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Early lung function testing in infants with aortic arch anomalies identifies patients at risk for airway obstruction

Charles Christoph Roehr1, Silke Wilitzki, Bernd Opgen-Rhein

  • 1Department of Neonatology, Charité Universitätsmedizin Berlin, Berlin, Germany. christoph.roehr@charite.de

Plos One
|October 4, 2011
PubMed

Insights

Infants with aortic arch anomalies (AAA) face airway obstruction risks. Neonatal lung function testing (LFT) effectively identifies and monitors these risks in infants with right-sided (RAAA) and double-sided (DAAA) aortic arch anomalies.

Area of Science:

  • Pediatric Cardiology
  • Respiratory Medicine
  • Medical Imaging

Background:

  • Aortic arch anomalies (AAA) are rare cardiovascular conditions.
  • Right-sided (RAAA) and double-sided (DAAA) aortic arch anomalies can lead to airway obstruction in infants.
  • Neonatal lung function testing (LFT) is utilized to assess airway obstruction in infants with AAA.

Purpose of the Study:

  • To investigate the degree of airway obstruction in infants diagnosed with aortic arch anomalies (AAA).
  • To evaluate the utility of neonatal lung function testing (LFT) in identifying and monitoring airway obstruction in infants with RAAA and DAAA.

Main Methods:

  • Seventeen infants (10 RAAA, 7 DAAA) with prenatal AAA diagnosis underwent LFT.
  • Measurements included tidal breathing flow-volume loops (TBFVL), airway resistance (R(aw)) via bodyplethysmography, and maximal expiratory flow (V'(max)FRC) using rapid thoracic-abdominal compression.
  • V'(max)FRC was analyzed using Z-scores relative to normative data.

Main Results:

  • Abnormal LFT findings were present in both RAAA and DAAA infants.
  • DAAA infants showed significantly more expiratory flow limitations and increased R(aw) compared to RAAA infants.
  • While R(aw) correlated with V'(max)FRC Z-scores, no significant difference in V'(max)FRC Z-scores was found between RAAA and DAAA groups. Four infants (24%) were at high risk for airway obstruction.

Conclusions:

  • Infants with both RAAA and DAAA are susceptible to airway obstruction.
  • Early LFT is crucial for identifying and monitoring these infants.
  • This monitoring can guide therapeutic interventions before the onset of clinical symptoms.
Abstract

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