Tidal breathing measurements at discharge and clinical outcomes in extremely low gestational age neonates

Clement L. Ren, Rui Feng, Stephanie Davis, Eric Eichenwald, Alan Jobe, Paul E. Moore, Howard B. Panitch, Jack K. Sharp, Jeff Kisling, Charles Clem, James S. Kemp

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Rationale: The relationship between respiratory function at hospital discharge and the severity of later respiratory disease in extremely low gestational age neonates is not well defined. Objectives: To test the hypothesis that tidal breathing measurements near the time of hospital discharge differ between extremely premature infants with bronchopulmonary dysplasia (BPD) or respiratory disease in the first year of life and those without these conditions. Methods: Study subjects were part of the PROP (Prematurity and Respiratory Outcomes Program) study, a longitudinal cohort study of infants born at less than 29 gestational weeks followed from birth to 1 year of age. Respiratory inductance plethysmography was used for tidal breathing measurements before and after inhaled albuterol 1 week before anticipated hospital discharge. Infants were breathing spontaneously and were receiving less than or equal to 1 L/min nasal cannula flow at 21% to 100% fraction of inspired oxygen. A survey of respiratory morbidity was administered to caregivers at 3, 6, 9, and 12 months corrected age to assess for respiratory disease. We compared tidal breathing measurements in infants with and without BPD (oxygen requirement at 36 wk) and with and without respiratory disease in the first year of life. Measurements were also performed in a comparison cohort of term infants. Results: A total of 765 infants survived to 36 weeks postmenstrual age, with research-quality tidal breathing data in 452 out of 564 tested (80.1%). Among these 452 infants, the rate of postdischarge respiratory disease was 65.7%. Compared with a group of 18 term infants, PROP infants had abnormal tidal breathing patterns. However, there were no clinically significant differences in tidal breathing measurements in PROP infants who had BPD or who had respiratory disease in the first year of life compared with those without these diagnoses. Bronchodilator response was not significantly associated with respiratory disease in the first year of life. Conclusions: Extremely premature infants receiving less than 1 L/min nasal cannula support at 21% to 100% fraction of inspired oxygen have tidal breathing measurements that differ from term infants, but these measurements do not differentiate those preterm infants who have BPD or will have respiratory disease in the first year of life from those who do not. Clinical trial registered with www.clinicaltrials.gov (NCT01435187)

Original languageEnglish (US)
Pages (from-to)1311-1319
Number of pages9
JournalAnnals of the American Thoracic Society
Volume15
Issue number11
DOIs
StatePublished - Nov 1 2018

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Gestational Age
Respiration
Newborn Infant
Bronchopulmonary Dysplasia
Extremely Premature Infants
Oxygen
Plethysmography
Albuterol
Bronchodilator Agents
Respiratory Rate
Premature Infants
Caregivers
Longitudinal Studies
Cohort Studies
Outcome Assessment (Health Care)
Clinical Trials
Parturition
Morbidity
Research

Keywords

  • Oximetry
  • Premature
  • Pulmonary function tests
  • Respiratory inductance plethysmography
  • Wheezing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Tidal breathing measurements at discharge and clinical outcomes in extremely low gestational age neonates. / Ren, Clement L.; Feng, Rui; Davis, Stephanie; Eichenwald, Eric; Jobe, Alan; Moore, Paul E.; Panitch, Howard B.; Sharp, Jack K.; Kisling, Jeff; Clem, Charles; Kemp, James S.

In: Annals of the American Thoracic Society, Vol. 15, No. 11, 01.11.2018, p. 1311-1319.

