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Respiratory morbidity in children with congenital heart disease

Authors :
Damien Bonnet
François Goffinet
Babak Khoshnood
S Guerin
M Lebourgeois
N. Lelong
D Khraiche
Christophe Delacourt
N Bertille
Source :
Archives de pediatrie : organe officiel de la Societe francaise de pediatrie. 28(7)
Publication Year :
2020

Abstract

Objective To evaluate the respiratory outcome in children with congenital heart disease (CHD), considering recent management procedures and the CHD pathophysiology. Design and Setting Clinical and functional respiratory outcome were evaluated in 8-year-old children with isolated CHD followed up from birth in the prospective population-based EPICARD cohort. Patients Children were assigned to two groups, based on the pathophysiology of the CHD: CHDs with left-to-right shunt (n = 212) and CHDs with right outflow tract obstruction (n = 113). Results Current wheezing episodes were observed in 15% of the children with isolated CHD and left-to-right shunt, and 11% of the children with isolated CHD and right outflow tract obstruction (not significant). Total lung capacity (TLC) was the only respiratory function parameter that significantly differed between the two groups. It was lower in children with left-to-right shunt (88.72 ± 0.65% predicted) than in those with right outflow tract obstruction (91.84 ± 0.96, p = 0.006). In multivariate analysis, CHD with left-to-right shunt (coeff. [95% CI]: -3.17 [-5.45; -0.89]) and surgery before the age of 2 months (-6.52 [-10.90; -2.15]) were identified as independent factors associated with significantly lower TLC values. Conclusion Lower TLC remains a long-term complication in CHD, particularly in cases with left-to-right shunt and in patients requiring early repair. These findings suggest that an increase in pulmonary blood flow may directly impair lung development.

Details

ISSN :
1769664X
Volume :
28
Issue :
7
Database :
OpenAIRE
Journal :
Archives de pediatrie : organe officiel de la Societe francaise de pediatrie
Accession number :
edsair.doi.dedup.....005111ed235c10ecf5e221b04a757499