Función pulmonar y calidad de vida en niños y adolescentes con bronquiolitis obliterante por adenovirus

Abstract

Introduction: Adenovirus infection is an important cause of pneumonia in Chilean children. Postinfectious Bronchiolitis Obliterans (PIBO) is the most important complication. There are few studies assessing pulmonary function and quality of life in PIBO patients. Objective: The aim of this study is to assess the pulmonary function and the quality of life ofpatients with PIBO and the correlation between both variables. Methods: 14 children with PIBO in follow up at the pediatric pulmonology outpatient clinic of a public children hospital were included in this study. Study period: April 2009 - April 2010. Pulmonary function was assessed in a medical visit by spirometry, flow/volume curve and intrathoracic gas volume measurement. The following indices were analyzed FVC, FEV1, FEV25-75, FEV1/FVC, RV, TLC, RV and RV/TLC. A survey of a self-administered Quality of Life (PedsQL, version 4.0, Spanish for Chile) was applied at the visit to investigate their global, physical and psychosocial quality of life. The Pearson linear correlation between quality of life and the pulmonary function test parameters was assessed, in the statistical analysis ap value < 0.05 was considered significant. Results: The mean age of our patients was 12.4 (range: 9-19 years-old). The functional alterations were characteristics of an obstructive respiratory disorder in 64.3% of the patients. Average pulmonary function test indices showed decreases in FEV1 (75%), FEV25-75 (48.8%), FEV1/FVC (67.6%) with normal value of FVC (93,7%) as well as pronounced increases in RV (333.5%), TLC (156%) and RV/TLC (51.8%). Mean change of FEV1 and FEV25-75post-bronchodilator was 11.3% and 26.4% respectively. Only 14.3% of our patients showed normal pulmonary function. The quality of life parameters were in average 58.2% of overall quality of life, 58.6% ofphysical quality of life and 57.9% ofpsychosocial quality of life. We found a positive correlation between global quality of life and FEV1, FVC and FEV25-75 (correlation index 0.54, 0.53 and 0.53 respectively) as well between physical quality of life and FEV1, FVC, FEV1/ FVC and FEV25-75 (correlation index 0.86, 0.82, 0.72 and 0.55 respectively). Conclusions: Most patients with PIBO showed pulmonary function impairment characterized by an obstructive respiratory pattern. Better quality of life correlates with better values in spirometric parameters.