Vladimir Gatzinsky1, Göran Wennergren2, Linus Jönsson3, Linda Ekerljung4, Birgitta Houltz5, Staffan Redfors6, Ulla Sillén3, Per Gustafsson7. 1. Department of Pediatric Surgery, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden. Electronic address: vladimir.gatzinsky@vgregion.se. 2. Department of Pediatrics, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden. 3. Department of Pediatric Surgery, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden. 4. Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden. 5. Department of Clinical Physiology, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden. 6. Department of Pediatric Clinical Physiology, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden. 7. Department of Pediatric Clinical Physiology, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden; Department of Pediatrics, Central Hospital, Skövde, Sweden.
Abstract
BACKGROUND: Esophageal atresia (EA) often leads to persistent symptoms and impaired respiratory function in adulthood. The role of peripheral airways in this impairment has not been previously investigated. Furthermore, asthma-like symptoms are common in these patients. PURPOSE: The purpose of this study was to investigate pulmonary outcome, including possible peripheral airway dysfunction, perhaps missed by conventional pulmonary function tests and to see if the diagnosis asthma was accurate. METHODS: Twenty eight patients operated for EA in Gothenburg 1968-1983 answered a questionnaire regarding respiratory symptoms and underwent pulmonary function tests. Peripheral airway function was measured by multiple breath washout. RESULTS: 22/28 (79%) patients had a history of respiratory symptoms. Abnormal peripheral airway function was found in 17 (61%) patients, while only 6 (21%) patients displayed values indicating central obstruction. Nine patients had restrictive disease. Airway hyperresponsiveness was frequent and associated with atopy and airway inflammation. However, respiratory symptoms or doctor-diagnosed asthma did not correlate with any specific lung function test abnormality. CONCLUSION: Different lung function abnormalities are present in EA survivors, and peripheral airway disease is common. Classical asthma seems to be difficult to diagnose in this patient group. Given the high prevalence of respiratory morbidity, long-term follow-up of pulmonary function, including peripheral airway function, is warranted.
BACKGROUND:Esophageal atresia (EA) often leads to persistent symptoms and impaired respiratory function in adulthood. The role of peripheral airways in this impairment has not been previously investigated. Furthermore, asthma-like symptoms are common in these patients. PURPOSE: The purpose of this study was to investigate pulmonary outcome, including possible peripheral airway dysfunction, perhaps missed by conventional pulmonary function tests and to see if the diagnosis asthma was accurate. METHODS: Twenty eight patients operated for EA in Gothenburg 1968-1983 answered a questionnaire regarding respiratory symptoms and underwent pulmonary function tests. Peripheral airway function was measured by multiple breath washout. RESULTS: 22/28 (79%) patients had a history of respiratory symptoms. Abnormal peripheral airway function was found in 17 (61%) patients, while only 6 (21%) patients displayed values indicating central obstruction. Nine patients had restrictive disease. Airway hyperresponsiveness was frequent and associated with atopy and airway inflammation. However, respiratory symptoms or doctor-diagnosed asthma did not correlate with any specific lung function test abnormality. CONCLUSION: Different lung function abnormalities are present in EA survivors, and peripheral airway disease is common. Classical asthma seems to be difficult to diagnose in this patient group. Given the high prevalence of respiratory morbidity, long-term follow-up of pulmonary function, including peripheral airway function, is warranted.
Authors: Michaela Dellenmark-Blom; John Eric Chaplin; Vladimir Gatzinsky; Linus Jönsson; Kate Abrahamson Journal: Qual Life Res Date: 2015-04-01 Impact factor: 4.147
Authors: Maria Francesca Patria; Stefano Ghislanzoni; Francesco Macchini; Mara Lelii; Alessandro Mori; Ernesto Leva; Nicola Principi; Susanna Esposito Journal: Int J Environ Res Public Health Date: 2017-09-27 Impact factor: 3.390