Shannon Simpson

PELICAN: Prematurity’s Effects on the Lungs in Children and Adults Network

The PELICAN (Prematurity’s Effects on the Lungs in Children and Adults Network) Clinical Research Collaboration was launched by the European Respiratory Society (ERS) in 2020

Compound Repurposing Into Novel Therapeutics In COVID-19 At risk Lungs (CRITICAL Study)

Preterm Paediatric Inhaled Corticosteroids Intervention (PICSI)

Understanding if ongoing inflammation in the lungs contributes to the poor lung health experienced by some children who were born preterm.

Understanding the relative contributions of the lung, respiratory muscles and the blood vessels to severity of chronic lung disease in very preterm infants (PIFCO Follow-up)

Predicting long term lung health outcomes in young adults born very preterm (WALHIP 19 year old follow-up)

Objective measures of bronchial hyper-responsiveness for asthma diagnosis in young children: Mannitol and exercise challenge testing

The development and refinement of a sensitive bedside test to continually measure the severity of BPD and lung development in preterm infants

Transcriptomic analysis of primary nasal epithelial cells reveals altered interferon signalling in preterm birth survivors at one year of age

Many survivors of preterm birth (<37 weeks gestation) have lifelong respiratory deficits, the drivers of which remain unknown. Influencers of pathophysiological outcomes are often detectable at the gene level and pinpointing these differences can help guide targeted research and interventions. This study provides the first transcriptomic analysis of primary nasal airway epithelial cells in survivors of preterm birth at approximately 1 year of age.

Prematurity-associated lung disease: is it asthma?

Preterm lung disease: not just for neonatologists

Improvements in neonatal critical care have resulted in more people than ever reaching adulthood after being born prematurely. At the same time, it is becoming clearer that preterm birth can increase the risk of respiratory disease throughout a person’s lifetime. Awareness that a patient was born preterm can enable early specialist assessment and intervention when there is any concern about lung health. 

Preterm birth and exercise capacity: what do we currently know?

The long-term cardiopulmonary outcomes following preterm birth during the surfactant era remain unclear. Respiratory symptoms, particularly exertional symptoms, are common in preterm children. Therefore, cardiopulmonary exercise testing may provide insights into the pathophysiology driving exertional respiratory symptoms in those born preterm. This review aims to outline the current knowledge of cardiopulmonary exercise testing in the assessment of children born preterm in the surfactant era.

Oscillometry and spirometry are not interchangeable when assessing the bronchodilator response in children and young adults born preterm

The European Respiratory Society Oscillometry Taskforce identified that clinical correlates of bronchodilator responses are needed to advance oscillometry in clinical practice. The understanding of bronchodilator-induced oscillometry changes in preterm lung disease is poor. Here we describe a comparison of bronchodilator assessments performed using oscillometry and spirometry in a population born very preterm and explore the relationship between bronchodilator-induced changes in respiratory function and clinical outcomes.

Elevated leukotriene B4 and 8-isoprostane in exhaled breath condensate from preterm-born infants

Inflammation and oxidative stress play a key role in the development of bronchopulmonary dysplasia (BPD), possibly contributing to persistent respiratory morbidity after preterm birth. We aimed to assess if inflammatory markers were elevated in exhaled breath condensate (EBC) of infants born very prematurely (< 32 weeks gestation) at 12-16 corrected months of age, and if increased levels were associated with BPD diagnosis and respiratory morbidity.

The cost of respiratory hospitalizations in children with cerebral palsy

To establish the burden of respiratory illness in cerebral palsy (CP) on the Western Australian health care system by quantifying the costs of respiratory hospitalizations in children with CP, compared with non-respiratory hospitalizations.

Inhaled corticosteroids to improve lung function in children (aged 6–12 years) who were born very preterm (PICSI): a randomised, double-blind, placebo-controlled trial

Despite the substantial burden of lung disease throughout childhood in children who were born very preterm, there are no evidence-based interventions to improve lung health beyond the neonatal period. We tested the hypothesis that inhaled corticosteroid improves lung function in this population.

Health service utilisation for acute respiratory infections in infants graduating from the neonatal intensive care unit: a population-based cohort study

Despite advances in neonatal intensive care, babies admitted to Neonatal Intensive Care Units (NICU) suffer from adverse outcomes. We aim to describe the longer-term respiratory infectious morbidity of infants discharged from NICU using state-wide population-based linked data in Western Australia.

Increasing airway obstruction through life following bronchopulmonary dysplasia: a meta-analysis

Few studies exist investigating lung function trajectories of those born preterm; however growing evidence suggests some individuals experience increasing airway obstruction throughout life. Here we use the studies identified in a recent systematic review to provide the first meta-analysis investigating the impact of preterm birth on airway obstruction measured by the forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio.

Risk factors for poorer respiratory outcomes in adolescents and young adults born preterm

The respiratory outcomes for adult survivors of preterm birth in the postsurfactant era are wide-ranging with prognostic factors, especially those encountered after the neonatal period, poorly understood.

Normal values of respiratory oscillometry in South African children and adolescents

Noninvasive measurement of respiratory impedance by oscillometry can be used in young children aged from 3 years and those unable to perform forced respiratory manoeuvres. It can discriminate between healthy children and those with respiratory disease. However, its clinical application is limited by the lack of reference data for African paediatric populations. The aim of the present study was to develop reference equations for oscillometry outcomes in South African children and adolescents.

