Abstract
Lower respiratory tract illness (LRTI) is a leading cause of mortality and morbidity in children. Sensitive and noninvasive infant lung function techniques are needed to measure risk for and impact of LRTI on lung health. The objective of this study was to investigate whether lung function derived from the intra-breath forced oscillation technique (FOT) was able to identify healthy infants at risk of LRTI in the first year of life.
Lung function was measured with the novel intra-breath FOT, in 6-week-old infants in a South African birth cohort (Drakenstein Child Health Study). LRTI during the first year was confirmed by study staff. The association between baseline lung function and LRTI was assessed with logistic regression and odds ratios determined using optimal cut-off values.
Of the 627 healthy infants with successful lung function testing, 161 (24%) had 238 LRTI episodes subsequently during the first year. Volume dependence of respiratory resistance (ΔR) and reactance (ΔX) was associated with LRTI. The predictive value was stronger if LRTI was recurrent (n=50 (31%): OR 2.5, ΔX), required hospitalisation (n=38 (16%): OR 5.4, ΔR) or was associated with wheeze (n=87 (37%): OR 3.9, ΔX).
Intra-breath FOT can identify healthy infants at risk of developing LRTI, wheezing or severe illness in the first year of life.
Abstract
Novel measurements of respiratory mechanics are feasible in infants in a community setting and able to detect changes in lung function in healthy infants associated with increased risk of subsequent LRTI in infancy http://ow.ly/IUKk30mCfi3
Footnotes
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Author contributions: D. Czovek, D.M. Gray, Z. Hantos and H.J. Zar conceived the study; D.M. Gray, D. Czovek, G.L. Hall, P.D. Sly, Z. Hantos and H.J. Zar contributed to the study design and provided intellectual input; D.M. Gray, L. McMillan, J.A.M. Stadler and A. Vanker recruited patients and collected data; D.M. Gray and L. McMillan recorded measurement data; B.L. Radics, Z. Gingl, D. Czovek and Z. Hantos contributed to development of the novel infant FOT technique; D.M. Gray, D. Czovek, Z. Hantos and L. Turkovic processed the recordings and analysed the data; D.M. Gray and D. Czovek drafted the manuscript; all authors have seen and approved the submitted manuscript.
Conflict of interest: D.M. Gray has nothing to disclose.
Conflict of interest: D. Czovek has nothing to disclose.
Conflict of interest: L. McMillan has nothing to disclose.
Conflict of interest: L. Turkovic has nothing to disclose.
Conflict of interest: J.A.M. Stadler has nothing to disclose.
Conflict of interest: A. Vanker reports grants from Bill and Melinda Gates Foundation (OPP1017641), Discovery Foundation, South African Thoracic Society AstraZeneca Respiratory Fellowship, National Research Fund, South Africa, CIDRI Clinical Fellowship, and MRC, South Africa, during the conduct of the study.
Conflict of interest: B.L. Radics has nothing to disclose.
Conflict of interest: Z. Gingl has nothing to disclose.
Conflict of interest: G.L. Hall has nothing to disclose.
Conflict of interest: P.D. Sly is a named inventor on a patent owned by the Telethon Kids Institute that covers this technology. The patent is licensed to Thorasys, Inc. (Canada); P.D. Sly receives no financial gain from this patent.
Conflict of interest: H.J. Zar reports grants from Gates Foundation, National Research Foundation South Africa, SA Medical Research Council, Wellcome Trust and National Institutes of Health, H3 Africa, during the conduct of the study.
Conflict of interest: Z. Hantos has a patent 2005903034 (A Method of Diagnosing a Respiratory Disease or Disorder or Monitoring Treatment of Same and a Devise for Use Therein) licensed to Thorasys P/L; Z. Hantos is named as an inventor on this patent owned by the Telethon Kids Institute, Perth, Australia, but receives no royalties or other payment from the patent or licensee.
Support statement: This study was supported by grants from the Wellcome Trust (098479/z/12/z; 204755/z/16/z), Bill and Melinda Gates Foundation (OPP1017641), Worldwide University Network Research Mobility Award, University of Cape Town equipment grant, the Hungarian Scientific Research Fund (105403). G.L. Hall is funded by the National Health and Medical Research Foundation of Australia (1025550). P.D. Sly is funded by the National Health and Medical Research Foundation of Australia (1002035). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received May 29, 2018.
- Accepted November 1, 2018.
- Copyright ©ERS 2019.
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