Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Presurgical pulmonary function tests in the first few days of life in neonates with congenital heart disease, a pilot study

Abstract

Objective

To compare early pulmonary function tests (PFTs) in neonates with critical congenital heart disease (CHD) compared to a historical reference group.

Design

Infants ≥ 37 weeks gestation with critical CHD were studied within the first few days of life, prior to cardiac surgery, and compared to data from a published reference group of healthy term neonates without CHD, studied at the same institution. Passive respiratory resistance (Rrs) and compliance (Crs) were measured with the single breath occlusion technique following specific acceptance criteria. The study was powered for a 30% difference in Rrs.

Results

PFTs in 24 infants with CHD were compared to 31 historical reference infants. There was no difference in the Rrs between the groups. The infants with CHD had a significantly decreased Crs (1.02 ± 0.26 mL/cmH2O/kg versus 1.32 ± 0.36; (p < 0.05; mean ± SD)).

Conclusions

Further prospective studies are required to quantify early PFTs in infants with CHD of different phenotypes.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1

Similar content being viewed by others

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39:1890–900.

    Article  PubMed  Google Scholar 

  2. Friedman AHF JT. The transition from fetal to neonatal circulation: normal responses and implications for infants wtih heart disease. Semin Perinatol. 1993;17:106–21.

    Google Scholar 

  3. Hauck A, Porta N, Lestrud S, Berger S. The pulmonary circulation in the single ventricle patient. Children. 2017;4:71.

  4. Simonato M, Padalino M, Vedovelli L, Carollo C, Sartori A, Vida V, et al. Effect of preoperative pulmonary hemodynamic and cardiopulmonary bypass on lung function in children with congenital heart disease. Eur J Pediatr. 2023;182:2549–57.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Stayer SA, Diaz LK, East DL, Gouvion JN, Vencill TL, McKenzie ED, et al. Changes in respiratory mechanics among infants undergoing heart surgery. Anesth Analg. 2004;98:49–55.

    Article  PubMed  Google Scholar 

  6. Yau KI, Fang LJ, Wu MH. Lung mechanics in infants with left-to-right shunt congenital heart disease. Pediatr Pulmonol. 1996;21:42–47.

    Article  CAS  PubMed  Google Scholar 

  7. Bancalari E, Jesse MJ, Gelband H, Garcia O. Lung mechanics in congenital heart disease withincreased and decreased pulmonary blood flow. J Pediatr. 1977;90:192–5.

    Article  CAS  PubMed  Google Scholar 

  8. Agha H, El Heinady F, El Falaky M, Sobih A. Pulmonary functions before and after pediatric cardiac surgery. Pediatr Cardiol. 2014;35:542–9.

    Article  PubMed  Google Scholar 

  9. Habre W, Schutz N, Pellegrini M, Beghetti M, Sly PD, Hantos Z, et al. Preoperative pulmonary hemodynamics determines changes in airway and tissue mechanics following surgical repair of congenital heart diseases. Pediatr Pulmonol. 2004;38:470–6.

    Article  CAS  PubMed  Google Scholar 

  10. Lin CH, Hsiao TC, Chen CH, Chen JW, Chuang TY, Chang JS, et al. A single center observational study of spirometry assessments in children with congenital heart disease after surgery. Medicina. 2023;59:764.

  11. Shakti D, McElhinney DB, Gauvreau K, Yarlagadda VV, Laussen PC, Betit P, et al. Pulmonary deadspace and postoperative outcomes in neonates undergoing stage 1 palliation operation for single ventricle heart disease. Pediatr Crit Care Med. 2014;15:728–34.

    Article  PubMed  Google Scholar 

  12. McEvoy C, Venigalla S, Schilling D, Clay N, Spitale P, Nguyen T. Respiratory function in healthy late preterm infants delivered at 33-36 weeks of gestation. J Pediatr. 2013;162:464–9.

    Article  PubMed  Google Scholar 

  13. McEvoy CT, Schilling D, Clay N, Jackson K, Go MD, Spitale P, et al. Vitamin C supplementation for pregnant smoking women and pulmonary function in their newborn infants: a randomized clinical trial. JAMA. 2014;311:2074–82.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Gappa MC AA, Goetz I, Stocks J. ERS/ATS task force on standards for infant respiratory function testing. European Respiratory Society/American Thoracic Society. Passive respiratory mechanics: the occlusion techniques. Eur Respir J. 2001;17:141–8.

    Google Scholar 

  15. Li DB, Xu XX, Hu YQ, Cui Q, Xiao YY, Sun SJ, et al. Congenital heart disease-associated pulmonary dysplasia and its underlying mechanisms. Am J Physiol Lung Cell Mol Physiol. 2023;324:L89–L101.

    Article  CAS  PubMed  Google Scholar 

  16. Klinger AP, Travers CP, Martin A, Kuo HC, Alishlash AS, Harris WT, et al. Non-invasive forced oscillometry to quantify respiratory mechanics in term neonates. Pediatr Res. 2020;88:293–9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Veneroni C, Dellaca RL, Kung E, Bonomi B, Berger A, Werther T. Oscillometry for personalizing continuous distending pressure maneuvers: an observational study in extremely preterm infants. Respir Res. 2024;25:4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Frey U. Forced oscillation technique in infants and young children. Paediatr Respir Rev. 2005;6:246–54.

    Article  PubMed  Google Scholar 

  19. Castillo A, Llapur CJ, Martinez T, Kisling J, Williams-Nkomo T, Coates C, et al. Measurement of single breath-hold carbon monoxide diffusing capacity in healthy infants and toddlers. Pediatr Pulmonol. 2006;41:544–50.

    Article  PubMed  Google Scholar 

  20. McEvoy C, Schilling D, Peters D, Tillotson C, Spitale P, Wallen L, et al. Respiratory compliance in preterm infants after a single rescue course of antenatal steroids: a randomized controlled trial. Am J Obstet Gynecol. 2010;202:544 e1-9.

    Article  PubMed  Google Scholar 

  21. Simonato M, Baritussio A, Carnielli VP, Vedovelli L, Falasco G, Salvagno M, et al. Influence of the type of congenital heart defects on epithelial lining fluid composition in infants undergoing cardiac surgery with cardiopulmonary bypass. Pediatr Res. 2018;83:791–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

Funding

Supported by Novice Researcher Award from the Gerber Foundation (HL) and R33HL147906 (CTM).

Author information

Authors and Affiliations

Authors

Contributions

HL, AM, CM and IS were all actively involved in study design. HL consented study participants. DS and KP conducted the PFT studies and AJ performed the statistical analysis. All authors participated in the drafting and review of the manuscript.

Corresponding author

Correspondence to Hayden Leeds.

Ethics declarations

Competing interests

The authors have no conflicts of interest to disclose. The study sponsors had no role in any of the following: (1) study design; (2) the collection, analysis, and interpretation of data; (3) the writing of the report; or (4) the decision to submit the manuscript for publication.

Ethics approval and consent to participate

This study was approved the IRB at Oregon Health and Science University and parental consent was obtained for all participants. The study was performed in accordance with the Declaration of Helsinki.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Leeds, H., Muralidaran, A., Johnson, A.J. et al. Presurgical pulmonary function tests in the first few days of life in neonates with congenital heart disease, a pilot study. J Perinatol (2024). https://doi.org/10.1038/s41372-024-01979-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41372-024-01979-3

Search

Quick links