Cousins Michael, Hart Kylie, Radics Bence, Henderson A John, Hantos Zoltán, Sly Peter D, Kotecha Sailesh
Department of Child Health, Cardiff University School of Medicine, Cardiff, UK.
Department of Paediatrics, Cardiff and Vale University Health Board, Cardiff, UK.
ERJ Open Res. 2025 Mar 31;11(2). doi: 10.1183/23120541.00840-2024. eCollection 2025 Mar.
Intra-breath oscillometry potentially offers detailed information regarding airway function, with increasing magnitude of difference between resistance and reactance at end-expiration to end-inspiration potentially associated with obstructive airway disease, but less is known about specific respiratory mechanics in preterm-born children using this methodology. We investigated whether different spirometry phenotypes of prematurity-associated lung disease (PLD) have specific intra-breath oscillometry features.
167 school-aged (7-12 years) children, 14 with prematurity-associated obstructive lung disease (POLD; forced expiratory volume in 1 s (FEV) <lower limit of normal (LLN), FEV/forced vital capacity (FVC) <LLN), 11 with prematurity-associated preserved ratio impaired spirometry (pPRISm; FEV <LLN, FEV/FVC ≥LLN), 90 preterm controls (FEV ≥LLN) and 52 term controls, performed intra-breath oscillometry at baseline, following maximal cardiopulmonary exercise testing and following post-exercise bronchodilation.
Children with POLD showed greater resistance and more negative reactance throughout the respiratory cycle, including at zero-flow states of end-expiration and end-inspiration. The difference between end-expiration and end-inspiration did not show differences between groups until corrected for tidal volume, whereby children with POLD and pPRISm both demonstrated approximately two-fold greater difference compared to both preterm and term controls for resistance (2.24 and 2.22 1.28 and 1.11 hPa·s·L, respectively), and in particular a greater magnitude of difference for reactance for children with POLD preterm and term controls only (-1.58 -0.26 and 0.03 hPa·s·L, respectively).
Intra-breath respiratory mechanics for preterm-born children with an obstructive lung phenotype have greater impedance throughout the respiratory cycle, features different to those observed in children with other wheeze phenotypes including preschool wheeze and asthma.
呼吸内振荡法有可能提供有关气道功能的详细信息，呼气末至吸气末阻力和电抗之间的差异幅度增加可能与阻塞性气道疾病相关，但对于使用这种方法的早产儿童的特定呼吸力学了解较少。我们调查了早产相关肺病（PLD）的不同肺量计表型是否具有特定的呼吸内振荡特征。
167名学龄儿童（7至12岁），14名患有早产相关阻塞性肺病（POLD；1秒用力呼气量（FEV）<正常下限（LLN），FEV/用力肺活量（FVC）<LLN），11名患有早产相关肺量计保留率受损（pPRISm；FEV<LLN，FEV/FVC≥LLN），90名早产对照（FEV≥LLN）和52名足月对照，在基线、最大心肺运动试验后和运动后支气管扩张后进行呼吸内振荡法检查。
患有POLD的儿童在整个呼吸周期中表现出更大的阻力和更负的电抗，包括在呼气末和吸气末的零流量状态。在根据潮气量校正之前，呼气末和吸气末之间的差异在各组之间未显示出差异，由此POLD和pPRISm儿童在阻力方面均显示出与早产和足月对照相比约两倍的更大差异（分别为2.24和2.22比1.28和1.11 hPa·s·L），特别是对于患有POLD的儿童，电抗的差异幅度更大，仅与早产和足月对照相比（分别为-1.58比-0.26和0.03 hPa·s·L）。
患有阻塞性肺表型的早产儿童的呼吸内呼吸力学在整个呼吸周期中具有更大的阻抗，其特征不同于在其他喘息表型儿童中观察到的特征，包括学龄前喘息和哮喘。
