http://repub.eur.nl/res/aut/15446/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/34521/ 2011-03-01T00:00:00Z Objective: To collect longitudinal data on lung function in the first year of life after extracorporeal membrane oxygenation and to evaluate relationships between lung function and perinatal factors. Longitudinal data on lung function in the first year of life after extracorporeal membrane oxygenation are lacking. Design: Prospective longitudinal cohort study. Setting: Outpatient clinic of a tertiary level pediatric hospital. Patients: The cohort consisted of 64 infants; 33 received extracorporeal membrane oxygenation for meconium aspiration syndrome, 14 for congenital diaphragmatic hernia, four for sepsis, six for persistent pulmonary hypertension of the neonate, and seven for respiratory distress syndrome of infancy. Evaluation was at 6 mos and 12 mos; 39 infants were evaluated at both time points. Interventions: None. Measurements And Main Results: Functional residual capacity and forced expiratory flow at functional residual capacity were measured and expressed as z score. Mean (sem) functional residual capacities in z score were 0.0 (0.2) and 0.2 (0.2) at 6 mos and 12 mos, respectively. Mean (sem) forced expiratory flow was significantly below average (z score = 0) (p <.001) at 6 mos and 12 mos:-1.1 (0.1) and-1.2 (0.1), respectively. At 12 mos, infants with diaphragmatic hernia had a functional residual capacity significantly above normal: mean (sem) z score = 1.2 (0.5). Conclusions: Infants treated with extracorporeal membrane oxygenation have normal lung volumes and stable forced expiratory flows within normal range, although below average, within the first year of life. There is reason to believe, therefore, that extracorporeal membrane oxygenation either ameliorates the harmful effects of mechanical ventilation or somehow preserves lung function in the very ill neonate. Copyright http://repub.eur.nl/res/pub/36507/ 2007-02-01T00:00:00Z Guidelines for the measurement of fractional exhaled nitric oxide (FENO) recommend refraining from lung function tests (LFT) and certain foods and beverages before performing FENOmeasurements, as they may lead to transiently altered FENOlevels. Little is known of such factors in infants. The aim of the present study was to evaluate whether forced expiratory maneuvers, sedation, nasal contamination, and breastfeeding affect FENOvalues in infants. FENOwas measured off-line during tidal breathing by means of a facemask covering nose and mouth. FENOmeasurements were performed in 45 sedated infants (mean age 12.1 months) who underwent LFT because of airway diseases and in 83 unsedated healthy infants (mean age 4.3 months). In infants with airway diseases, no difference was found in FENOvalues before and 5 min after LFT (n = 19 infants, p = 0.7) and FENOvalues before sedation did not differ from FENOvalues during sedation (n = 10 infants, p = 0.2).Oral FENOvalues were significantly lower than mixed (nasal + oral) FENO(n = 42 infants, p < 0.001). FENOvalues before and 5 min after breastfeeding were not different (n = 11 healthy infants, p = 0.57). The short-term reproducibility in healthy infants (n = 54) was satisfactory (intraclass correlation coefficient = 0.94). We conclude that, in infants with airway diseases, LFT prior to FENOmeasurement did not influence FENOvalues and FENOvalues did not change after sedation. Oral FENOvalues were significantly lower than mixed (oral + nasal) FENO, and breastfeeding did not influence FENO. Short-term reproducibility in awake healthy infants was good. http://repub.eur.nl/res/pub/13567/ 2005-02-15T00:00:00Z The role of inhaled corticosteroids in the treatment of recurrent or persistent wheeze in infancy remains unclear. We evaluated the effect of 3 months of treatment with inhaled fluticasone propionate, 200 microg daily (FP200), on lung function and symptom scores in wheezy infants. Moreover, we evaluated whether infants with atopy and/or eczema respond better to FP200 as compared with non-atopic infants. Forced expiratory flow (Vmax(FRC)) was measured at baseline and after treatment. Sixty-five infants were randomized to receive FP200 or placebo, and 62 infants (mean age, 11.3 months) completed the study. Mean Vmax(FRC), expressed as a Z score, was significantly below normal at baseline and after treatment in both groups. The change from baseline of Vmax(FRC) was not different between the two treatment arms. After 6 weeks of treatment, and not after 13 weeks, the FP200 group had a significantly higher percentage of symptom-free days and a significant reduction in mean daily cough score compared with placebo. Separate analysis of treatment effect in infants with atopy or eczema showed no effect modification. We conclude that in wheezy infants, after 3 months of treatment with fluticasone, there was no improvement in lung function and no reduction in respiratory symptoms compared with placebo.