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This study aimed to describe the early assessment of lung function and respiratory morbidity in children born extremely preterm with or without bronchopulmonary dysplasia (BPD)., Methods: This was a prospective study including all the children born at gestational age ≤28 weeks who received treatment in the NICU of the Centre Intercommunal de Créteil in France, from January 2006 to March 2012. Lung function, using the impulse oscillometry system, respiratory morbidity and growth were assessed at age 4 years. Lung function and clinical course of children were compared in children with and without BPD., Results: We included 136 extremely premature children; 26 (19%) had BPD. Children with and without BPD did not significantly differ in resistance measurements at 5 Hz (R 5 ) and 20 Hz (R 20 ) and reactance (X 5 ) measurements at age 4 years. A total of 104 (76%) pre-term children had respiratory resistance R 5 above the 95th percentile for the reference population (z-score > 1.64), regardless of BPD status. The mean (SD) R 5 z-score for all children was 2.1 (±0.7), whereas the mean (SD) R 20 was in the normal range (z-score=1.1 [±0.3]). After treatment with bronchodilators, all children showed no significant change in resistance. The prevalence of asthma symptoms at age 4 years was common and estimated at 30% regardless of BPD status., Conclusion: Early assessment of lung function by the impulse oscillometry system revealed that most preschool children who were born extremely preterm had abnormal total airway resistance regardless of BPD status. The system is an essential tool for the early assessment of children born prematurely., Competing Interests: Declaration of Competing Interest ☐ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ☒ The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Epaud reports a relationship with AstraZeneca Pharmaceuticals LP that includes: board membership, speaking and lecture fees, and travel reimbursement. Epaud reports a relationship with Sanofi-Aventis France SA that includes: board membership and speaking and lecture fees. Epaud reports a relationship with GSK that includes: board membership, speaking and lecture fees, and travel reimbursement. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Sickle cell disease (SCD) patients with asthma have an increased rate of vaso-occlusive crisis (VOC) and acute chest syndrome (ACS) episodes when compared to those without asthma. We hypothesized that either asthma diagnosis or bronchodilator treatment might aggravate SCD via their modulating effect on the autonomic nervous system (ANS)., Methods: Cross-sectional evaluation of heart rate variability (HRV) during pulmonary function tests, including salbutamol administration, in children with SCD receiving asthma treatment or not when compared to asthmatic children without SCD matched for ethnicity., Results: SCD children with asthma ( n = 30, median age of 12.9 years old) were characterized by a reduced FEV 1 /FVC ratio, an increased bronchodilator response, and a greater incidence of VOC and ACS when compared to SCD children without asthma ( n = 30, 12.7 years). Children with asthma without SCD ( n = 29, 11.4 years) were characterized by a higher exhaled NO fraction than SCD children. SCD children when compared to non-SCD children showed reduced HRV [total power, low (LF) and high (HF, vagal tone) frequencies], which was further worsened by salbutamol administration in all the groups: reduction in total power and HF with an increase in LF/HF ratio. After salbutamol, the LF/HF ratio of the SCD children was higher than that of the non-SCD children. The two groups of SCD children were similar, suggesting that asthma diagnosis per se did not modify ANS functions., Conclusion: SCD children are characterized by impaired parasympathetic control and sympathetic overactivity that is worsened by salbutamol administration., Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT04062409., (Copyright © 2020 Bokov, El Jurdi, Denjoy, Peiffer, Medjahdi, Holvoet, Benkerrou and Delclaux.)