Pulmonary function in hospitalized infants and toddlers with cystic fibrosis

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Abstract

Objectives

(1) To test the hypothesis that improvement in lung function occurs in infants and toddlers hospitalized because of CF pulmonary exacerbations. (2) To compare changes in lung function measured during forced expiratory flow and tidal breathing.

Study design

Seventeen infants and toddlers with CF were evaluated at the beginning and end of hospitalization by the rapid thoracic compression technique to yield maximal flow at forced residual capacity. Tidal mechanics were measured by the esophageal balloon technique to yield lung conductance and compliance.

Results

Lung function improved during the course of hospitalization. The greatest change was observed in measurements of maximal flow at functional residual capacity (Vmax FRC), increasing from 38.5% +/- 6% predicted (mean +/- SEM) to 59.8% +/- 6% at the end (p < 0.005). Lung conductance (GL) increased from 60% +/- 6% to 78% +/- 8% (p < 0.02); lung compliance (CL) increased from 66% +/- 5% to 75% +/- 5% (p < 0.03). The degree of improvement of Vmax FRC, GL, and CL was related to baseline measurements; those with poorer pulmonary function at baseline had the greatest degree of improvement during hospitalization.

Conclusion

Assessments of airflow obstruction from measurements of V sub max FRC and GL do not necessarily demonstrate similar findings in a given infant with CF, perhaps because these two techniques measure different physiologic properties. Changes in Vmax FRC may best reflect the predominant pathophysiology of lung disease in infants and toddlers with CF. (J Pediatr 1998;132:405-8)

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