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Lung Function in Wheezing Infants after Acute Lower Respiratory Tract Infection and Its Association with Respiratory
Yuan-Yuan Qi1, Gao-Li Jiang1, Li-Bo Wang1
1Department of Respiration, Children's Hospital of Fudan University, Shanghai 201102, China.
Insights
Wheezing infants with acute lower respiratory tract infection show impaired lung function that persists over time. Lower expiratory flow rates are linked to recurrent wheezing and pneumonia, indicating a poor respiratory outcome.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Infant Health
Background:
- Wheezing is a prevalent condition in early childhood, posing significant health challenges.
- Assessing lung function in infants with wheezing is crucial for understanding respiratory health.
- The relationship between lung function and long-term respiratory outcomes in these infants requires further investigation.
Purpose of the Study:
- To evaluate the lung function of infants experiencing wheezing.
- To determine the association between lung function parameters and subsequent respiratory outcomes in wheezing infants.
Main Methods:
- A cohort of infants under 2 years with acute lower respiratory tract infection (ALRTI) underwent lung function testing.
- Infants were categorized into wheeze and no-wheeze groups based on clinical assessment, with healthy infants serving as controls.
- Lung function was assessed during the acute infection phase and at a 3-month follow-up, with a one-year follow-up for ALRTI patients.
Main Results:
- Infants with wheezing exhibited significantly reduced time to peak tidal expiratory flow (TPTEF/TE) and increased peak tidal expiratory flow (PTEF) compared to control and no-wheeze groups.
- These lung function deficits, specifically lower TPTEF/TE and volume to peak tidal expiratory flow (VPTEF/VE), persisted at the 3-month follow-up in the wheeze group.
- A significant inverse correlation was observed between TPTEF/TE, VPTEF/VE, and the incidence of recurrent wheezing and pneumonia.
Conclusions:
- Wheezing infants with ALRTI demonstrate persistent impairments in lung function.
- Reduced TPTEF/TE and VPTEF/VE levels serve as indicators of an increased risk for adverse respiratory outcomes, including recurrent infections.
Background:
Wheezing is common in early childhood and remains an important health concern. The aim of this study was to assess the lung function of wheezing infants and to investigate the relationship between lung function and respiratory outcome.
Methods:
Infants <2 years of age with acute lower respiratory tract infection (ALRTI) who had undergone lung function tests were included in the study. They were assigned to wheeze or no wheeze group based on physical examination. Infants without any respiratory diseases were enrolled as controls. Lung function was measured during the acute phase and 3 months after ALRTI. One-year follow-up for infants with ALRTI was achieved.
Results:
A total of 252 infants with ALRTI who had acceptable data regarding tidal breathing were included in the final analysis. Compared with the control and the no wheeze groups, infants in the wheeze group had significantly decreased time to peak tidal expiratory flow as a percentage of total expiratory time (TPTEF/TE) (20.1 ± 6.4% vs. 34.4 ± 6.2% and 26.4 ± 8.3%, respectively, P < 0.0001) and significantly increased peak tidal expiratory flow (PTEF) (90.7 ± 26.3 ml/s vs. 79.3 ± 18.4 ml/s and 86.1 ± 28.0 ml/s, respectively, P < 0.01), sReff and Reff. The infants in the wheeze group still had lower TPTEF/TE and volume to peak tidal expiratory flow as a percentage of total expiratory volume (VPTEF/VE) than the no wheeze infants 3 months after the ALRTI. Moreover, there was a significant inverse relationship between TPTEF/TE, VPTEF/VE, and the recurrence of wheezing and pneumonia.
Conclusions:
Impaired lung function was present in wheezing infants with ALRTI and the deficits persisted. In addition, the lower level of TPTEF/TE and VPTEF/VE was a risk factor for poor respiratory outcome.
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