Early Lung Function Testing in Infants with Aortic Arch Anomalies Identifies Patients at Risk for Airway Obstruction 英文参考文献.docVIP

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Early Lung Function Testing in Infants with Aortic Arch Anomalies Identifies Patients at Risk for Airway Obstruction 英文参考文献.doc

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Early Lung Function Testing in Infants with Aortic Arch Anomalies Identifies Patients at Risk for Airway Obstruction 英文参考文献

EarlyLungFunctionTestinginInfantswithAorticArch AnomaliesIdentifiesPatientsatRiskforAirway Obstruction CharlesChristophRoehr1*,SilkeWilitzki1,BerndOpgen-Rhein2,KarimKalache3,HansProquitte′1, ChristophBu¨hrer1,GerdSchmalisch1 1Department of Neonatology, Charite′ Universita¨tsmedizin Berlin, Berlin, Germany, 2Department of Paediatric Cardiology, Charite′ Universita¨tsmedizin Berlin, Berlin, Germany,3DepartmentofObstetricsandPrenatalMedicine,Charite′ Universita¨tsmedizin Berlin,Berlin,Germany Abstract 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 obstructionininfantswithAAAbyneonatallungfunctiontesting(LFT). PatientsandMethods:17patients(10RAAAand7DAAA)withprenataldiagnosisofAAAwereinvestigated.Themedian (range)postconceptionageatLFTwas40.3(36.6–44.1)weeks,medianbodyweight3400(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 (V9maxFRC) by rapid thoracic-abdominal compression (RTC) technique. V9maxFRCwasalsoexpressedinZ-scores,basedonpublishedgender-,ageandheight-specificreferencevalues. Results:AbnormallungfunctiontestswereseeninbothRAAAandDAAAinfants.ComparedtoRAAAinfants,infantswith DAAAhadsignificantlymoreexpiratoryflowlimitationsintheTBFVL,(86%vs.30%,p,0.05)andasignificantlyincreased Raw(p=0.015).DespiteasignificantcorrelationbetweenRawandtheZ-scoreofV9maxFRC(r=0.740,p,0.001),therewere no statistically significant differences in V9maxFRC and it’s Z-scores between RAAA and DAAA infants. 4 (24%) infants (2 RAAA,2DAAA)werenearorbelowthe10thpercentileofV9maxFRC,indicatingahighriskforairwayobstruction. Conclusion:Both,infantswithRAAAandDAAA,areatriskforairwayobstructionandearlyLFThelpstoidentifyandto monitortheseinfants.Thismaysupportthedecisionforth