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Background <p>Bronchopulmonary dysplasia (BPD) is a major complication of preterm birth and may lead to long-term respiratory morbidity. Early measurements of impaired lung function are needed to guide the development of preventive strategies. This study aimed to evaluate the feasibility and potential utility of MBW-derived parameters for detecting early lung function impairment in preterm infants at a corrected age of 12 months.</p> Methods <p>We conducted a single-centre study of preterm infants at 12 months’ corrected age using sulfur hexafluoride MBW during spontaneous sleep. Tidal Breathing Flow Volume Loops (TBFVL) and MBW were used to assess respiratory parameters including lung clearance index (LCI). This was complemented by parental questionnaires on infant health. The cohort was stratified into three groups based on BPD diagnosis: (I) severe BPD (oxygen requirement at 28 days and respiratory support at 36 weeks’ postmenstrual age), (II) mild BPD (oxygen requirement at 28 days but no oxygen or respiratory support at 36 weeks’ postmenstrual age ) and (III) no BPD.</p> Results <p>Reliable TBFVL and MBW measurements during spontaneous sleep were obtained in 45 of 112 infants (40%) including 8 infants with severe BPD and 7 infants with mild BPD. Infants with BPD exhibited higher LCI values (7.0 vs. 6.5, <i>p</i> = 0.018) and lower ratios of tidal volume to functional residual capacity (0.40 vs. 0.51, <i>p</i> = 0.022) compared to infants without BPD. Infants with severe BPD had higher LCI values than those without BPD (7.1 vs. 6.5, <i>p</i> = 0.022). LCI was positively correlated with the duration of continuous positive airway pressure (CPAP) support (Pearson correlation coefficient <i>r</i> = 0.476, <i>p</i> = 0.001), oxygen supplementation (<i>r</i> = 0.444, <i>p</i> = 0.002) and antibiotic treatment (<i>r</i> = 0.435, <i>p</i> = 0.003), respectively. Higher LCI values were also associated with an increased rate of hospital readmissions due to respiratory infections.</p> Conclusions <p>Despite limited feasibility, MBW measurements obtained during spontaneous sleep at 12 months’ corrected age revealed impaired lung function in preterm infants with BPD. LCI correlated with the duration of antibiotic treatment, CPAP support, and oxygen supplementation all of which represent potentially modifiable clinical factors. These findings suggest that LCI may serve as a promising early lung function parameter for long-term respiratory vulnerability.</p>

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Multiple-breath washout at 12 months of age reveals lung function impairments in preterm infants with bronchopulmonary dysplasia

  • 期刊论文

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  • 发表日期：

    2026年7月28日

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  • Isabell Ricklefs,
  • Elisa Grützner,
  • Hannah Wedman,
  • Mats Ingmar Fortmann,
  • Désirée Lasserre,
  • Nikolas Jakobs,
  • Friederike Pagel,
  • Fumi Sugihara,
  • Wolfgang Göpel,
  • Folke Christina Brinkmann,
  • Matthias Volkmar Kopp,
  • Mirjam Stahl,
  • Christoph Härtel,
  • Julia Pagel

摘要

Background

Bronchopulmonary dysplasia (BPD) is a major complication of preterm birth and may lead to long-term respiratory morbidity. Early measurements of impaired lung function are needed to guide the development of preventive strategies. This study aimed to evaluate the feasibility and potential utility of MBW-derived parameters for detecting early lung function impairment in preterm infants at a corrected age of 12 months.

Methods

We conducted a single-centre study of preterm infants at 12 months’ corrected age using sulfur hexafluoride MBW during spontaneous sleep. Tidal Breathing Flow Volume Loops (TBFVL) and MBW were used to assess respiratory parameters including lung clearance index (LCI). This was complemented by parental questionnaires on infant health. The cohort was stratified into three groups based on BPD diagnosis: (I) severe BPD (oxygen requirement at 28 days and respiratory support at 36 weeks’ postmenstrual age), (II) mild BPD (oxygen requirement at 28 days but no oxygen or respiratory support at 36 weeks’ postmenstrual age ) and (III) no BPD.

Results

Reliable TBFVL and MBW measurements during spontaneous sleep were obtained in 45 of 112 infants (40%) including 8 infants with severe BPD and 7 infants with mild BPD. Infants with BPD exhibited higher LCI values (7.0 vs. 6.5, p = 0.018) and lower ratios of tidal volume to functional residual capacity (0.40 vs. 0.51, p = 0.022) compared to infants without BPD. Infants with severe BPD had higher LCI values than those without BPD (7.1 vs. 6.5, p = 0.022). LCI was positively correlated with the duration of continuous positive airway pressure (CPAP) support (Pearson correlation coefficient r = 0.476, p = 0.001), oxygen supplementation (r = 0.444, p = 0.002) and antibiotic treatment (r = 0.435, p = 0.003), respectively. Higher LCI values were also associated with an increased rate of hospital readmissions due to respiratory infections.

Conclusions

Despite limited feasibility, MBW measurements obtained during spontaneous sleep at 12 months’ corrected age revealed impaired lung function in preterm infants with BPD. LCI correlated with the duration of antibiotic treatment, CPAP support, and oxygen supplementation all of which represent potentially modifiable clinical factors. These findings suggest that LCI may serve as a promising early lung function parameter for long-term respiratory vulnerability.