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Growth in post-viral chronic lung disease
Mariana del Pino1, Gabriela Bauer, Hebe González Pena
1Growth and Development, Garrahan Hospital, Combate de los Pozos 1881 (1245), Buenos Aires, Argentina. mdelpino@garrahan.gov.ar
Insights
Children with post-viral chronic lung disease (PVCLD) show varied growth patterns, but most achieve satisfactory outcomes. Chronic hypercapnia is linked to slower growth in these pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Child Health
Background:
- Adenovirus infections can lead to chronic lung disease (CLD) in infants.
- Post-viral chronic lung disease (PVCLD) impacts children's long-term respiratory health.
- Understanding growth patterns in PVCLD is crucial for managing chronic respiratory conditions in children.
Purpose of the Study:
- To describe height and weight growth in children diagnosed with PVCLD.
- To investigate associations between growth and factors like mechanical ventilation, chronic hypercapnia, home oxygen therapy, and steroid use.
- To analyze growth trajectories and identify risk factors for impaired growth in pediatric PVCLD.
Main Methods:
- A cohort of 99 patients with PVCLD and over one year of follow-up was studied.
- Median follow-up duration was 3.10 years, with a median age at disease onset of 0.50 years.
- Growth patterns were categorized, and associations with clinical variables were statistically analyzed.
Main Results:
- Growth in height was categorized into normal (Type A, 48 children) and slow growth (Type B, 50 children), with most experiencing catch-up growth.
- Chronic hypercapnia was identified as a significant risk factor for slow growth (OR: 5.03; 95% CI: 1.83/13.83).
- Higher weight-for-height ratios during slow growth correlated with greater subsequent height gains (r=0.46).
Conclusions:
- Growth in children with PVCLD is heterogeneous but generally satisfactory for most individuals.
- Chronic hypercapnia is a key factor associated with slower growth trajectories in pediatric PVCLD.
- These findings highlight the importance of monitoring and managing hypercapnia to optimize growth in children with post-viral chronic lung disease.
Introduction:
Acute lower respiratory infection due to adenovirus is an important cause of chronic lung disease (CLD) in infants. The objectives of this paper is to describe growth in the height and weight of children with post-viral chronic lung disease (PVCLD) and to relate it with associated variables (invasive mechanical ventilation, chronic hypercapnia, oxygen therapy at home and steroid treatment).
Materials And Methods:
Ninety-nine patients with diagnosis of PVCLD with one or more years of follow-up were included in the study. The median duration of follow-up was 3.10 years. The median age at onset of the disease was 0.50 years.
Results:
According to the growth in height, there were 48 children with normal growth (Type A) and 50 with slow growth (Type B) followed by catch-up growth (N=45) or normal growth velocity (N=5); only one patient showed persistent slow growth. Chronic hypercapnia was a risk factor significantly associated to slow growth, with odds ratio, OR: 5.03; and 95% confidence interval, CI: 1.83/13.83. Patients with higher weight for height at the end of the slow-growth period showed greater gains in height during the following period (r=0.46).
Conclusion:
Growth in children with PVCLD is heterogeneous but, in the majority of individual cases, it can be considered satisfactory. Chronic hypercapnia was associated with slow growth.
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