Respiratory and cardiac function in children after acute hypoxemic respiratory failure

Irwin Weiss, Henry Michael Ushay, William DeBruin, John O'Loughlin, Ingrid Rosner, Daniel Notterman

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objective: To examine the pulmonary and cardiac function of children who survived an episode of acute hypoxemic respiratory failure. Design: Descriptive cohort analysis. Setting: Pediatric clinical research center of a university hospital. Patients: Utilizing the criteria of Pao2 <75 torr (<10 kPa) with an Flo2 of >0.5 while intubated, bilateral diffuse pulmonary infiltrates on chest radiograph, and exclusion of cardiogenic pulmonary edema, 147 patients were identified during the 6-yr period from July 1, 1986 to August 1, 1993. Fifty patients survived to discharge and 37 were alive at the time of follow-up. Fourteen patients were eventually entered into the study. Interventions: The study patients were given a test battery consisting of a questionnaire specific for cardiopulmonary status, a physical examination, a chest radiograph, electrocardiography, echocardiography with detailed examination of the pulmonary circulation, pulse oximetry, complete blood count, and serum chemistries and pulmonary function testing with bronchoprovocation in selected patients. Measurements and Main Results: The 14 follow-up patients were evaluated an average of 23 ± 23 months (range 3 to 66) following intensive care unit discharge. No child reported a significant alteration in lifestyle or limitation of activities. Physical examinations were generally unremarkable. The room air oxyhemoglobin saturation was ≥0.98 in all patients. Comparison of chest radiographs at the time of follow-up with those chest radiographs during the period of critical illness showed marked but not complete improvement in all. Electrocardiograms and echocardiograms showed new evidence of left ventricular hypertrophy in one child. The right ventricular preejection period to ejection time ratio was normal in all subjects. Eleven patients completed spirometry. Four patients were normal and the other patients had evidence of restrictive or obstructive disease either at baseline or after bronchoprovocation challenge. Ten children had lung volume measurements. Five children were normal, two showed increased volumes consistent with obstruction, and three showed decreased volumes indicative of restriction. Four of seven patients showed evidence of decreased diffusion capacity. Six of seven patients with evidence of abnormal pulmonary function had a positive response to bronchodilator administration. Conclusions: Although pediatric survivors of acute hypoxemic respiratory failure perceive neither a limitation in lifestyle nor chronic pulmonary morbidity, careful examination of the cardiopulmonary system demonstrates a significant number with abnormal chest radiographs and abnormalities in pulmonary function. These children require careful follow-up and may benefit from use of a bronchodilator.

Original languageEnglish (US)
Pages (from-to)148-154
Number of pages7
JournalCritical Care Medicine
Volume24
Issue number1 SUPPL.
StatePublished - 1996
Externally publishedYes

Fingerprint

Respiratory Insufficiency
Thorax
Lung
Bronchodilator Agents
Physical Examination
Life Style
Electrocardiography
Pediatrics
Lung Volume Measurements
Oxyhemoglobins
Pulmonary Circulation
Oximetry
Blood Cell Count
Spirometry
Left Ventricular Hypertrophy
Pulmonary Edema
Critical Illness
Intensive Care Units
Survivors
Echocardiography

Keywords

  • Adult respiratory distress syndrome
  • Critical illness
  • Lung disease
  • Mechanical ventilation
  • Pediatrics
  • Pneumocystis carinii pneumonia
  • Pulmonary emergencies
  • Respiratory failure
  • Right ventricular function

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Weiss, I., Ushay, H. M., DeBruin, W., O'Loughlin, J., Rosner, I., & Notterman, D. (1996). Respiratory and cardiac function in children after acute hypoxemic respiratory failure. Critical Care Medicine, 24(1 SUPPL.), 148-154.

Respiratory and cardiac function in children after acute hypoxemic respiratory failure. / Weiss, Irwin; Ushay, Henry Michael; DeBruin, William; O'Loughlin, John; Rosner, Ingrid; Notterman, Daniel.

In: Critical Care Medicine, Vol. 24, No. 1 SUPPL., 1996, p. 148-154.

Research output: Contribution to journalArticle

Weiss, I, Ushay, HM, DeBruin, W, O'Loughlin, J, Rosner, I & Notterman, D 1996, 'Respiratory and cardiac function in children after acute hypoxemic respiratory failure', Critical Care Medicine, vol. 24, no. 1 SUPPL., pp. 148-154.
Weiss I, Ushay HM, DeBruin W, O'Loughlin J, Rosner I, Notterman D. Respiratory and cardiac function in children after acute hypoxemic respiratory failure. Critical Care Medicine. 1996;24(1 SUPPL.):148-154.
Weiss, Irwin ; Ushay, Henry Michael ; DeBruin, William ; O'Loughlin, John ; Rosner, Ingrid ; Notterman, Daniel. / Respiratory and cardiac function in children after acute hypoxemic respiratory failure. In: Critical Care Medicine. 1996 ; Vol. 24, No. 1 SUPPL. pp. 148-154.
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