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Serial lung volume measurements during the perinatal period in infants with abdominal wall defects
B Laubscher1, A Greenough, G Dimitriou
1Department of Child Health, Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, England.
Insights
Infants with abdominal wall defects often have low lung volumes (functional residual capacity, FRC) before surgery. Surgical repair temporarily worsens lung function, suggesting abnormal prenatal lung development.
Area of Science:
- Neonatal physiology
- Pediatric surgery
- Respiratory medicine
Background:
- Abdominal wall defects (AWDs) are congenital conditions impacting infant development.
- Pulmonary function in neonates with AWDs requires further investigation.
- Understanding lung development in AWDs is crucial for clinical management.
Purpose of the Study:
- To assess lung volumes in infants with abdominal wall defects.
- To evaluate the impact of surgical intervention on lung function.
- To explore potential links between AWDs and antenatal lung growth.
Main Methods:
- Daily measurements of functional residual capacity (FRC) were performed.
- The study included eight infants with abdominal wall defects (median gestational age 37 weeks).
- Measurements were taken during the perinatal period, before and after surgical repair.
Main Results:
- Four infants presented with FRC below the reference range preoperatively.
- Low lung volumes were not significantly correlated with gestational age or diagnosis.
- Surgical closure temporarily reduced median FRC from 25 mL/kg to 12 mL/kg (P < .02).
Conclusions:
- Data suggest abnormal antenatal lung growth in infants with AWDs.
- Postnatal lung function is significantly affected by surgical repair.
- These findings highlight the complex interplay between AWDs and respiratory development.
Methods:
Daily measurements of lung volume (functional residual capacity, FRC) were made during the perinatal period in eight infants (median gestational age, 37 weeks; range, 34 to 38 weeks) with abdominal wall defects.
Results:
On the first day of life and before surgical intervention, four infants had FRCs below the reference range; the occurrence of low lung volumes was not significantly related to gestational age or diagnosis. Lung volume was further, but only temporarily, impaired by surgical closure of the abdominal wall defect, with a reduction in the median FRC from 25 mL/kg (range, 18 to 36) preoperatively to 12 mL/kg (range, 5 to 19) on the first postoperative day (P < .02).
Conclusion:
These data are consistent with abnormal antenatal lung growth in certain infants with abdominal wall defects.