A new study led by researchers at King's College London has found that premature babies supported immediately after birth by high-frequency oscillation - a type of breathing support - had better lung function as adolescents than those who received conventional ventilation. The children ventilated with the high frequency method also showed higher academic achievement in three of eight school subjects.
The findings of the research, funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme and the NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, could change the use of ventilation in neonatal units across the UK, where around 60,000 babies are born prematurely each year.
Babies born extremely prematurely are at a high risk of developing breathing problems as their lungs are not yet mature and can be damaged by the breathing support that is needed to keep them alive.
Breathing support can be provided by conventional ventilation, which assists their breathing at their breathing rate, or by high-frequency oscillatory ventilation (HFOV). During HFOV smaller, shorter bursts of gas are delivered which may be less damaging to their fragile lungs and therefore may reduce the chronic respiratory problems experienced by babies born very prematurely.
Published today in the New England Journal of Medicine, the study at King's is the first to examine whether HFOV improves the lung function in adolescence of children who were born very prematurely. The children supported by HFOV, who were entered into a randomised trial at birth (the United Kingdom Oscillation Study - UKOS), were found to have superior lung function on a number of measures between the ages of 11 and 14 than children who had been supported by conventional ventilation at birth. A series of assessments at King's College Hospital found in particular that the children were able to breathe out more easily.
Results from some early studies had raised concern that HFOV might be associated with an increased risk of bleeding into the brain, which would put the babies at increased risk of neurodevelopmental problems. In UKOS, there were no significant differences in the occurrence of bleeding into the brain and the current follow-up study found no evidence of adverse neurological effects. Indeed, some cognitive skills were found to be enhanced in the HFOV group. The children's teachers completed questionnaires designed to measure academic achievement demonstrated that the children supported by HFOV after birth were rated significantly higher in three of the eight school subjects assessed: art and design, information technology and design and technology suggesting they had better visual and spatial abilities.
Anne Greenough, Professor of Clinical Respiratory Physiology at King's College London, said: 'Poorer lung function in adolescence could have further consequences later in life, such as making children more vulnerable to the damaging effects of smoking and infection.'
For further information please contact Jack Stonebridge, Press Officer at King's College London, on 0207 848 3238 or email jack.stonebridge@kcl.ac.uk
Notes to editors:
King's College London
King's College London is one of the top 20 universities in the world (2013/14 QS World University Rankings), and the fourth oldest in England. A research-led university based in the heart of London, King's has nearly 23,500 students (of whom more than 9,000 are graduate students) from nearly 140 countries, and some 6,000 employees. King's is in the second phase of a £1 billion redevelopment programme which is transforming its estate.
King's has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 23 departments were ranked in the top quartile of British universities; over half of our academic staff work in departments that are in the top 10 per cent in the UK in their field and can thus be classed as world leading. The College is in the top seven UK universities for research earnings and has an overall annual income of nearly £450 million.
King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar.
King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: http://www.kingshealthpartners.org.
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website.
The National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme funds research about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest NIHR programme and publishes the results of its research in the Health Technology Assessment journal, with over 600 issues published to date. The journal's 2011 Impact Factor (4.255) ranked it in the top 10% of medical and health-related journals. All issues are available for download, free of charge, from the website. The HTA Programme is funded by the NIHR, with contributions from the CSO in Scotland, NISCHR in Wales, and the HSC R&D Division, Public Health Agency in Northern Ireland. http://www.nets.nihr.ac.uk/programmes/hta
Journal
New England Journal of Medicine