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Respiratory Mechanics in Children with Post-Viral Chronic Pulmonary Disease (PCPD)

Viral lower respiratory tract infections can cause severe lung injury resulting in a chronic condition known as PCPD. We have previously shown that patients with PCPD have a severe and fixed airway obstruction and changes in the elastic recoil properties of the lung [increased resistance (R) and decreased compliance (C)] during the first two years of life. The aim of the study was to evaluate the respiratory mechanics with the forced oscillation technique (FOT), in older children with PCPD. Methods. Respiratory mechanics of patients diagnosed with PCPD and followed at our hospital was prospectively evaluated (6 years after initial injury) during 2000/2001. Measurements were done using FOT (Vmax machine series 2, SensorMedics). Bronchodilator response (BDR) was evaluated 30 min after the inhalation of 200 mcg salbutamol. Inclusion critera were: diagnosis of PCPD, older than 4 yrs, capable of performing PFTs, and clinically stable. A control group of children older than 4 yrs with a normal spirometry was included for comparison. Study group (SG): 17 patients (12 male; mean age 7 yrs; age-range 4–14); Control group (CG): 17 children (5 male; mean age 7 yrs; range 4–15). Results were as follows (mean ± SD): R 4–16 (cmH2O/l/s) SG 8.5±3 & CG 4.9±1 (p<0.01); R 0 SG 10.1±4 & CG 5±1 (p<0.01); R Mn SG 7.5±2 & CG 4.9±1 (p<0.01); C (ml/cmH2O) SG 5.4±3 & CG 20.5±12 (p<0.01). Coefficients of variation were adequate (7.3, 8, 7.6, and 16 for R 4–16, R 0, R Mn and C, respectively). BDR (SG only) was: R 4–16: 16.5 %, R 0: 21 %, R Mn: 13.3%, C: 41.8%. Children with PCPD showed persistent changes in their respiratory mechanics 6 years after the initial insult. They showed an increase in resistance and a decrease in compliance compared to the control group.