Early Lung Function Testing in Infants with Aortic Arch Anomalies Identifies Patients at Risk for Airway ObstructionReportar como inadecuado




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Background

Aortic arch anomalies AAA are rare cardio-vascular anomalies. Right-sided and double-sided aortic arch anomalies RAAA, DAAA are distinguished, both may cause airway obstructions. We studied the degree of airway obstruction in infants with AAA by neonatal lung function testing LFT.

Patients and Methods

17 patients 10 RAAA and 7 DAAA with prenatal diagnosis of AAA were investigated. The median range post conception age at LFT was 40.3 36.6–44.1 weeks, median body weight 3400 2320–4665 g. Measurements included tidal breathing flow-volume loops TBFVL, airway resistance Raw by bodyplethysmography and the maximal expiratory flow at functional residual capacity V′maxFRC by rapid thoracic-abdominal compression RTC technique. V′maxFRC was also expressed in Z-scores, based on published gender-, age and height-specific reference values.

Results

Abnormal lung function tests were seen in both RAAA and DAAA infants. Compared to RAAA infants, infants with DAAA had significantly more expiratory flow limitations in the TBFVL, 86% vs. 30%, p<0.05 and a significantly increased Raw p = 0.015. Despite a significant correlation between Raw and the Z-score of V′maxFRC r = 0.740, p<0.001, there were no statistically significant differences in V′maxFRC and it-s Z-scores between RAAA and DAAA infants. 4 24% infants 2 RAAA, 2 DAAA were near or below the 10th percentile of V′maxFRC, indicating a high risk for airway obstruction.

Conclusion

Both, infants with RAAA and DAAA, are at risk for airway obstruction and early LFT helps to identify and to monitor these infants. This may support the decision for therapeutic interventions before clinical symptoms arise.



Autor: Charles Christoph Roehr , Silke Wilitzki, Bernd Opgen-Rhein, Karim Kalache, Hans Proquitté, Christoph Bührer, Gerd Schmalisch

Fuente: http://plos.srce.hr/



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