Mark R Thomas

King's College London, London, ENG, United Kingdom

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Publications (2)14.09 Total impact

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    ABSTRACT: To determine whether abnormalities of lung volume and/or airway function were associated with wheeze at follow-up in infants born very prematurely and to identify risk factors for wheeze. Lung function data obtained at 1 year of age were collated from two cohorts of infants recruited into the UKOS and an RSV study, respectively. Infant pulmonary function laboratory. 111 infants (mean gestational age 26.3 (SD 1.6) weeks). Lung function measurements at 1 year of age corrected for gestational age at birth. Diary cards and respiratory questionnaires were completed to document wheeze. Functional residual capacity (FRC(pleth) and FRC(He)), airways resistance (R(aw)), FRC(He):FRC(pleth) and tidal breathing parameters (T(PTEF):T(E)). The 60 infants who wheezed at follow-up had significantly lower mean FRC(He), FRC(He):FRC(pleth) and T(PTEF):T(E), but higher mean R(aw) than the 51 without wheeze. Regression analysis demonstrated that gestational age, length at assessment, family history of atopy and a low FRC(He):FRC(pleth) were significantly associated with wheeze. Wheeze at follow-up in very prematurely born infants is associated with gas trapping, suggesting abnormalities of the small airways.
    Archives of Disease in Childhood 10/2007; 92(9):776-80. · 3.05 Impact Factor
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    ABSTRACT: Prematurely born infants supported by conventional ventilation (CV) frequently have abnormal pulmonary function when assessed in childhood. The aim of this study was to test the hypothesis that infants who were randomly assigned to high-frequency oscillatory ventilation would have superior pulmonary function at follow-up compared with those who received CV (UK Oscillation Study). Infants from 12 trial centers were recruited for pulmonary function testing at a single center. Seventy-six infants, of a mean gestational age 26.4 weeks, were studied after sedation with chloral hydrate at between 11 and 14 months of age, corrected for prematurity. Infants assigned to CV had similar pulmonary function compared with those assigned to high-frequency oscillatory ventilation, with mean (SD) results as follows: functional residual capacity measured by whole-body plethysmography, 26.9 (6.3) versus 26.5 (6.4) ml/kg; functional residual capacity measured by helium dilution, 24.1 (5.4) versus 23.5 (5.7) ml/kg; inspiratory airway resistance, 3.3 (1.3) versus 3.4 (1.6) kPa. second. L; expiratory airway resistance, 4.4 (2.8) versus 4.1 (2.5) kPa. second. L; respiratory rate, 31.2 (6.0) versus 33.9 (8.0) breaths/minute. We conclude that early use of high-frequency oscillatory ventilation in very preterm infants appears to offer no advantage over CV in terms of pulmonary function at follow-up.
    American Journal of Respiratory and Critical Care Medicine 05/2004; 169(7):868-72. · 11.04 Impact Factor