Postnatal lung function in congenital cystic adenomatoid malformation of the lung

Ann Thorac Surg. 2015 Apr;99(4):1164-9. doi: 10.1016/j.athoracsur.2014.11.018. Epub 2015 Feb 14.

Abstract

Background: Management of prenatally diagnosed but postnatal asymptomatic pulmonary lesions remains controversial. The aim of this study was to investigate the effect of congenital cystic adenomatoid malformation of the lung (CCAM) on postnatal lung function tests (LFT) and to elucidate whether LFTs help identify infants who would benefit from early surgery.

Methods: The LFTs were performed in 26 CCAM infants at a median (interquartile range) postmenstrual age of 42.4 (39.6 to 44.0) weeks and compared with LFT from 30 healthy controls. The LFT included the measurement of tidal breathing, functional residual capacity by body plethysmography, respiratory mechanics (respiratory compliance), and respiratory resistance by occlusion test and blood gas analysis.

Results: The CCAM infants showed a restrictive ventilation disorder with increased respiratory rates (p = 0.006) and marginally decreased tidal volumes (p = 0.043). Furthermore, respiratory compliance was significantly reduced as compared with controls (p < 0.001). No statistically significant differences were seen in the respiratory resistance, functional residual capacity, and capillary blood gases. Particularly in CCAM infants who had surgery in the first 2 years of life, a marked reduction of respiratory compliance (p < 0.001) was seen preoperatively.

Conclusions: Congenital cystic adenomatoid malformation can cause restrictive ventilation disorders, which can be detected and monitored by postnatal LFT. Thus, LFT represents an additional tool to support the decision for or against surgical intervention.

MeSH terms

  • Blood Gas Analysis
  • Case-Control Studies
  • Cystic Adenomatoid Malformation of Lung, Congenital / complications*
  • Cystic Adenomatoid Malformation of Lung, Congenital / diagnosis*
  • Cystic Adenomatoid Malformation of Lung, Congenital / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Monitoring, Physiologic / methods
  • Reference Values
  • Respiratory Distress Syndrome, Newborn / etiology*
  • Respiratory Distress Syndrome, Newborn / physiopathology
  • Respiratory Distress Syndrome, Newborn / therapy
  • Respiratory Function Tests
  • Respiratory Mechanics / physiology*
  • Retrospective Studies
  • Severity of Illness Index
  • Tidal Volume