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Lung function in children following empyema
G J Redding1, L Walund, D Walund
1Department of Pediatrics, University of Washington School of Medicine, Seattle 98195.
Insights
Children recovering from empyema (pleural infection) may experience mild airway obstruction, impacting lung function. This study found no restrictive changes but identified obstructive abnormalities in half of the participants.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Respiratory Medicine
Background:
- Empyema, a serious pleural infection, can affect lung development and function in children.
- Understanding the long-term respiratory sequelae of childhood empyema is crucial for effective management.
- Previous studies have indicated potential impacts on lung function, but data on mild obstructive changes are less defined.
Purpose of the Study:
- To evaluate the impact of childhood empyema on subsequent lung function and exercise response.
- To compare lung function outcomes in children treated with and without chest tube drainage.
- To identify the prevalence of restrictive and obstructive spirometric abnormalities post-empyema.
Main Methods:
- Spirometry and exercise response testing were conducted in 15 children post-recovery from empyema.
- Participants were categorized based on treatment: chest tube drainage versus no chest tube drainage.
- Lung function parameters, including forced expiratory volume in 1 second (FEV1) and forced expiratory flow (FEF), were analyzed.
Main Results:
- No children exhibited restrictive spirometric changes (total lung capacity or vital capacity <80% predicted).
- Seven out of 15 children (47%) showed mild airway obstruction (FEV1 <80% or FEF <75% predicted).
- Obstructive abnormalities were found equally in children treated with or without chest tubes, with no reduced exercise tolerance observed.
Conclusions:
- Childhood empyema can lead to mild, often asymptomatic, obstructive lung function abnormalities.
- Chest tube drainage did not appear to influence the frequency of these mild obstructive changes.
- Further research is warranted to understand the long-term clinical significance of these findings in pediatric populations.
Abstract:
Spirometry was performed and response to exercise was measured in 15 children following recovery from empyema to evaluate the impact of pleural infection on subsequent lung function. Seven children underwent chest tube drainage; eight did not. The two groups were similar in age (mean +/- SD, 6 +/- 5 years), sex distribution, bacterial pathogen-producing empyema, and age at follow-up evaluation (12 +/- 5 years). Only one child reported recurrent respiratory symptoms. No child had restrictive spirometric changes (total lung capacity, less than 80%; vital capacity, less than 80% predicted) but seven of 15 had a reduced forced expiratory volume in 1 second (less than 80% predicted) or forced expiratory flow during the middle half of the vital capacity (less than 75% predicted), suggesting mild airway obstruction. No child demonstrated reduced exercise tolerance due to restrictive ventilatory limitations. Mild obstructive abnormalities in lung function were identified with equal frequency in children treated with and without chest tube drainage.