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Impaired respiratory function in infants with anterior abdominal wall defects
P J Thompson1, A Greenough, E Dykes
1Department of Child Health, King's College Hospital, London, England.
Insights
Infants with anterior abdominal wall defects, including gastroschisis and exomphalos, show reduced respiratory function. This suggests potential impaired lung growth during fetal development in these neonates.
Area of Science:
- Pediatric Surgery
- Neonatal Respiratory Physiology
- Developmental Biology
Background:
- Anterior abdominal wall defects (AAWDS) like gastroschisis and exomphalos require surgical repair in neonates.
- Postnatal respiratory function in infants with AAWDS is not well-characterized.
Purpose of the Study:
- To assess respiratory function in infants following surgical repair of AAWDS.
- To compare respiratory function between infants with gastroschisis and exomphalos.
- To identify potential long-term respiratory implications of AAWDS.
Main Methods:
- Respiratory function was evaluated by measuring functional residual capacity (FRC) in 13 infants (6 exomphalos, 7 gastroschisis) at a median age of 5 months.
- Infant FRC measurements were compared to a control group of 50 healthy infants.
Main Results:
- The mean FRC in infants with AAWDS (25 mL/kg) was significantly lower than in healthy controls (30 mL/kg).
- No significant difference in FRC was observed between infants with gastroschisis and exomphalos.
- Five infants with AAWDS had FRC below the normal range's 95% confidence limit.
Conclusions:
- Infants with AAWDS may experience impaired lung growth before birth.
- Reduced FRC in this cohort suggests potential long-term respiratory compromise.
- Further research is warranted to explore antenatal factors affecting lung development in AAWDS.
Abstract:
Respiratory function at follow-up was assessed in 13 infants who had undergone surgical repair of an anterior abdominal wall defect. Six infants had exomphalos and seven had gastroschisis. The infants were delivered at a median gestational age of 36 weeks (range, 32 to 38 weeks). Respiratory function was assessed by measurement of functional residual capacity (FRC) at a median postnatal age of 5 months (range, 1 to 10 months). Although there was no significant difference in the FRC of the infants with gastroschisis compared with those with exomphalos, the study group's mean FRC (25 mL/kg) was significantly lower than that of 50 healthy control infants (mean, 30 mL/kg; 95% CI, +/- 6 mL/kg). Five infants had an FRC below the 95% confidence limit of the normal range. These data suggest that infants with anterior abdominal wall defects may have impaired antenatal lung growth.