Research output: Contribution to journalArticle

Ren, CL, Feng, R, Davis, S, Eichenwald, E, Jobe, A, Moore, PE, Panitch, HB, Sharp, JK, Kisling, J, Clem, C & Kemp, JS 2018, 'Tidal breathing measurements at discharge and clinical outcomes in extremely low gestational age neonates', Annals of the American Thoracic Society, vol. 15, no. 11, pp. 1311-1319. https://doi.org/10.1513/AnnalsATS.201802-112OC
Ren, Clement L. ; Feng, Rui ; Davis, Stephanie ; Eichenwald, Eric ; Jobe, Alan ; Moore, Paul E. ; Panitch, Howard B. ; Sharp, Jack K. ; Kisling, Jeff ; Clem, Charles ; Kemp, James S. / Tidal breathing measurements at discharge and clinical outcomes in extremely low gestational age neonates. In: Annals of the American Thoracic Society. 2018 ; Vol. 15, No. 11. pp. 1311-1319.
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abstract = "Rationale: The relationship between respiratory function at hospital discharge and the severity of later respiratory disease in extremely low gestational age neonates is not well defined. Objectives: To test the hypothesis that tidal breathing measurements near the time of hospital discharge differ between extremely premature infants with bronchopulmonary dysplasia (BPD) or respiratory disease in the first year of life and those without these conditions. Methods: Study subjects were part of the PROP (Prematurity and Respiratory Outcomes Program) study, a longitudinal cohort study of infants born at less than 29 gestational weeks followed from birth to 1 year of age. Respiratory inductance plethysmography was used for tidal breathing measurements before and after inhaled albuterol 1 week before anticipated hospital discharge. Infants were breathing spontaneously and were receiving less than or equal to 1 L/min nasal cannula flow at 21{\%} to 100{\%} fraction of inspired oxygen. A survey of respiratory morbidity was administered to caregivers at 3, 6, 9, and 12 months corrected age to assess for respiratory disease. We compared tidal breathing measurements in infants with and without BPD (oxygen requirement at 36 wk) and with and without respiratory disease in the first year of life. Measurements were also performed in a comparison cohort of term infants. Results: A total of 765 infants survived to 36 weeks postmenstrual age, with research-quality tidal breathing data in 452 out of 564 tested (80.1{\%}). Among these 452 infants, the rate of postdischarge respiratory disease was 65.7{\%}. Compared with a group of 18 term infants, PROP infants had abnormal tidal breathing patterns. However, there were no clinically significant differences in tidal breathing measurements in PROP infants who had BPD or who had respiratory disease in the first year of life compared with those without these diagnoses. Bronchodilator response was not significantly associated with respiratory disease in the first year of life. Conclusions: Extremely premature infants receiving less than 1 L/min nasal cannula support at 21{\%} to 100{\%} fraction of inspired oxygen have tidal breathing measurements that differ from term infants, but these measurements do not differentiate those preterm infants who have BPD or will have respiratory disease in the first year of life from those who do not. Clinical trial registered with www.clinicaltrials.gov (NCT01435187)",
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AU - Moore, Paul E.

AU - Panitch, Howard B.

AU - Sharp, Jack K.

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AU - Clem, Charles

AU - Kemp, James S.

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N2 - Rationale: The relationship between respiratory function at hospital discharge and the severity of later respiratory disease in extremely low gestational age neonates is not well defined. Objectives: To test the hypothesis that tidal breathing measurements near the time of hospital discharge differ between extremely premature infants with bronchopulmonary dysplasia (BPD) or respiratory disease in the first year of life and those without these conditions. Methods: Study subjects were part of the PROP (Prematurity and Respiratory Outcomes Program) study, a longitudinal cohort study of infants born at less than 29 gestational weeks followed from birth to 1 year of age. Respiratory inductance plethysmography was used for tidal breathing measurements before and after inhaled albuterol 1 week before anticipated hospital discharge. Infants were breathing spontaneously and were receiving less than or equal to 1 L/min nasal cannula flow at 21% to 100% fraction of inspired oxygen. A survey of respiratory morbidity was administered to caregivers at 3, 6, 9, and 12 months corrected age to assess for respiratory disease. We compared tidal breathing measurements in infants with and without BPD (oxygen requirement at 36 wk) and with and without respiratory disease in the first year of life. Measurements were also performed in a comparison cohort of term infants. Results: A total of 765 infants survived to 36 weeks postmenstrual age, with research-quality tidal breathing data in 452 out of 564 tested (80.1%). Among these 452 infants, the rate of postdischarge respiratory disease was 65.7%. Compared with a group of 18 term infants, PROP infants had abnormal tidal breathing patterns. However, there were no clinically significant differences in tidal breathing measurements in PROP infants who had BPD or who had respiratory disease in the first year of life compared with those without these diagnoses. Bronchodilator response was not significantly associated with respiratory disease in the first year of life. Conclusions: Extremely premature infants receiving less than 1 L/min nasal cannula support at 21% to 100% fraction of inspired oxygen have tidal breathing measurements that differ from term infants, but these measurements do not differentiate those preterm infants who have BPD or will have respiratory disease in the first year of life from those who do not. Clinical trial registered with www.clinicaltrials.gov (NCT01435187)

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