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Original article
Lung function prior to viral lower respiratory tract infections in prematurely born infants
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  1. Simon B Drysdale1,
  2. Theresa Wilson1,
  3. Mireia Alcazar1,
  4. Simon Broughton1,
  5. Mark Zuckerman2,
  6. Melvyn Smith2,
  7. Gerrard F Rafferty1,
  8. S L Johnston3,
  9. Anne Greenough1
  1. 1Division of Asthma, Allergy and Lung Biology, King's College London, London, UK
  2. 2South London Specialist Virology Centre & Health Protection Agency London Regional Laboratory, King's College Hospital, London, UK
  3. 3Department of Respiratory Medicine, National Heart and Lung Institute, Imperial College London, UK
  1. Correspondence to Professor Anne Greenough, Neonatal Intensive Care Centre, 4th Floor Golden Jubilee Wing, King's College Hospital, Denmark Hill, London SE5 9RS, UK; anne.greenough{at}kcl.ac.uk

Abstract

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.

  • RSV
  • functional residual capacity
  • resistance of respiratory system
  • respiratory infection
  • respiratory measurement

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Supplementary materials

  • Web Only Data thx.2010.148023

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Footnotes

  • Funding SBD is supported by the National Institute for Health Research Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust/King's College London. TW was, and MA is, supported by Abbott Laboratories.

  • Competing interests Abbott Laboratories who supported TW and presently support MA market palivizumab, a monoclonal antibody against RSV.

  • Ethics approval This study was conducted with the approval of the Research Ethics Committee of King's College Hospital NHS Trust.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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