V/Q ratio and alveolar surface area in preterm infants

  • Research type

    Research Study

  • Full title

    Functional morphometry and ventilation perfusion ratio to estimate the alveolar surface area in prematurely born infants

  • IRAS ID

    287018

  • Contact name

    Anne Greenough

  • Contact email

    anne.greenough@kcl.ac.uk

  • Sponsor organisation

    King's College London

  • Clinicaltrials.gov Identifier

    NCT04936477

  • Duration of Study in the UK

    0 years, 11 months, 31 days

  • Research summary

    Summary of Research

    Many babies that are born prematurely have problems with their breathing due to their lungs being not fully developed when they are born. It is thought that their lungs have a simpler structure when they are born and do not continue to grow in the same way after birth as they would have done during pregnancy. This simpler structure leads to less surface area to allow for oxygen and carbon dioxide to exchange effectively during breathing. As a result, many of these babies develop chronic lung disease and may often require breathing support on the neonatal unit for a long period of time and they may end up being discharge home on oxygen.

    Current ways of predicting which babies may have more severe lung disease and breathing difficulties often fail to fully encompass all at risk infants. It is therefore important that we can have better ways of understanding which babies might have more underdeveloped lungs when they are born so that we can help give them better support during the neonatal period and into childhood.

    Being able to non-invasively calculate the surface area of the lungs by taking measurements of oxygen and carbon dioxide may enable us to accurately calculate the surface area and hence predict outcome and be able to give these babies the support they may require.

    Summary of Results

    The main characteristic of chronic respiratory disease following extremely premature birth is arrested lung growth which translates to a smaller alveolar surface area (SA). Non-invasive measurements were used to estimate the SA in extremely preterm infants. Thirty infants with an average gestational age of 26.3 weeks were recruited. The adjusted SA was 647.9cm2. The adjusted SA was lower in the infants that required home oxygen compared to those that did not. Furthermore the adjusted SA had good predictive ability with 86% sensitivity and 77% specificity in predicting the need for supplemental home oxygen. The alveolar surface area thus can be estimated non-invasively in extremely preterm infants. The adjusted alveolar surface area has the potential to predict the subsequent need for discharge home on supplemental oxygen.

  • REC name

    London - Brighton & Sussex Research Ethics Committee

  • REC reference

    20/PR/0299

  • Date of REC Opinion

    22 Sep 2020

  • REC opinion

    Further Information Favourable Opinion