Labor Status at Delivery and Lung Function in Extremely Prematurely Born Young Adults.

Background: There has been conflicting evidence regarding the impact of mode of delivery on respiratory outcomes in later childhood and adulthood. It is possible labor status, rather than mode of delivery, influences later respiratory morbidity. We hypothesized that extremely premature infants born to mothers in labor would have better lung function at follow-up than those born to mothers not in labor.

Lung function at 16-19 years in males and females born very prematurely.

Objectives: To determine if there were differences in lung function at 16-19 years of age between males and females born very prematurely.

Working Hypothesis: Females compared with males would have superior lung function and exercise capacity.

Study Design: Cohort study.

Influence of bronchopulmonary dysplasia on lung function in adolescents who were born extremely prematurely.

Objectives: To assess if a previous diagnosis of bronchopulmonary dysplasia (BPD) was associated with poorer lung function at 16 to 19 years of age, regardless of whether postnatal corticosteroids had been administered.

Working Hypothesis: Infants with BPD will have poorer lung function at 16 to 19 years of age.

Study Design: Prospective follow-up study.

Longitudinal changes in lung function in very prematurely born young people receiving high-frequency oscillation or conventional ventilation from birth.

Objective: To examine changes in lung function over time in extremely prematurely born adolescents.

Working Hypothesis: Changes in lung function during adolescence would vary by ventilation mode immediately after birth.

Study Design: Longitudinal follow-up study.

Intrauterine growth retardation and lung function of very prematurely born young people.

Objectives: To assess if intrauterine growth retardation (IUGR) was associated with reduced lung function at 16-19 years.

Working Hypothesis: Very prematurely born young people who had IUGR would have reduced lung function postpuberty.

Study Design: Prospective follow-up study.

ACE inhibition and cardiometabolic risk factors, lung and gene expression, and plasma ACE2 levels: a Mendelian randomization study.

Angiotensin-converting enzyme 2 (ACE2) and serine protease TMPRSS2 have been implicated in cell entry for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). The expression of and in the lung epithelium might have implications for the risk of SARS-CoV-2 infection and severity of COVID-19. We use human genetic variants that proxy angiotensin-converting enzyme (ACE) inhibitor drug effects and cardiovascular risk factors to investigate whether these exposures affect lung and gene expression and circulating ACE2 levels.

Postnatal dexamethasone exposure and lung function in adolescents born very prematurely.

We previously demonstrated corticosteroid administration on the neonatal intensive care unit was associated with reduced lung function at 11 to 14 years of age in children born very prematurely. The objective of this observational study was to assess if lung function remained impaired at 16 to 19 years of age in those who had received postnatal corticosteroids and whether the trajectory of lung function with increasing age differed between those who had and had not received corticosteroids. One hundred and fifty-nine children born prior to 29 weeks of gestational age had comprehensive lung function measurements; 49 had received postnatal dexamethasone.

Lung function and exercise capacity in prematurely born young people.

Objectives: To determine if lung function abnormalities in young people born very prematurely routinely exposed to antenatal corticosteroids and postnatal surfactant were associated with reduced exercise capacity.

Working Hypothesis: In the current era, lung function abnormalities would not be associated with exercise intolerance STUDY DESIGN: Follow-up of young people from the United Kingdom Oscillation study (UKOS).

Patient-subject Selection: One hundred twenty-six young people of 797 recruited to UKOS, born at a mean gestational age of 27 weeks were assessed at a mean age of 17 years.

Lung function and respiratory outcomes in teenage boys and girls born very prematurely.

Objectives: Male sex in prematurely born infants has been associated with worse respiratory outcomes in early childhood.

Working Hypothesis: Respiratory outcomes at 11 to 14 years of age in children born very prematurely and routinely exposed to antenatal corticosteroids and postnatal surfactant would differ according to sex.

Study Design: Analysis of follow-up data.

Nutritional status and pulmonary outcome in children and young people with cystic fibrosis.

Background: Nutrition is closely related to mortality and pulmonary and respiratory muscle function in cystic fibrosis (CF) patients. We initially validated results from a bioelectrical impedance device against dual energy x-ray absorptiometry (DEXA). We then determined whether fat free mass assessed by a portable impedance device rather than body mass index (BMI) better correlated with pulmonary function, respiratory muscle strength and exercise capacity in CF patients.

Effect of dexamethasone exposure on the neonatal unit on the school age lung function of children born very prematurely.

The objective of this study was to determine the impact of postnatal dexamethasone treatment on the neonatal unit on the school age lung function of very prematurely born children. Children born prior to 29 weeks of gestational age had been entered into a randomised trial of two methods of neonatal ventilation (United Kingdom Oscillation Study). They had comprehensive lung function measurements at 11 to 14 years of age.

Predicting healthcare outcomes in prematurely born infants using cluster analysis.

