Growth of the Lung Parenchyma Early in Life

Early in life, lung growth can occur by alveolarization, an increase in the number of alveoli, as well as expansion. We hypothesized that if lung growth early in life occurred primarily by alveolarization, then the ratio of pulmonary diffusion capacity of carbon monoxide (Dl(CO)) to alveolar volume...

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Published in:	American journal of respiratory and critical care medicine Vol. 179; no. 2; pp. 134 - 137
Main Authors:	Balinotti, Juan E, Tiller, Christina J, Llapur, Conrado J, Jones, Marcus H, Kimmel, Risa N, Coates, Cathy E, Katz, Barry P, Nguyen, James T, Tepper, Robert S
Format:	Journal Article
Language:	English
Published:	New York, NY Am Thoracic Soc 15-01-2009 American Thoracic Society
Subjects:	Age Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Asthma Biological and medical sciences Carbon monoxide D. Pediatrics and Lung Development Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Female Helium Humans Infant Intensive care medicine Lung - growth & development Lung Volume Measurements Male Medical sciences Odds Ratio Pulmonary Alveoli - physiology Pulmonary Diffusing Capacity Reference Values Regression Analysis Retrospective Studies Statistical analysis Toddlers Indiana United States > US alveolar volume Intensive care Diffusion pulmonary diffusion capacity Resuscitation lung development
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Summary:	Early in life, lung growth can occur by alveolarization, an increase in the number of alveoli, as well as expansion. We hypothesized that if lung growth early in life occurred primarily by alveolarization, then the ratio of pulmonary diffusion capacity of carbon monoxide (Dl(CO)) to alveolar volume (V(A)) would remain constant; however, if lung growth occurred primarily by alveolar expansion, then Dl(CO)/V(A) would decline with increasing age, as observed in older children and adolescents. To evaluate the relationship between alveolar volume and pulmonary diffusion capacity early in life. In 50 sleeping infants and toddlers, with equal number of males and females between the ages of 3 and 23 months, we measured Dl(CO) and V(A) using single breath-hold maneuvers at elevated lung volumes. Dl(CO) and V(A) increased with increasing age and body length. Males had higher Dl(CO) and V(A) when adjusted for age, but not when adjusted for length. Dl(CO) increased with V(A); there was no gender difference when Dl(CO) was adjusted for V(A). The ratio of Dl(CO)/V(A) remained constant with age and body length. Our results suggest that surface area for diffusion increases proportionally with alveolar volume in the first 2 years of life. Larger Dl(CO) and V(A) for males than females when adjusted for age, but not when adjusted for length, is primarily related to greater body length in boys. The constant ratio for Dl(CO)/V(A) in infants and toddlers is consistent with lung growth in this age occurring primarily by the addition of alveoli rather than the expansion of alveoli.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Originally Published in Press as DOI: 10.1164/rccm.200808-1224OC on November 7, 2008 Correspondence and requests for reprints should be addressed to Robert S. Tepper, M.D., Ph.D., Department of Pediatrics, Indiana University Medical Center, James Whitcomb Riley Hospital for Children, 702 Barnhill Drive, ROC 4270, Indianapolis, Indiana 46202-5225. E-mail: rtepper@iupui.edu Conflict of Interest Statement: None of the authors has a financial relationship with a commercial entity that has an interest in the subject of this manuscript. This article has an online supplement, which is accessible from this issue's table of contents at www.atsjournals.org Supported by National Institutes of Health grant #HL054062 (R.S.T.).
ISSN:	1073-449X 1535-4970
DOI:	10.1164/rccm.200808-1224OC