title: Timing of recovery of lung function after severe hypoxemic respiratory failure in children.
abstract: OBJECTIVE
  To describe the timing of recovery of lung function after severe acute hypoxemic respiratory failure (AHRF) in children.
  
  
  METHODS
  A serial observational follow-up study of clinical and lung function measurements up to 53 months after acute illness.
  
  
  METHODS
  University pediatric intensive care unit in a national children's hospital.
  
  
  METHODS
  Five critically ill children aged 5-14 years.
  
  
  METHODS
  None
  
  
  RESULTS
  Clinical recovery: each patient required a 3-5 month convalescence before being able to attend full-time school because of lethargy and dyspnea. All patients developed wheeze 3-12 months after illness and four received long-term bronchodilator therapy. Lung function recovery: for both the forced vital capacity (FVC) and forced vital capacity in the first second (FEV1) four patients had abnormally low values, regaining only 60-70% of predicted values for their height and sex, and all of this improvement had occurred by 6-12 months after illness. Beyond this interval, patients remained on their same FVC and FEV1 centile. FEV1/FVC ratios were consistently within the normal range, indicating a predominantly restrictive defect. Changes in peak expiratory flow exhibited a time course of improvement similar to the other lung function tests.
  
  
  CONCLUSIONS
  In children, pulmonary recovery after severe AHRF may occur for 6-12 months. A 1-year follow-up could offer a rational single point for assessment of outcome and long-term counselling of child and parents.
authors.affiliation: Department of Paediatric Intensive Care, Great Ormond Street Hospital for Children, London, UK.
authors.forename: N D
authors.initials: ND
authors.lastname: Golder
authors.forename: R
authors.initials: R
authors.lastname: Lane
authors.forename: R C
authors.initials: RC
authors.lastname: Tasker
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003289:Convalescence; D016638:Critical Illness; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology*; D008168:Lung / Q000503:physiopathology*; D008297:Male; D012131:Respiratory Insufficiency / Q000503:physiopathology*; D013997:Time Factors