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Lung function of preterm infants before and after viral infections

Abstract

Our aim was to determine whether viral lower respiratory tract infections (LRTIs) adversely affect prematurely born infants’ lung function at follow up. Seventy infants, median gestational age 34 (range, 24–35) weeks were prospectively followed; 32 had an RSV (n = 14) or another respiratory viral (n = 18) LRTI (viral LRTI group) and 38 had no LRTI (no LRTI group). Six of the viral LRTI and five of the no LRTI group had been hospitalised. Nasopharyngeal aspirates (NPAs) obtained whenever the infants had an LRTI. Lung function (functional residual capacity [FRCHe], compliance [Crs] and resistance [Rrs] of the respiratory system) was measured at 36 weeks postmenstrual age (PMA) and 1 year corrected. At 1 year, lung volume (FRCpleth) and airways resistance (Raw) were also assessed. There were no significant differences in the lung function of the two groups at 36 weeks PMA but at 1 year, the viral LRTI compared to the no LRTI group had a higher mean Raw (23 versus 17 cm H2O/l/s, p = 0.0068), the differences remained significant after adjustment. Conclusion: These results suggest viral LRTIs, regardless of whether hospitalisation is required, adversely affect prematurely born infants’ airway resistance at follow up.

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Fig. 1

Abbreviations

BPD:

Bronchopulmonary dysplasia

Crs:

Compliance of the respiratory system

FRCHe :

Functional residual capacity (by helium gas)

FRCpleth:

Functional residual capacity (by plethysmograph)

LRTI:

Lower respiratory tract infection

NPA:

Nasopharyngeal aspirate

PCR:

Polymerase chain reaction

PMA:

Post menstrual age

Raw:

Airway resistance

Rrs:

Resistance of the respiratory system

RSV:

Respiratory syncytial virus

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Funding

The research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

MA and TW were supported by Abbott Laboratories. SLJ is supported by the Asthma UK Clinical Chair CH11SJ, and ERC FP7 Advanced grant 233015. SLJ and AG are MRC and Asthma UK Centre in Allergic Mechanisms of Asthma Investigators, supported by MRC Centre Grant G1000758. AG and SLJ are NIHR Senior Investigators.

Conflict of interest

Abbott Laboratories, who supported Mrs Wilson and Mrs Alcazar, market palivizumab a monoclonal antibody against RSV.

Contributorship list

AG and SLJ designed the study. SBD, MA and TW collected the data, SBD, MS and MZ undertook the viral studies. JL and JLP undertook the statistical analysis. SBD, MP, SB and GFR were involved in the lung function studies. All authors were involved in producing the manuscript.

Author information

Correspondence to Anne Greenough.

Additional information

Communicated by Patrick Van Reempts

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Drysdale, S.B., Lo, J., Prendergast, M. et al. Lung function of preterm infants before and after viral infections. Eur J Pediatr 173, 1497–1504 (2014). https://doi.org/10.1007/s00431-014-2343-1

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Keywords

  • Airways resistance
  • Resistance of the respiratory system
  • Respiratory syncytial virus
  • Rhinovirus