title: Functional residual capacity and lung clearance index in infants treated for esophageal atresia and tracheoesophageal fistula.
abstract: BACKGROUND
  Newborn babies with esophageal atresia/tracheoesophageal fistula (EA/TEF) are prone to respiratory tract disorders. Functional residual capacity (FRC) and lung clearance index (LCI) are commonly considered useful and sensitive tools to investigate lung function and early detecting airways diseases. The aim of the present study is to report the first series of EA/TEF infants prospectively evaluated for FRC and LCI.
  
  
  METHODS
  Prospective observational cohort study of all patients treated for EA/TEF. Lung volume and ventilation inhomogeneity were measured by helium gas dilution technique using an ultrasonic flow meter. Babies were studied both in assisted controlled ventilation (sedated) and in spontaneous breathing (quiet sleep). Three consecutive FRC and LCI measurements were collected for each test at three different time points: before surgery (T0), 24hours after surgery (T1) and after extubation (T2).
  
  
  RESULTS
  16 EA newborns were eligible for the study between December 2011 and July 2013. Three were excluded because of technical problems. At T0 FRC values were in the normal range regardless the presence of TEF but worsened afterwards at T1, with a subsequent recovering after extubation; a significant improvement after surgery was observed concerning LCI while no differences were found in tidal volume.
  
  
  CONCLUSIONS
  Helium gas dilution technique is a suitable method to measure the effect of surgery on lung physiology, even in ventilated infants with EA. The changes observed could be related to the ventilatory management and lung compression during surgical procedure.
authors.affiliation: Department of Medical and Surgical Neonatology, Bambino Gesù Research Children's Hospital, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Landolfo
authors.affiliation: Department of Medical and Surgical Neonatology, Bambino Gesù Research Children's Hospital, Rome, Italy. Electronic address: andrea.conforti@opbg.net.
authors.forename: Andrea
authors.initials: A
authors.lastname: Conforti
authors.affiliation: Department of Medical and Surgical Neonatology, Bambino Gesù Research Children's Hospital, Rome, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Columbo
authors.affiliation: Department of Medical and Surgical Neonatology, Bambino Gesù Research Children's Hospital, Rome, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Savignoni
authors.affiliation: Department of Medical and Surgical Neonatology, Bambino Gesù Research Children's Hospital, Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Bagolan
authors.affiliation: Department of Medical and Surgical Neonatology, Bambino Gesù Research Children's Hospital, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Dotta
mesh_terms: D004933:Esophageal Atresia / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D005652:Functional Residual Capacity; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000503:physiopathology*; D008297:Male; D009079:Mucociliary Clearance; D011446:Prospective Studies; D012121:Respiration, Artificial; D013990:Tidal Volume; D014138:Tracheoesophageal Fistula / Q000503:physiopathology* / Q000628:therapy
keywords: Esophageal atresia; Functional residual capacity; Lung clearance index; Pulmonary function test