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Respiratory problems 2 years after acute bronchiolitis in infancy
Insights
Many children experience persistent respiratory symptoms and variable airway obstruction for years after acute bronchiolitis. Lung function tests reveal significant hyperinflation and reversible airway issues in a substantial portion of these young patients.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Pediatrics
Background:
- Acute bronchiolitis is a common childhood respiratory infection.
- Long-term respiratory sequelae after bronchiolitis are not fully understood.
Purpose of the Study:
- To evaluate the clinical progress and lung function in children 2 years post-hospitalization for acute bronchiolitis.
- To identify factors associated with persistent respiratory symptoms and airway obstruction.
Main Methods:
- Prospective follow-up of 55 children admitted with acute bronchiolitis.
- Lung function tests, including assessment of hyperinflation and airway reversibility to salbutamol, performed on 40 children at 2 years.
- Clinical assessment of respiratory symptoms and hospital readmissions.
Main Results:
- 75% of children experienced wheezing, and 36% had recurrent lower respiratory symptoms within 2 years.
- 60% showed hyperinflation on lung function tests, with evidence of variable airway obstruction.
- Nine children demonstrated reversible airway obstruction after salbutamol, correlating with higher baseline airway resistance.
- Higher airway resistance was observed in children with a family history of atopy.
Conclusions:
- Children hospitalized for acute bronchiolitis frequently experience persistent respiratory symptoms and abnormal lung function, including hyperinflation and variable airway obstruction, for up to two years.
- Airway hyperresponsiveness to bronchodilators may occur in a subset of these children.
- Family history of atopy may be associated with increased airway resistance post-bronchiolitis.
Abstract:
We assessed the clinical progress of 55 children 2 years after admission to hospital with acute bronchiolitis and performed lung function tests on 40. During the 2 year follow up period 75% of the children had wheezed, 36% had 2 or more lower respiratory symptoms lasting more than 2 weeks, 33% had more than 100 days of lower respiratory symptoms, and 13% were readmitted to hospital with acute respiratory disease. In addition 60% of the children were hyperinflated on lung function tests. Many of the children with hyperinflation at the 2 year assessment had not been hyperinflated 1 year earlier, suggesting variable airways obstruction. Reversibility of airways obstruction was also assessed by response to nebulised salbutamol. Nine children had a fall greater than 15% in airways resistance after salbutamol and these children had the highest baseline airways resistances. Airways resistance was higher in the children with a family history of atopy.