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Diaphragmatic flutter in three babies with bronchopulmonary dysplasia and respiratory syncytial virus bronchiolitis
J A Adams1, I A Zabaleta, M A Sackner
1Mount Sinai Medical Center, Division of Neonatology, Miami Beach, FL 33140, USA.
Insights
Respiratory syncytial virus (RSV) infection in infants can cause abnormal breathing. This study identifies diaphragmatic flutter (DF), a new respiratory control abnormality, in infants with RSV infection.
Area of Science:
- Pediatrics
- Neonatology
- Respiratory Medicine
Background:
- Infants with respiratory syncytial virus (RSV) infections are known to experience respiratory control abnormalities, particularly apnea.
- Diaphragmatic flutter (DF) has not been previously reported in infants with RSV infection.
Purpose of the Study:
- To report the first occurrence of diaphragmatic flutter (DF) as a novel respiratory control abnormality in infants diagnosed with respiratory syncytial virus (RSV) infection.
Main Methods:
- Respiratory inductive plethysmography was utilized to monitor infants for apnea.
- Diaphragmatic flutter (DF) was incidentally detected during monitoring in infants presenting with typical RSV clinical symptoms.
Main Results:
- Diaphragmatic flutter (DF) presented as intermittent, high-frequency diaphragmatic contractions.
- Episodes of DF lasted a maximum of 4 days and did not correlate with changes in arterial oxygen saturation or heart rate.
- All infants were discharged without DF, and no recurrences were observed during a 12-month follow-up period.
Conclusions:
- Diaphragmatic flutter (DF) is a newly identified, transient respiratory control abnormality associated with respiratory syncytial virus (RSV) infection in infants.
- DF appears to be a benign condition in this context, resolving spontaneously without lasting impact on infant health.
- Further research may be warranted to understand the mechanisms and prevalence of DF in pediatric respiratory infections.
Abstract:
Abnormalities of respiratory control, especially apnea, have been reported previously in infants with respiratory syncytial virus (RSV) infections. This is the first report of yet another abnormality of respiratory control, diaphragmatic flutter (DF), in infants with RSV infection. The presentation of these infants did not differ from the usual clinical presentation of RSV infection. While being monitored with respiratory inductive plethysmography for occurrences of apnea known to be common in RSV infection, DF was detected. This abnormality consisted of high frequency, diaphragmatic contractions which were intermittent in nature. They lasted no more than 4 days and were not associated with change in arterial oxygen saturation or heart rate. These infants were discharged free of DF and no further episodes have been observed over a 12-month period.