Abstract
Evidence regarding the prevalence of expiratory flow limitation (EFL) during exercise and the ventilatory response to exercise in children born preterm is limited. This study aimed to determine the prevalence of EFL as well as contributing factors to EFL and the ventilatory response to exercise in preterm children with and without bronchopulmonary dysplasia (BPD).
Preterm children (≤32 weeks gestational age) aged 9–12 years with (n=64) and without (n=42) BPD and term controls (n=43), performed an incremental treadmill exercise test with exercise tidal flow–volume loops.
More preterm children with BPD (53%) had EFL compared with preterm children without BPD (26%) or term controls (28%) (p<0.05). The presence of EFL was independently associated with decreased forced expiratory volume in 1 s/forced vital capacity z-score and lower gestational age (p<0.05). There was no difference in peak oxygen uptake between preterm children with BPD and term controls (48.0 versus 48.4 mL·kg−1·min−1; p=0.063); however, children with BPD had a lower tidal volume at peak exercise (mean difference −27 mL·kg−1, 95% CI −49– −5; p<0.05). Children born preterm without BPD had ventilatory responses to exercise similar to term controls.
Expiratory flow limitation is more prevalent in children born preterm with BPD and is associated with airway obstruction and a lower gestational age.
Abstract
Children born preterm have an increased prevalence of expiratory limitation during exercise associated with reduced lung function and lower gestational age http://ow.ly/jLsk30leOVI
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Author contributions: C.A O'Dea performed data measurement and interpretation, conducted the statistical analysis and drafted the initial versions of the manuscript. K. Logie and G.L. Banton performed data measurement and revision of the manuscript. S.J. Simpson performed data measurement, assisted with data analysis and interpretation, and revision of manuscript. A. Maiorana, A.C. Wilson, J.J. Pillow and G.L. Hall designed the study, obtained funding, had oversight of data collection and interpretation, and reviewed the manuscript.
Conflict of interest: K. Logie has nothing to disclose.
Conflict of interest: A. Maiorana has nothing to disclose.
Conflict of interest: G.L. Banton has nothing to disclose.
Conflict of interest: S.J. Simpson has nothing to disclose.
Conflict of interest: G.L. Hall has nothing to disclose.
Conflict of interest: C.A. O'Dea has nothing to disclose.
Conflict of interest: J.J. Pillow has nothing to disclose.
Conflict of interest: A.C. Wilson has nothing to disclose.
Support statement: Princess Margaret Hospital Foundation, Raine Medical Foundation and National Health and Medical Research Council (APP513730). G.L. Hall, S.J. Simpson and J.J. Pillow were supported by National Health and Medical Research Council Fellowships (APP1025550, APP1073301, APP1077691). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received March 25, 2018.
- Accepted July 29, 2018.
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