RT Journal Article
SR Electronic
A1 Rygl, Michal
A1 Rounova, Petra
A1 Sulc, Jan
A1 Slaby, Krystof
A1 Stranak, Zbynek
A1 Pycha, Karel
A1 Svobodova, Tamara
A1 Pohunek, Petr
A1 Skaba, Richard
T1 Abnormalities in pulmonary function in infants with high-risk congenital diaphragmatic hernia
JF Biomedical papers
YR 2015
VO 159
IS 3
SP 497
OP 502
DO 10.5507/bp.2015.040
UL https://biomed.papers.upol.cz/artkey/bio-201503-0026.php
AB Aims: The aim of the study was to analyze lung growth and abnormality of infant pulmonary function tests (IPFT) in congenital diaphragmatic hernia (CDH) survivors younger than three years of age with respect to unfavorable prognostic factors.
Methods: Thirty high-risk CDH survivors at the age of 1.32±0.54 years, body weight 9.76±1.25 kg were examined using IPFT: tidal breathing analysis, baby resistance/compliance, whole baby body plethysmography and rapid thoraco-abdominal compression. Gore-Tex patch was used in 13% of patients (GORE group). Pulmonary hypertension was diagnosed and managed in 13% (iNO group). Standard protocols and appropriate reference values were used and obtained data were statistically analysed.
Results: High incidence of peripheral airway obstruction (70%), increased value of functional residual capacity (FRC&lt;sub&gt;p&lt;/sub&gt;) 191.3±24.5 mL (126.5±36.9 % predicted; P &amp;lt; 0.0005), increased value of effective airway resistance (R&lt;sub&gt;eff&lt;/sub&gt;) 1.71±0.93 kPa.L&lt;sup&gt;-1&lt;/sup&gt;.s (144.4±80.1 % predicted; P &amp;lt; 0.01) and decreased specific compliance of the respiratory system (C&lt;sub&gt;rs&lt;/sub&gt;/kg) 14.1±2.3 mL.kPa.kg&lt;sup&gt;-1&lt;/sup&gt; (i.e., 76.1±20.1 % predicted, P &amp;lt; 0.0005) was noted in infants with CDH in comparison with reference values. Increased value of FRC&lt;sub&gt;p&lt;/sub&gt; was found in GORE group (165.7±51.9 versus 120.4±31.2, P &amp;lt; 0.02) and in iNO group (183.1±52.6 versus 117.8±25.7 mL; P &amp;lt; 0.0005).
Conclusion: A high incidence of peripheral airway obstruction, an increased value of FRC&lt;sub&gt;p&lt;/sub&gt; and decreased specific compliance of the respiratory system was noted in infants with CDH. Unfavorable prognostic factors (Gore-Tex patch, pulmonary hypertension) correlate with more severe alteration of pulmonary function in infants.