was performed on 166 asymptomatic children: these assessments included Rint, resistance at 8 Hz (Rrs8) and reactance at 8 Hz (Xrs8) performed with commercial devices (“i2m” and “microQuark” by Cosmed, and “MicroRint” by MicroMedical). Statistical analyses were conducted with STATA (version 12.1 SE). Ethical approvals were obtained from the Ethics Committees of Bambin Gesù Children's Hospital (Rome) and Meyer Children's Hospital (Florence). RESULTS: A total of 166 patients underwent lung function tests at 10 years of age, and their results were compared with reference values and previously published data (see table 1). No statistically significant abnormalities were observed in lung function as measured by Rint, Rrs8, Xrs8, and FEV1 at 10 years. Additionally, Rint, Rrs8, and Xrs8 showed significant improvement at the 10-year evaluation. CONCLUSIONS: This study found no significant lung function abnormalities in this cohort of very preterm children at 10 years of age, despite observed impairment at age 5. These findings may indicate a temporary adaptation in lung function or may reflect the cohort's “unselected” nature, which includes a low prevalence of BPD and is thus more representative of the broader population of very preterm births. Further research is essential to better understand the long-term lung function trajectories in this group. References 1. Lombardi E, Fainardi V, Calogero et al. Pediatr Pulmonol. Dec 2018;53(12):1633-9. 2. Gagliardi L, Rusconi F et al. Pediatr Res. 2013;73(6):794-801.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.