Characteristics Of Tidal Breathing Lung Function In Severe Pneumonia Infants With Varying Degrees In Recovery Period

Pneumonia is the inflammation of lung caused by different pathogens and other factors such as physical and chemical irritants. It is a common disease in children. Because of poor resistance and systems of the body not well developed, infant pneumonia is vulnerable to worsen. With the development of clinical medicine, the mortality of pneumonia in children declines. While pneumonia is still the first cause of death in children under 5 years old. Some of the severe pneumonia children may have persistent damages of lung function or changes of lung structures forever which lead to recurrent respiratory infections and wheezing, decreasing in physical activity and so on. The life quality of these children declines. The diagnosis and treatments of severe pneumonia children are still thorny problems. A large number of studies showed that lung function of pneumonia infants especially severe pneumonia infants appeared small airway obstruction, even after treatment. This paper studied lung function characteristics of severe pneumonia infants with varying degrees in recovery period and whether ventilation affect lung function to provide a scientific evidence for evaluating prognosis and continuous treatment out of hospital.ObjectiveExplore changes of pulmonary ventilation function and small airway function in recovery period of severe pneumonia infants with varying degrees and effects of mechanical ventilation on severe pneumonia infants.Methods65 infants of severe pneumonia who were clinical rehabilitation were recruited. These children were hospitalized in the Third Affiliated Hospital of Zhengzhou University because of severe pneumonia from Nov, 2013 to Jun, 2015. 50 infants of mild pneumonia who were clinical rehabilitation taking part in this study at the same time were set as the control group. All these infants were born at term, and not suffering from congenital heart disease, thoracic malformation, congenital laryngeal stridor or other diseases that may damage lung function. All these infants were calculated the Pediatric Critical Illness Score(PCIS) according to clinical manifestations and laboratory results within 24 hours of admission, and by which severe pneumonia infants were divided into different groups. Severe pneumonia infants can also be divided into mechanical ventilation group(including invasive mechanical ventilation infants and non-invasive mechanical ventilation infants) and non-mechanical ventilation group. The flow volume loops and main parameters were achieved via testing the tidal breathing lung function of all these infants one day before discharging by Master Screen IOS lung function instrument produced by German Jeager.Results1.The differences of RR、VT/kg were not statistically significant among groups of severe pneumonia infants with varying degrees and mild pneumonia group in recovery period(P>0.05).2.The differences of TPTEF/TE、VPTEF/VE were statistically significant among groups of severe pneumonia infants with varying degrees and mild pneumonia infants in recovery period(P<0.001). TPTEF/TE and VPTEF/VE of critically severe pneumonia group were lower than other groups; TPTEF/TE and VPTEF/VE of severe pneumonia group were lower than non-severe group and mild pneumonia group; TPTEF/TE and VPTEF/VE of non-severe pneumonia group were lower than mild pneumonia group; All these differences are statistically significant(P>0.05).3.The differences of RR、VT/kg were not statistically significant between mechanical ventilation group and non-mechanical ventilation group of severe pneumonia infants in recovery period(P>0.05).4.TPTEF/TE and VPTEF/VE of mechanical ventilation group were lower than non-mechanical ventilation group and mild pneumonia group in recovery period;TPTEF/TE and VPTEF/VE of non-mechanical ventilation group were lower than mild pneumonia group in recovery period; All these differences were statistically significant.ConclusionsSmall airways of severe pneumonia infants in recovery period were obstructive as well. The more critical severe pneumonia infants were, the more heavily small airways were obstructive in recovery period; Mechanical ventilation may affect the function of small airways.