ABSTRACT
BACKGROUND: The use of pulmonary function tests (PFTs) in infants has increased during the last decades, making the need for equipment- and ethnic-specific reference data mandatory for appropriate interpretation of the results. AIM: Our aim was to investigate how well the already published reference equations for infant spirometry fit a healthy population of Swedish infants. METHOD: We performed forced tidal and raised volume expiratory maneuvers in healthy infants using Jaeger BabyBody equipment. RESULTS: PFT data were collected from 91 healthy infants aged between 3 months to 2 years at 143 occasions. Mean (standard deviation) z-scores were 0.68(1.33) for maximal flow at functional residual capacity (V'max FRC), -0.15(0.96) for forced vital capacity (FVC), 0.40(1.33) for the forced expired volume in the initial 0.5 seconds (FEV0.5 ) and 0.52(0.93) for the ratio FEV0.5 /FVC, respectively. Z-scores for all indices but FEV0.5 /FVC were highly dependent on length. CONCLUSIONS: We have shown that the use of previously published reference equations may result in an age-related misinterpretation of lung function measure in a Swedish infant population.
Subject(s)
Forced Expiratory Volume , Functional Residual Capacity , Lung/physiology , Vital Capacity , Female , Humans , Infant , Male , Reference Values , Spirometry , SwedenABSTRACT
AIM: It is common in Sweden to discharge infants early from a neonatal intensive care unit (NICU) and provide hospital-assisted neonatal home care (HANHC), as an alternative to hospital care, for infants with a persisting need for specialised care. This study assessed the safety of HANHC by reviewing hospital readmissions. METHODS: We retrospectively reviewed the files of all 1410 infants enrolled in HANHC at the NICU at Sachs' Children's Hospital, Stockholm, from 2002 to 2011 up until hospital readmission or their discharge from HANHC. Each readmitted infant was matched to the next HANHC infant who was not readmitted. Predictors and reasons for readmission were investigated in a retrospective nested case-control study. RESULTS: We readmitted 74 (5.2%) of the 1410 infants in HANHC. Extremely preterm infants, born at less than 28 weeks, were readmitted more frequently than other infants, with an odds ratio of 6.07 (range 2.06-17.8). The most common symptoms were respiratory symptoms (55%), and viral respiratory tract infections were the most common reason (28%) for readmission. CONCLUSION: HANHC was safe for the vast majority of infants (94.8%). Extremely preterm birth was identified as a predictor for hospital readmission. Further studies investigating the safety of HANHC in other settings would be valuable.
Subject(s)
Home Care Services, Hospital-Based , Intensive Care Units, Neonatal , Patient Readmission/statistics & numerical data , Adult , Female , Humans , Infant, Newborn , Infant, Premature , Patient Discharge , Pregnancy , Retrospective Studies , SwedenABSTRACT
OBJECTIVES: To investigate whether gestational age modifies the association of airway infections that result in hospital admission during the first year after birth, with subsequent asthma risk after age 5 years. SETTING: Hospital inpatients and a general population comparison group in Sweden followed for subsequent diagnoses in primary and secondary care. PARTICIPANTS: National registers identified 42 334 children admitted to hospital for respiratory infection in their first year after birth during 1981-1995, individually matched with 211 594 children not admitted to hospital for infection during their first year. PRIMARY OUTCOME: Asthma diagnoses and prescribed asthma treatments after the age of 5 years identified through registers. RESULTS: Cox regression was used to identify a HR (and 95% CI) of 1.51 (1.47 to 1.51) for the association of respiratory infection before 1 year of age with asthma after age 5 years, after adjustment for sex, gestational age, chronic lung disease, maternal asthma and maternal smoking. When stratified by gestational age (and with additional adjustment for birth weight), there is statistically significant effect modification by gestational age, with the highest magnitude asthma risk among those born with a gestational age of less than 28 weeks, producing an adjusted HR of 2.22 (1.59 to 3.09). This higher magnitude asthma risk persisted until after age 10 years, but differences in risk by gestational age were less pronounced for asthma after age 16 years. CONCLUSIONS: Extremely preterm infants are most likely to have chronic respiratory sequelae following respiratory infections in early life.
