Timing of recovery of lung function after severe hypoxemic respiratory failure in children.
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.
Golder
N D
ND
Department of Paediatric Intensive Care, Great Ormond Street Hospital for Children, London, UK.
Lane
R
R
Tasker
R C
RC
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