Aims: Prematurely born infants are at high risk of respiratory morbidity following neonatal unit discharge, though prediction of outcomes is challenging. We have tested the hypothesis that cluster analysis would identify discrete groups of prematurely born infants with differing respiratory outcomes during infancy.

Methods: A total of 168 infants (median (IQR) gestational age 33 (31-34) weeks) were recruited in the neonatal period from consecutive births in a tertiary neonatal unit.

Longitudinal assessment of lung function in extremely prematurely born children.

Objectives: To assess longitudinally small airway function in children born extremely prematurely and whether there was a correlation between airway function in infancy and at 11-14 years.

Working Hypotheses: There would be tracking of airways obstruction and small airway function would deteriorate during childhood in those born extremely prematurely.

Study Design: A longitudinal study.

The influence of dilution on the offline measurement of exhaled nitric oxide.

Objective: Measurement of fractional exhaled nitric oxide (FeNO) is used to determine the presence and severity of eosinophilic airway inflammation in asthma and other wheezing illnesses. The gold standard of online measurement during a single prolonged exhalation is not suitable for use in young children. The international guidelines for offline measurements recommend collection of exhaled gas in an appropriate reservoir for later analysis in young children.

Heterogeneity of respiratory disease in children and young adults with sickle cell disease.

To detect and characterise different phenotypes of respiratory disease in children and young adults with sickle cell disease (SCD), 11 lung function and haematological biomarkers were analysed using k-means cluster analysis in a cohort of 114 subjects with SCD aged between 5 and 27 years. Three clusters were detected: cluster 1 had elevated pulmonary capillary blood volume, mixed obstructive/restrictive lung disease, hypoxia and moderately severe anaemia; cluster 2 were older patients with restrictive lung disease; and cluster 3 were younger patients with obstructive lung disease, elevated serum lactate dehydrogenase and bronchodilator reversibility. These results may inform more personalised management strategies to improve outcomes.

Respiratory load perception in overweight and asthmatic children.

Overweight asthmatic children report greater symptoms than normal weight asthmatics, despite comparable airflow obstruction. This has been widely assumed to be due to heightened perception of respiratory effort. Three groups of children (healthy weight controls, healthy weight asthmatics, overweight asthmatics) rated perceived respiratory effort throughout an inspiratory resistive loading protocol.

Parasternal intercostal muscle activity during methacholine-induced bronchoconstriction.

What is the central question of this study? The parasternal intercostal electromyogram (EMGpara) is known to provide an accurate, non-invasive index of respiratory load-capacity balance. Although relationships between EMGpara and both airflow obstruction and hyperinflation have been shown, the independent contribution of each factor has not been examined. What is the main finding and its importance? Reductions in airway calibre and inspiratory capacity along with increases in EMGpara were induced via methacholine challenge.

Longitudinal assessment of lung function in children with sickle cell disease.

Objectives: To prospectively assess longitudinal lung function in children with sickle cell disease (SCD).

Working Hypothesis: Lung function in SCD children deteriorates with increasing age and the decline is more marked in younger children who have recently suffered ACS episodes.

Study Design: Two prospective longitudinal studies.

Lung function, transfusion, pulmonary capillary blood volume and sickle cell disease.

Lung function abnormalities occur in children with sickle cell disease (SCD) and may be associated with elevated pulmonary blood volume. To investigate that association, we determined whether blood transfusion in SCD children acutely increased pulmonary capillary blood volume (PCBV) and increased respiratory system resistance (Rrs5). Measurements of Rrs5 and spirometry were made before and after blood transfusion in 18 children, median age 14.

Airway and alveolar nitric oxide production, lung function, and pulmonary blood flow in sickle cell disease.

Background: Children with sickle cell disease (SCD) often have obstructive lung function abnormalities which could be due to asthma or increased pulmonary blood volume; it is important to determine the underlying mechanism to direct appropriate treatment. In asthmatics, exhaled nitric oxide (FeNO) is elevated. FeNO, however, can also be raised due to increased alveolar production.

Pulmonary Haemodynamics in Sickle Cell Disease Are Driven Predominantly by a High-Output State Rather Than Elevated Pulmonary Vascular Resistance: A Prospective 3-Dimensional Echocardiography/Doppler Study.

Aims: Patients with sickle cell disease have significant morbidity and mortality. Pulmonary hypertension is suggested to be an important contributor but its nature and severity in these patients and how best to non-invasively assess it are controversial. We hypothesised that a high-output state rather than primary pulmonary vascular pathology may be the major abnormality in sickle cell disease.

Observational study of the effect of obesity on lung volumes.

Background: Severe obesity causes respiratory morbidity and mortality. The impact of obesity on the mechanics of breathing is not fully understood.

Patients And Methods: We undertook a comprehensive observational study of lung volumes and elasticity in nine obese and nine normal weight subjects, seated and supine, during spontaneous breathing.