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Clinical correlations and pulmonary function at 8 years of age after severe neonatal respiratory failure
Author(s) -
Majaesic Carina M.,
Jones Richard,
Dinu Irina A.,
Montgomery Mark D.,
Sauve Reginald S.,
Robertson Charlene M.T.
Publication year - 2007
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20663
Subject(s) - medicine , pulmonary function testing , spirometry , vital capacity , extracorporeal membrane oxygenation , lung volumes , respiratory failure , congenital diaphragmatic hernia , gestational age , prospective cohort study , lung , pregnancy , diffusing capacity , asthma , fetus , lung function , biology , genetics
Abstract Objectives: The aim of this study was to determine the pulmonary sequelae of severe neonatal respiratory failure. Study Design: This was a multicenter, prospective study. Fifty‐four survivors of neonatal respiratory failure (oxygenation indices >25 on two occasions), completed pulmonary function testing at 8 years of age. Thirty‐one (57%) received extracorporeal membrane oxygenation (ECMO). Pulmonary outcome was based on spirometry and lung volume data. Pulmonary outcome for each diagnostic and treatment group is reported as mean and as percent predicted. Individually subjects were also classified based on spirometry, as either normal, obstructed (defined as forced expiratory volume (FEV 1 ) in 1 sec:forced vital capacity (FVC) of <80 % predicted, or with reduced FVC (FCV of <80% predicted) with normal FEV 1 /FVC. Risk for adverse outcome was determined using univariate analysis. Results: Mean FVC, FEV 1 and FEV 25–75 were reduced in the total cohort. The reduction was greatest in the subgroup with CDH and the group treated with ECMO. Assessed individually, 54% of subjects had normal spirometry and lung volumes, 19% airflow obstruction, and 27% reduced FVC. Poorer pulmonary outcome was linked to ECMO, congenital diaphragmatic hernia (CDH), birth weight for gestational age <10th percentile, duration of hospitalization, or need for prolonged supplemental oxygen. Conclusion: Neonates with severe respiratory failure due to CDH or needing ECMO and small for gestation are at increased risk of poorer pulmonary outcome and require close follow‐up. Pediatr Pulmonol. 2007; 42:829–837. © 2007 Wiley‐Liss, Inc.