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Long-Term Lung Function and Exercise Capacity in Postinfectious chILD

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Long-Term Lung Function and Exercise Capacity in Postinfectious chILD

Auteurs : Yagmur Sisman ; Frederik F. Buchvald ; Astrid Madsen Ring ; Katharina Wassilew ; Kim Gjerum Nielsen

Source :

Pediatric Allergy, Immunology, and Pulmonology [ 2151-321X ] ; 2019.

RBID : PMC:6484343

Abstract

Background: Severe postinfectious diffuse pulmonary disease may clinically mimic other entities of children's interstitial lung disease and is clinically challenging comprising various disease severities despite treatment. Long-term lung function trend and physical capacity in children with postinfectious diffuse pulmonary disease are rarely reported. We investigated trends in pulmonary function by long-term follow-up and assessed physical capacity in such patients.

Methods: We performed a descriptive, single-center follow-up study in children with biopsy-verified postinfectious diffuse pulmonary disease. Patients with completed primary treatment course were eligible for follow-up, including pulmonary function and exercise (VO_2peak) testing.

Results: Thirty patients with postinfectious diffuse pulmonary disease were identified and included. Median (range) age at diagnose was 27.5 (2–172) months after a mean lag time of 23 months. H. influenzae and rhinovirus were the most frequent pathogens. Fifteen patients were available for follow-up after mean (range) 7.6 (2–15) years of treatment completion. Lung clearance index (LCI_2.5), forced expiratory volume in 1 second (FEV₁), and bronchodilator responsiveness were abnormal in 80%, 53%, and 44%, respectively. Diffusion capacity for monoxide was abnormal in 7% and total lung capacity in 33%. Only 8% demonstrated low VO_2peak, while 40% reported difficulties during physical exertion. Longitudinal data on spirometry (n = 14) remained unchanged from end of treatment throughout follow-up. A significant association was found between zLCI_2.5 and zFEV₁ (multiple linear regression; r² = 0.61; P = 0.0003).

Conclusion: Postinfectious diffuse pulmonary disease in children carries a varying degree of chronic pulmonary impairment with onset of symptoms in the first months of life and a typical considerable lag time before diagnosis. Follow-up several years after the initial injury demonstrated moderate-to-severe peripheral airway impairment although no further lung function decline was found years after completion of treatment. Despite acceptable VO_2peak, a considerable proportion struggled during heavy exercise.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484343

DOI: 10.1089/ped.2018.0973
PubMed: 31032143
PubMed Central: 6484343

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PMC:6484343

Le document en format XML

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<author><name sortKey="Sisman, Yagmur" sort="Sisman, Yagmur" uniqKey="Sisman Y" first="Yagmur" last="Sisman">Yagmur Sisman</name>
<affiliation><nlm:aff id="aff1"></nlm:aff>
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<author><name sortKey="Buchvald, Frederik F" sort="Buchvald, Frederik F" uniqKey="Buchvald F" first="Frederik F." last="Buchvald">Frederik F. Buchvald</name>
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<author><name sortKey="Ring, Astrid Madsen" sort="Ring, Astrid Madsen" uniqKey="Ring A" first="Astrid Madsen" last="Ring">Astrid Madsen Ring</name>
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<author><name sortKey="Wassilew, Katharina" sort="Wassilew, Katharina" uniqKey="Wassilew K" first="Katharina" last="Wassilew">Katharina Wassilew</name>
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<author><name sortKey="Nielsen, Kim Gjerum" sort="Nielsen, Kim Gjerum" uniqKey="Nielsen K" first="Kim Gjerum" last="Nielsen">Kim Gjerum Nielsen</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Long-Term Lung Function and Exercise Capacity in Postinfectious chILD</title>
<author><name sortKey="Sisman, Yagmur" sort="Sisman, Yagmur" uniqKey="Sisman Y" first="Yagmur" last="Sisman">Yagmur Sisman</name>
<affiliation><nlm:aff id="aff1"></nlm:aff>
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<author><name sortKey="Buchvald, Frederik F" sort="Buchvald, Frederik F" uniqKey="Buchvald F" first="Frederik F." last="Buchvald">Frederik F. Buchvald</name>
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<author><name sortKey="Ring, Astrid Madsen" sort="Ring, Astrid Madsen" uniqKey="Ring A" first="Astrid Madsen" last="Ring">Astrid Madsen Ring</name>
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<author><name sortKey="Wassilew, Katharina" sort="Wassilew, Katharina" uniqKey="Wassilew K" first="Katharina" last="Wassilew">Katharina Wassilew</name>
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<author><name sortKey="Nielsen, Kim Gjerum" sort="Nielsen, Kim Gjerum" uniqKey="Nielsen K" first="Kim Gjerum" last="Nielsen">Kim Gjerum Nielsen</name>
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<series><title level="j">Pediatric Allergy, Immunology, and Pulmonology</title>
<idno type="ISSN">2151-321X</idno>
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<front><div type="abstract" xml:lang="en"><p><bold><italic>Background:</italic>
</bold>
 Severe postinfectious diffuse pulmonary disease may clinically mimic other entities of children's interstitial lung disease and is clinically challenging comprising various disease severities despite treatment. Long-term lung function trend and physical capacity in children with postinfectious diffuse pulmonary disease are rarely reported. We investigated trends in pulmonary function by long-term follow-up and assessed physical capacity in such patients.</p>
<p><bold><italic>Methods:</italic>
</bold>
 We performed a descriptive, single-center follow-up study in children with biopsy-verified postinfectious diffuse pulmonary disease. Patients with completed primary treatment course were eligible for follow-up, including pulmonary function and exercise (VO<sub>2peak</sub>
) testing.</p>
<p><bold><italic>Results:</italic>
</bold>
 Thirty patients with postinfectious diffuse pulmonary disease were identified and included. Median (range) age at diagnose was 27.5 (2–172) months after a mean lag time of 23 months. <italic>H. influenzae</italic>
 and <italic>rhinovirus</italic>
 were the most frequent pathogens. Fifteen patients were available for follow-up after mean (range) 7.6 (2–15) years of treatment completion. Lung clearance index (LCI<sub>2.5</sub>
), forced expiratory volume in 1 second (FEV<sub>1</sub>
), and bronchodilator responsiveness were abnormal in 80%, 53%, and 44%, respectively. Diffusion capacity for monoxide was abnormal in 7% and total lung capacity in 33%. Only 8% demonstrated low VO<sub>2peak</sub>
, while 40% reported difficulties during physical exertion. Longitudinal data on spirometry (<italic>n</italic>
 = 14) remained unchanged from end of treatment throughout follow-up. A significant association was found between zLCI<sub>2.5</sub>
 and zFEV<sub>1</sub>
 (multiple linear regression; <italic>r</italic>
<sup>2</sup>
 = 0.61; <italic>P</italic>
 = 0.0003).</p>
<p><bold><italic>Conclusion:</italic>
</bold>
 Postinfectious diffuse pulmonary disease in children carries a varying degree of chronic pulmonary impairment with onset of symptoms in the first months of life and a typical considerable lag time before diagnosis. Follow-up several years after the initial injury demonstrated moderate-to-severe peripheral airway impairment although no further lung function decline was found years after completion of treatment. Despite acceptable VO<sub>2peak</sub>
, a considerable proportion struggled during heavy exercise.</p>
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Long-Term Lung Function and Exercise Capacity in Postinfectious chILD

Long-Term Lung Function and Exercise Capacity in Postinfectious chILD

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Abstract

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