Gas Transfer and Pulmonary Blood Flow at Rest and during Exercise in Adults 21 Years after Preterm Birth
Gas Transfer and Pulmonary Blood Flow at Rest and during Exercise in Adults 21 Years after Preterm Birth
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DOI：
10.1164/rccm.200809-1523oc
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发表时间：
2009-08-15
影响因子：
24.7
通讯作者：
Rosenthal, Mark
中科院分区：
文献类型：
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作者：
Narang, Indra;Bush, Andrew;Rosenthal, Mark
理由：早产后，关于成年期肺泡毛细血管生长和运动能力的数据有限。静止时通过运动进行的气体转移是肺泡毛细血管发育的一种无创测量方法。目的：确定前早产儿成人休息和运动时的运动能力和气体转移。方法：出生时招募的前早产儿（n = 60，中位妊娠31.5周）在21岁时进行运动测试，同时与50名健康对照者进行比较。测量和主要结果：受试者在循环计量器上运动，并使用呼吸质谱计测量心率（HR）、FRC、有效肺血流量(Q) / dotpeff、卒中量（SV）、DLCO (V) / soto(2)、动静脉氧差（AVO）、传递时间（TT）、呼吸速率（Rf）、(V) / dotCO(2)、(V) / dotE、VT和呼吸商（RQ）。在指数研究组和对照组中，静止时DLCO （mmol/min/kPa/m(2)）的中位数分别为4.33（95%可信区间[CI]， 4.18 ~ 4.62）和4.75 (95% CI, 4.50 ~ 5.10) (P = 0.01)，静止时DLCO （L/min/m(2)）的中位数(Q)分别为3.26 （95% CI, 3.16 ~ 3.49）和3.59 (95% CI, 3.43 ~ 3.81) （P = 0.04）。(Q) over dotpeff和DLCO值在运动期间正常化，但在恢复期后降低并低于对照组。两组之间的运动能力没有显著差异。结论：数据表明早产对静息心输出量和气体传递有长期影响，不是由于心脏或肺功能异常，也没有运动限制的证据。
Rationale: After preterm birth, limited data exist in adulthood regarding alveolar-capillary growth and exercise capacity. Gas transfer at rest through exercise is a noninvasive measure of alveolar-capillary development.Objectives: To determine exercise capacity and gas transfer at rest and during exercise in ex-preterm adults.Methods: Ex-preterm subjects (n = 60; median gestation, 31.5 wk) recruited at birth underwent exercise testing at 21 years of age and were contemporaneously compared with 50 healthy control subjects.Measurements and Main Results: Subjects exercised on a cycle ergometer, and measurements of heart rate (HR), FRC, effective pulmonary blood flow ((Q) over dotpeff), stroke volume (SV), DLCO, (V)over soto(2), arteriovenous oxygen difference (AVO), transit time (TT), respiratory rate (Rf), (V) over dotCO(2), (V) over dotE, VT, and respiratory quotient (RQ) were made using a respiratory mass spectrometer. In the index study group and control subjects, the median DLCO (mmol/min/kPa/m(2)) at rest was 4.33 (95% confidence interval [CI], 4.18-4.62) and 4.75 (95% CI, 4.50-5.10), respectively (P = 0.01), and the median (Q) over dotpeff (L/min/m(2)) at rest was 3.26 (95% CI, 3.16-3.49) and 3.59 (95% CI, 3.43-3.81), respectively (P = 0.04). (Q) over dotpeff and DLCO values normalized during exercise but were reduced and lower than controls after a recovery period. No significant differences were found in exercise capacity between the groups.Conclusions: The data suggest a long-term effect of premature delivery on resting cardiac output and gas transfer, not due to abnormal cardiac or pulmonary function and with no evidence of exercise limitation.