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Long‐term pulmonary function in esophageal atresia—A case‐control study
Author(s) -
Pedersen Rikke N.,
Markøw Simone,
KruseAndersen Søren,
Qvist Niels,
Gerke Oke,
Husby Steffen,
Agertoft Lone
Publication year - 2017
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.23477
Subject(s) - medicine , spirometry , vital capacity , pulmonary function testing , lung volumes , restrictive lung disease , cardiology , lung , gastroenterology , asthma , diffusing capacity , lung function
Summary Background Esophageal atresia (EA) is a congenital anomaly associated with substantial pulmonary morbidity throughout childhood. Aim The aim of this study was to evaluate pulmonary complications among 59 five to 15‐year‐old children and adolescents with surgically corrected congenital EA. Methods Participants underwent a structured interview, spirometry, body plethysmography, mannitol challenge test, skin prick test, as well as measurements of the diffusion capacity, airway resistance, fraction of exhaled NO, and specific immunoglobulin E in serum. A control group consisted of 25 children being evaluated for gastroesophageal reflux disease. Results Among the EA patients 33 (55.9%) had respiratory symptoms, 31 (53.4%) had a history of at least three pneumonias, and 32 (54.2%) reported more frequent cough episodes than peers. The Forced Vital Capacity (FVC) was 84.9% ± 13.2% of predicted, forced expiratory volume 1 sec (FEV1) was 78.2% ± 12.4% of predicted, and forced expiratory fraction 25–75% (FEF25–75%) was 71.5 ± 17.8% of predicted in EA patients, lower than disease controls ( P < 0.0001 for all). In addition, the total lung capacity (TLC) was lower in patients with EA than in the controls ( P < 0.0001). Fifteen patients (28.8%) with EA had obstructive ventilatory impairment, compared to nine patients (17.3%) with restrictive ventilatory impairment, while one had a combination. Conclusions The present study demonstrated significantly decreased pulmonary characteristics in EA patients. Restrictive ventilatory impairment occurring in EA is probably due to poor lung growth after thoracotomy. No single factor predicted ventilatory impairment in children and adolescents with EA. Pediatr Pulmonol. 2017;52:98–106. © 2016 Wiley Periodicals, Inc.