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Differences and similarities between bronchopulmonary dysplasia and asthma in schoolchildren
Author(s) -
Nordlund Björn,
James Anna,
Ebersjö Christina,
Hedlin Gunilla,
Broström Eva B.
Publication year - 2017
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23741
Subject(s) - medicine , bronchopulmonary dysplasia , exhaled nitric oxide , asthma , methacholine , dlco , pulmonary function testing , pediatrics , pulmonology , respiratory system , gastroenterology , gestational age , spirometry , lung , respiratory disease , lung function , diffusing capacity , pregnancy , genetics , biology
Background The long‐term respiratory characteristics of ex‐preterm children with bronchopulmonary dysplasia (BPD) are not established. The objective of this study was to describe hallmarks of BPD at school age in comparison to children with atopic asthma. Methods This study was a cross‐sectional descriptive comparative study in a hospital‐based setting. Thirty schoolchildren diagnosed with BPD (10.4 years/born at 26.6 weeks’ gestation) and 30 age‐ and sex‐matched children with asthma and sensitized to airborne allergens (IgE >0.35 kU A /L) were analyzed. Measurements included fraction of exhaled nitric oxide (FENO, ppb), dynamic and static lung function, and bronchial provocation with methacholine (PD:20) and mannitol (PD:15), as well as an evaluation of respiratory symptoms using the asthma control test (C‐ACT). Results Lung function measures (FEV1% 77 vs 84, FEV1/FVC% 85 vs 91, FEF50% 61 vs 80) and carbon monoxide diffusion capacity (DLCO%, 81 vs 88) were all reduced in children with BPD compared to asthma ( P values <0.042). FENO values were also significantly lower in children with BPD (12 vs 23, P = 0.019). The proportion of positive methacholine tests (74% vs 93%, P = 0.14) was comparable between BPD and asthma. However, less responsiveness towards mannitol (19% vs 61%, P = 0.007) and fewer self‐reported symptoms (C‐ACT, median 26 vs 24, P = 0.003) were found in the BPD group. Conclusion Respiratory hallmarks of BPD at school‐age were reduced lung function, limited responsiveness towards indirectly acting mannitol but hyper‐responsiveness towards direct acting methacholine and impairment in diffusion capacity. Children with BPD displayed less evidence of airway inflammation compared with atopic asthma.