Spirometry/Pulmonary Volumes
Previous studies showed that adolescents who developed BPD in the
pre-surfactant era had greater airflow limitation and air-trapping than
EP adolescents without BPD and full-term control individuals; these
differences tended to persist over time2,3.
With regard to adolescents born in the post-surfactant era, there is
less information available, and only a few have reached
adulthood20. Available data show that differences
between children with BPD aged 6 to 12 years and full-term controls are
similar to those observed previously2. However,
studies comparing pulmonary function between EP children aged 6 to 12
years with and without BPD have shown somewhat contradictory findings.
Some studies reported that those with BPD had greater airway obstruction
and air-trapping21-25, while other studies found no
differences in either spirometry or pulmonary volumes between EP
children with and without BPD18,23,24. This study
focused on 14-year-old adolescents who developed BPD in the
post-surfactant era. We found that they had greater airflow limitation
and air-trapping than EP adolescents without BPD and MLP
adolescents2,3. The differences between the EP
adolescents with and without BPD suggest that BPD is associated with
deficits in pulmonary function in addition to the complications related
to prematurity itself. Notably, most adolescents with BPD in our study
had mild pulmonary function deficits, and even patients in the “high
severity” BPD subgroup reached acceptable results. Despite this,
further follow-up is necessary to assess the long-term consequences of
early lung injury, particularly in patients with spirometry values below
the LLN who usually experience more severe forms of BPD. Indeed, it is
possible that BPD is linked to the development of chronic obstructive
pulmonary disease in adulthood4.
Interestingly, we found that spirometry values were within the normal
range in most adolescents in the EP-noBPD group, and the findings
suggest that the lung may be able to resume its growth and
alveolarization process after disruption caused by premature birth,
although the recovery might not be completely
achieved26. These results differ from those reported
by Fawke et al. 21, who showed a slightly higher
deficit in lung function in EP-noBPD adolescents. This discrepancy may
be due to the differences in participants’ age and clinical
characteristics. The patients in Fawke et al.’s21study were 11 years old with a mean GA of 25 weeks, and the patients in
our study were 14 years old with a mean GA of 27 weeks.