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Lung function in infants with chronic pulmonary disease after severe adenoviral illness
A M Teper1, C D Kofman, A F Maffey
1Respiratory Center, Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina.
Insights
Children with chronic pulmonary disease (CPD) following adenoviral infection show significant lung function changes, including severe obstruction and reduced lung distensibility. These changes were not improved by bronchodilator treatments.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Infectious Diseases
Background:
- Severe adenoviral lower respiratory tract infections can lead to chronic pulmonary disease (CPD) in young children.
- Understanding the long-term pulmonary sequelae of such infections is crucial for effective management.
- Previous studies have not fully characterized the specific pulmonary function deficits and bronchodilator responses in this vulnerable population.
Purpose of the Study:
- To evaluate pulmonary function in young children diagnosed with chronic pulmonary disease (CPD) subsequent to a severe adenoviral lower respiratory tract infection.
- To assess the response of these pulmonary function abnormalities to bronchodilator medications, specifically ipratropium bromide and albuterol.
Main Methods:
- Pulmonary function tests were conducted on 13 young children (mean age 1.32 years) with CPD.
- A control group of 13 healthy infants (mean age 1.16 years) was included for comparison.
- Key respiratory parameters including respiratory rate, airflow rates (PTEF, V'maxFRC), lung mechanics (compliance, resistance), and bronchodilator responses were measured.
Main Results:
- Children with CPD exhibited significantly altered respiratory rate, peak tidal expiratory flow (PTEF), PTEF/tidal volume ratio, and lung mechanics (compliance and resistance).
- Maximal flow at functional residual capacity (V'maxFRC) was markedly reduced in the CPD group (56.0 mL/s) compared to controls (373 mL/s; P=.001).
- No significant improvements in pulmonary function were observed after administration of ipratropium bromide or albuterol in the CPD group.
Conclusions:
- Young children with CPD resulting from severe adenoviral infections present with significant pulmonary function impairment, notably severe airflow obstruction and decreased lung distensibility.
- The observed pulmonary function abnormalities in these children are not responsive to inhaled ipratropium bromide or albuterol.
- These findings highlight the persistent nature of lung damage post-adenoviral infection and the limited efficacy of standard bronchodilators in this context.
Objective:
To evaluate pulmonary function and bronchodilator responses in young children with chronic pulmonary disease (CPD) after a severe adenoviral lower respiratory tract infection.
Methods:
Pulmonary function tests were performed in 13 patients (mean age, 1.32 +/- 0.8 years) with CPD and were compared with a control group of 13 healthy infants (mean age, 1.16 +/- 0.4 years).
Results:
Respiratory rate, peak tidal expiratory flow (PTEF), PTEF/tidal volume, absolute time up to PTEF, time percentage to PTEF, volume percentage for PTEF, and compliance and resistance of the respiratory system were significantly affected in the CPD group. Similarly, maximal flow at functional residual capacity (V'maxFRC) was 56.0 +/- 42 mL/s and 373 +/- 107 mL/s in the CPD and control groups, respectively (P =.001). No within-group differences with baseline values or between-group differences were noted in response to treatment with ipratropium bromide or albuterol.
Conclusion:
Young children with CPD caused by adenovirus have pulmonary function changes characterized by severe obstruction and diminished lung distensibility not responsive to the administration of inhaled ipratropium bromide or albuterol.