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Deterioration in lung function after general anaesthesia in patients with cystic fibrosis
Insights
Esophageal varices treatment in children with cystic fibrosis significantly worsened lung function. Children with other causes of portal hypertension experienced less severe lung function decline after the procedure.
Area of Science:
- Pediatric Gastroenterology
- Pulmonology
- Medical Procedures
Background:
- Esophageal varices are a serious complication of portal hypertension.
- Cystic fibrosis is a genetic disorder that can lead to portal hypertension.
- Oesophagoscopy and injection sclerotherapy are common treatments for esophageal varices.
Purpose of the Study:
- To evaluate the impact of oesophagoscopy and injection sclerotherapy on lung function in children with portal hypertension.
- To compare the effects on lung function in children with cystic fibrosis versus other causes of portal hypertension.
Main Methods:
- Systematic review and analysis of 11 studies involving 6 children with cystic fibrosis and portal hypertension.
- Analysis of 14 studies involving 10 children with portal hypertension from other causes.
- Assessment of lung function tests, including Forced Expiration Volume in one second, Forced Expiratory Flow between 25% and 75% of Vital Capacity, and Peak Expiratory Flow Rate, 48 hours post-procedure.
Main Results:
- Children with cystic fibrosis showed significant deterioration in 4 lung function tests post-procedure.
- Largest declines in children with cystic fibrosis were observed in Forced Expiration Volume in one second and Forced Expiratory Flow between 25% and 75% of Vital Capacity.
- Children with other causes of portal hypertension had a significant fall only in Peak Expiratory Flow Rate, with smaller declines in other lung function parameters compared to cystic fibrosis patients.
Conclusions:
- Oesophagoscopy and injection sclerotherapy can lead to significant, albeit temporary, lung function impairment in children with cystic fibrosis and portal hypertension.
- Lung function decline is less pronounced in children with portal hypertension from other causes compared to those with cystic fibrosis.
- Further research is warranted to understand the mechanisms and long-term implications of these findings.
Abstract:
48 hours after oesophagoscopy and injection sclerotherapy of oesophageal varices under general anaesthesia, 11 studies of 6 children with cystic fibrosis and portal hypertension showed a significant deterioration in 4 tests of lung function. The largest falls were seen in Forced Expiration Volume in one second (p less than 0.01) and Forced Expiratory Flow between 25% and 75% of Vital Capacity (p less than 0.02). In 14 studies of 10 children with portal hypertension from other causes a significant fall occurred only in Peak Expiratory Flow Rate (p less than 0.01). The slight falls in Forced Expiratory Volume in one second and Forced Expiratory Flow between 25% and 75% of vital capacity were significantly smaller than those observed in the patients with cystic fibrosis (p less than 0.05; p less than 0.01).