Ventilatory response and stability of oxygen saturation during a hypoxic challenge in very preterm infants

Preterm infants have immature control of breathing and impaired pulmonary gas exchange. We hypothesized that infants with bronchopulmonary dysplasia (BPD) have a blunted ventilatory response and peripheral oxygen saturation (SpO2 ) instability during a hypoxic challenge.

The ventilatory response to hypoxia is blunted in some preterm infants during the second year of life

Preterm birth and subsequent neonatal ventilatory treatment disrupts development of the hypoxic ventilatory response (HVR). An attenuated HVR has been identified in preterm neonates, however it is unknown whether the attenuation persists into the second year of life.

Living with lung disease: experimental models to assess the long-term effects of prematurity

Laboratory models provide an important tool in helping to understand the cellular and molecular drivers of respiratory disease. Many animal models exist that model the neonatal outcomes of preterm birth.

Geographical Differences and Temporal Improvements in Forced Expiratory Volume in 1 Second of Preterm-Born Children: A Systematic Review and Meta-analysis

Although preterm birth is associated with later deficits in lung function, there is a paucity of information on geographical differences and whether improvements occur over time, especially after surfactant was introduced.

Nasal airway epithelial repair after very preterm birth

Nasal epithelial cells from very preterm infants have a functional defect in their ability to repair beyond the first year of life, and failed repair may be associated with antenatal steroid exposure.

Clinical significance and applications of oscillometry

Recently, "Technical standards for respiratory oscillometry" was published, which reviewed the physiological basis of oscillometric measures and detailed the technical factors related to equipment and test performance, quality assurance and reporting of results. Here we present a review of the clinical significance and applications of oscillometry.

Collecting exhaled breath condensate from non-ventilated preterm-born infants: a modified method

Exhaled breath condensate (EBC) collection is a non-invasive, safe method for measurement of biomarkers in patients with lung disease. Other methods of obtaining samples from the lungs, such as bronchoalveolar lavage, are invasive and require anaesthesia/sedation in neonates and infants. EBC is particularly appealing for assessing biomarkers in preterm-born infants, a population at risk of ongoing lung disease.

The PELICAN (Prematurity's Effect on the Lungs In Children and Adults Network) ERS Clinical Research Collaboration: understanding the impact of preterm birth on lung health throughout life

An estimated 15 million babies (∼11%) are born preterm each year (before 37 weeks of gestation), the rates of which are increasing worldwide. Enhanced perinatal care, including antenatal corticosteroids, postnatal surfactant and improved respiratory management, have markedly improved survival outcomes since the 1990s, particularly for babies born very preterm (<32 weeks gestation). However, long-term pulmonary sequelae are frequent in preterm survivors and ongoing clinical management is often required.

Pulmonary Gas Exchange Improves over the First Year in Preterm Infants with and without Bronchopulmonary Dysplasia

Right shift of the peripheral oxyhaemoglobin saturation (SpO2) versus inspired oxygen pressure (PIO2) curve is a sensitive marker of pulmonary gas exchange. The aim of this study was to assess the impact of prematurity and bronchopulmonary dysplasia (BPD) on gas exchange and right-to-left shunt in the neonatal period, and its evolution over the first year of life.

Lung abnormalities do not influence aerobic capacity in school children born preterm

Children born preterm have impaired lung function and altered lung structure. However, there are conflicting reports on how preterm birth impacts aerobic exercise capacity in childhood. We aimed to investigate how neonatal history and a diagnosis of bronchopulmonary dysplasia (BPD) impact the relationship between function and structure of the lung, and aerobic capacity in school-aged children born very preterm.

Technical standards for respiratory oscillometry

The aim of the task force was to provide technical recommendations regarding oscillometry measurement

Bronchopulmonary dysplasia: Rationale for a pathophysiological rather than treatment based approach to diagnosis

This review describes the evolution of bronchopulmonary dysplasia definitions, evaluates the benefits and limitations of each approach

Upper Airway Pathology Contributes to Respiratory Symptoms in Children Born Very Preterm

The upper airway may play a role in the respiratory symptoms experienced by some very preterm children and should be considered by clinicians

Preterm birth: Born too soon for the developing airway epithelium

This review examines the consequences of preterm birth on the airway epithelium and explores the clinical relevance of currently available models

Identifying pediatric lung disease: A comparison of forced oscillation technique outcomes

These findings suggest the utility of specific FOT outcomes is dependent on the respiratory disease being assessed

Increased prevalence of expiratory flow limitation during exercise in children with bronchopulmonary dysplasia

Expiratory flow limitation is more prevalent in children born preterm with bronchopulmonary dysplasia and is associated with airway obstruction

Persistent and progressive long-term lung disease in survivors of preterm birth

This review aims to summarise what is known about the long-term pulmonary outcomes of contemporary preterm birth

The impact of respiratory viruses on lung health after preterm birth

The aim of this review is to highlight the risk factors that may contribute to increased susceptibility to viral respiratory infections among preterm infants

Lung function trajectories throughout childhood in survivors of very preterm birth: a longitudinal cohort study

Lung function trajectories are impaired in survivors of very preterm birth

How ‘healthy’ do children really need to be? Going beyond the limits

The authors assessed the impact of including preschool‐aged children with a history of preterm birth, early life wheeze, asthma diagnoses and/or recent respiratory symptoms in healthy reference ranges for respiratory impedance using the forced oscillation technique (FOT).

Effect of posture on lung ventilation distribution and associations with structure in children with cystic fibrosis

Background: We assessed the effect of posture on ventilation distribution and the impact on associations with structural lung disease.

Altered lung structure and function in mid-childhood survivors of very preterm birth

To obtain comprehensive data on lung structure and function in mid-childhood from survivors of preterm birth.