Dept of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.
These two authors are joint first authors.
Eur Respir J. 2019 Jan 31;53(2). doi: 10.1183/13993003.00998-2018. Print 2019 Feb.
Lower respiratory tract illness (LRTI) is a leading cause of mortality and morbidity in children. Sensitive and noninvasive infant lung function techniques are needed to measure risk for and impact of LRTI on lung health. The objective of this study was to investigate whether lung function derived from the intra-breath forced oscillation technique (FOT) was able to identify healthy infants at risk of LRTI in the first year of life.Lung function was measured with the novel intra-breath FOT, in 6-week-old infants in a South African birth cohort (Drakenstein Child Health Study). LRTI during the first year was confirmed by study staff. The association between baseline lung function and LRTI was assessed with logistic regression and odds ratios determined using optimal cut-off values.Of the 627 healthy infants with successful lung function testing, 161 (24%) had 238 LRTI episodes subsequently during the first year. Volume dependence of respiratory resistance (Δ) and reactance (Δ) was associated with LRTI. The predictive value was stronger if LRTI was recurrent (n=50 (31%): OR 2.5, Δ), required hospitalisation (n=38 (16%): OR 5.4, Δ) or was associated with wheeze (n=87 (37%): OR 3.9, Δ).Intra-breath FOT can identify healthy infants at risk of developing LRTI, wheezing or severe illness in the first year of life.
下呼吸道疾病 (LRTI) 是导致儿童死亡和发病的主要原因。需要敏感且非侵入性的婴儿肺功能技术来衡量 LRTI 对肺部健康的风险和影响。本研究旨在探讨呼吸内强迫振荡技术 (FOT) 得出的肺功能是否能够识别生命第一年患 LRTI 的健康婴儿。
在南非出生队列（Drakenstein 儿童健康研究）中，对 6 周龄的婴儿使用新型呼吸内 FOT 测量肺功能。通过研究人员确认了生命第一年的 LRTI。使用逻辑回归评估基线肺功能与 LRTI 之间的关联，并使用最佳截断值确定优势比。
在成功进行肺功能测试的 627 名健康婴儿中，有 161 名（24%）在生命的第一年中发生了 238 次 LRTI 发作。呼吸阻力 (Δ) 和电抗 (Δ) 的体积依赖性与 LRTI 相关。如果 LRTI 反复发作（n=50 (31%)：OR 2.5，Δ）、需要住院治疗（n=38 (16%)：OR 5.4，Δ）或与喘息相关（n=87 (37%)：OR 3.9，Δ），则预测价值更强。
呼吸内 FOT 可以识别生命第一年患 LRTI、喘息或重病风险的健康婴儿。
