Lung function prior to viral lower respiratory tract infections in prematurely born infants

TY - JOUR

T1 - Lung function prior to viral lower respiratory tract infections in prematurely born infants

AU - Drysdale, Simon B.

AU - Wilson, Theresa

AU - Alcazar, Mireia

AU - Broughton, Simon

AU - Zuckerman, Mark

AU - Smith, Melvyn

AU - Rafferty, Gerrard F.

AU - Johnston, S. L.

AU - Greenough, Anne

PY - 2011/6

Y1 - 2011/6

N2 - Objective Prematurely born infants who develop respiratory syncytial virus (RSV) lower respiratory tract infections (LRTIs) have lung function abnormalities at follow-up. The aim of this study was to determine whether prematurely born infants who developed symptomatic RSV, or other viral LRTI(s), had poorer premorbid lung function than infants who did not develop LRTIs during the RSV season. Methods Lung function (functional residual capacity (FRC), compliance (Crs) and resistance (Rrs) of the respiratory system) was measured at 36 weeks postmenstrual age. After neonatal unit discharge, nasopharyngeal aspirates were obtained whenever the infants had an LRTI, regardless of whether this was in the community or in hospital. Nasopharyngeal aspirates were examined for RSV A and B, rhinovirus, influenza A and B, parainfluenza 1, 2 and 3, human metapneumovirus and adenovirus. Results 159 infants with a median gestational age of 34 (range 23-36) weeks were prospectively followed. 73 infants developed LRTIs: 27 had at least one RSV LRTI and 31 had at least one other viral LRTI, but not an RSV LRTI. Overall, there were no significant differences in the FRC (p=0.54), Crs (p=0.11) or Rrs (p=0.12) results between those who developed an RSV or other viral LRTI and those who did not develop an LRTI. Infants with RSV or other viral LRTIs who were admitted to hospital compared with those who were not had higher Rrs results (p=0.033 and p=0.039, respectively). Conclusion Diminished premorbid lung function may predispose prematurely born infants to severe viral LRTIs in infancy.

AB - Objective Prematurely born infants who develop respiratory syncytial virus (RSV) lower respiratory tract infections (LRTIs) have lung function abnormalities at follow-up. The aim of this study was to determine whether prematurely born infants who developed symptomatic RSV, or other viral LRTI(s), had poorer premorbid lung function than infants who did not develop LRTIs during the RSV season. Methods Lung function (functional residual capacity (FRC), compliance (Crs) and resistance (Rrs) of the respiratory system) was measured at 36 weeks postmenstrual age. After neonatal unit discharge, nasopharyngeal aspirates were obtained whenever the infants had an LRTI, regardless of whether this was in the community or in hospital. Nasopharyngeal aspirates were examined for RSV A and B, rhinovirus, influenza A and B, parainfluenza 1, 2 and 3, human metapneumovirus and adenovirus. Results 159 infants with a median gestational age of 34 (range 23-36) weeks were prospectively followed. 73 infants developed LRTIs: 27 had at least one RSV LRTI and 31 had at least one other viral LRTI, but not an RSV LRTI. Overall, there were no significant differences in the FRC (p=0.54), Crs (p=0.11) or Rrs (p=0.12) results between those who developed an RSV or other viral LRTI and those who did not develop an LRTI. Infants with RSV or other viral LRTIs who were admitted to hospital compared with those who were not had higher Rrs results (p=0.033 and p=0.039, respectively). Conclusion Diminished premorbid lung function may predispose prematurely born infants to severe viral LRTIs in infancy.

KW - Airway Resistance

KW - Disease Susceptibility

KW - Functional Residual Capacity

KW - Humans

KW - Gestational Age

KW - Infant, Newborn

KW - Infant, Premature, Diseases

KW - Infant, Premature

KW - Respiratory Syncytial Virus Infections

KW - Lung Compliance

KW - Respiratory Tract Infections

KW - Lung

KW - Female

KW - Male

U2 - 10.1136/thx.2010.148023

DO - 10.1136/thx.2010.148023

M3 - Article

C2 - 21447496

SN - 1468-3296

VL - 66

SP - 468

EP - 473

JO - Thorax

JF - Thorax

IS - 6

ER -