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Respiratory health outcomes in neonates - lung function, exercise and airway mechanics

Cousins, Michael 2021. Respiratory health outcomes in neonates - lung function, exercise and airway mechanics. PhD Thesis, Cardiff University.
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Abstract

My thesis uses data collected during the course of the Respiratory Outcomes in Neonates study, which aimed to identify, investigate mechanisms and establish potential treatments for lung disease in a population of preterm-born children in South Wales. As part of this study, 241 children attended our research unit where they underwent in-depth lung function testing, as reported in my thesis. My results observed preterm-born children with low lung function had increased air trapping on lung volume testing, functional exercise impairment, and greater response to post-exercise bronchodilator. When classifying preterm-born children with low lung function by obstructive versus non-obstructive lung disease, those children with obstructive disease had greater impairment of forced expiratory volume in one second (FEV1) and greater post-exercise reversibility. On oscillometry testing, preterm-born children with low lung function, in particular those with obstructive lung disease, had impaired resistance and compliance, with evidence of peripheral airways being most affected. Post-exercise bronchodilator was effective in improving airway mechanical properties in children with low lung function. Intra-breath oscillometry, unexplored in the preterm population to date, demonstrated impairment throughout the respiratory cycle in children with low lung function, and was not limited to expiration, suggesting a different disease process to that seen in other childhood wheeze disorders. I demonstrated that my method for classification of obstructive and non-obstructive lung disease was appropriate in my population for identification of children with postexercise bronchodilator reversibility, and was comparative to other established methods of defining obstructive lung disease. Finally, I explored differences between two methods of spirometry, and noted systematic bias towards higher results using a pneumotachograph system compared to an infra-red turbine spirometry, with implications for clinical practice.

Item Type: Thesis (PhD)
Date Type: Completion
Status: Unpublished
Schools: Medicine
Date of First Compliant Deposit: 28 March 2022
Last Modified: 28 Mar 2022 13:00
URI: https://orca.cardiff.ac.uk/id/eprint/148775

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