Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1975 Aug;30(4):452–460. doi: 10.1136/thx.30.4.452

Generalized pulmonary hyperinflation and Fallot's tetralogy in a neonate investigated by pulmonary physiological and radioisotopic methods.

S Godfrey, R Ronchetti, J Stocks, K Hallidie-Smith
PMCID: PMC470308  PMID: 1179330

Abstract

An infant is described who presented a complex cardiopulmonary problem which was evaluated with the help of new physiological techniques. the infant was born at term after an emergency Caesarian section for fetal distress and was found to have meconium aspiration. He remained persistently tachypnoeic and hypoxic despite high ambient oxygen. Chest radiography suggested cystic lesions at the lung bases, and lung function tests confirmed hyperinflation with delayed nitrogen washout. In addition the child had signs of Fallot's tetralogy, and this diagnosis was confirmed by cardiac catheterization. Because of persistent hypoxia and tachypnoea disproportionate to the cardiac condition, the possibility of localized lung disease was considered. Regional lung function tests were carried out in the neonatal period and again at six months of age useing radioisotopic 13N given by both inhalation and injection. These studies showed gross ventilation/perfusion imbalance in the lungs, particularly marked at the bases, but with enough generalized abnormality to preclude the possibility of surgical intervention. The principles of the measurement of lung mechanics in the newborn by whole-body plethysmography, nitrogen washout, and regional radioisotopic spirometry are outlined. The particular value of these techniques in the evaluation of complex disorders is discussed, especially where both cardiac and pulmonary abnormalities are present.

Full text

PDF
452

Images in this article

453Image
on p.453

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. CHU J. S., DAWSON P., KLAUS M., SWEET A. Y. LUNG COMPLIANCE AND LUNG VOLUME MEASURED CONCURRENTLY IN NORMAL FULL-TERM AND PREMATURE INFANTS. Pediatrics. 1964 Oct;34:525–532. [PubMed] [Google Scholar]
  2. COOK C. D., SUTHERLAND J. M., SEGAL S., CHERRY R. B., MEAD J., MCILROY M. B., SMITH C. A. Studies of respiratory physiology in the newborn infant. III. Measurements of mechanics of respiration. J Clin Invest. 1957 Mar;36(3):440–448. doi: 10.1172/JCI103441. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. CROSS K. W. The respiratory rate and ventilation in the newborn baby. J Physiol. 1949 Sep;109(3-4):459–474. doi: 10.1113/jphysiol.1949.sp004409. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. DUBOIS A. B., BOTELHO S. Y., BEDELL G. N., MARSHALL R., COMROE J. H., Jr A rapid plethysmographic method for measuring thoracic gas volume: a comparison with a nitrogen washout method for measuring functional residual capacity in normal subjects. J Clin Invest. 1956 Mar;35(3):322–326. doi: 10.1172/JCI103281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. GEUBELLE F., KARLBERG P., KOCH G., LIND J., WALLGREN G., WEGELIUS C. [Aeration of the lung in the newborn infant]. Biol Neonat. 1959 Oct;1:169–210. [PubMed] [Google Scholar]
  6. Hislop A., Reid L. New pathological findings in emphysema of childhood. 1. Polyalveolar lobe with emphysema. Thorax. 1970 Nov;25(6):682–690. doi: 10.1136/thx.25.6.682. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Howlett G. Lung mechanics in normal infants and infants with congenital heart disease. Arch Dis Child. 1972 Oct;47(255):707–715. doi: 10.1136/adc.47.255.707. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hutchin P., Friedman P. J., Saltzstein S. L. Congenital cystic adenomatoid malformation with anomalous blood supply. J Thorac Cardiovasc Surg. 1971 Aug;62(2):220–225. [PubMed] [Google Scholar]
  9. KLAUS M., TOOLEY W. H., WEAVER K. H., CLEMENTS J. A. Lung volume in the newborn infant. Pediatrics. 1962 Jul;30:111–116. [PubMed] [Google Scholar]
  10. Koch G., Heiskanen T., Rihimäki E., Lind J., Tähti E., Osterlund K. Regional distribution of ventilation and perfusion in the healthy newborn infant and in the idiopathic respiratory distress syndrome. Bull Physiopathol Respir (Nancy) 1973 Nov-Dec;9(6):1511–1532. [PubMed] [Google Scholar]
  11. Krauss A. N., Auld P. A. Measurement of functional residual capacity in distressed neonates by helium rebreathing. J Pediatr. 1970 Aug;77(2):228–232. doi: 10.1016/s0022-3476(70)80328-6. [DOI] [PubMed] [Google Scholar]
  12. Lincoln J. C., Stark J., Subramanian S., Aberdeen E., Bonham-Carter R. E., Berry C. L., Waterston D. J. Congenital lobar emphysema. Ann Surg. 1971 Jan;173(1):55–62. doi: 10.1097/00000658-197101000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Merenstein G. B. Congenital cystic adenomatoid malformation of the lung. Report of a case and review of the literature. Am J Dis Child. 1969 Nov;118(5):772–776. doi: 10.1001/archpedi.1969.02100040774017. [DOI] [PubMed] [Google Scholar]
  14. NELSON N. M., PROD'HOM L. S., CHERRY R. B., LIPSITZ P. J., SMITH C. A. Pulmonary function in the newborn infant. I. Methods: ventilation and gaseous metabolism. Pediatrics. 1962 Dec;30:963–974. [PubMed] [Google Scholar]
  15. Phelan P. D., Williams H. E. Ventilatory studies in healthy infants. Pediatr Res. 1969 Sep;3(5):425–432. doi: 10.1203/00006450-196909000-00005. [DOI] [PubMed] [Google Scholar]
  16. Polgar G., String S. T. The viscous resistance of the lung tissues in newborn infants. J Pediatr. 1966 Nov;69(5):787–792. doi: 10.1016/s0022-3476(66)80125-7. [DOI] [PubMed] [Google Scholar]
  17. Radford M. Measurement of airway resistance and thoracic gas volume in infancy. Arch Dis Child. 1974 Aug;49(8):611–615. doi: 10.1136/adc.49.8.611. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Roberton N. R., Hallidie-Smith K. A., Davis J. A. Severe respiratory distress syndrome mimicking cyanotic heart-disease in term babies. Lancet. 1967 Nov 25;2(7526):1108–1110. doi: 10.1016/s0140-6736(67)90616-2. [DOI] [PubMed] [Google Scholar]
  19. Ronchetti R., Federici E., Ciofetta L., Benci S., Manfredi M., Gentili G. Theoretical bases for the calculation of the regional ventilation/perfusion ratio (V/Q) of the lung in the newborn. J Nucl Biol Med. 1974 Jul-Sep;18(3):123–135. [PubMed] [Google Scholar]
  20. Ronchetti R., Geubelle F., Chantraine J. M., Senterre J. Studio del rapporto ventilazione-perfusione nel neonato mediante lo Xe 133. Minerva Pediatr. 1971 Sep 8;23(36):1476–1485. [PubMed] [Google Scholar]
  21. SWYER P. R., REIMAN R. C., WRIGHT J. J. Ventilation and ventilatory mechanics in the newborn: methods and results in 15 resting infants. J Pediatr. 1960 May;56:612–622. doi: 10.1016/s0022-3476(60)80334-4. [DOI] [PubMed] [Google Scholar]
  22. Secker-Walker R. H., Hill R. I., Markham J., Baker J., Wilhelm J., Alderson P. O., Potchen E. J. The measurement of regional ventilation in man: a new method of quantitation. J Nucl Med. 1973 Oct;14(10):725–732. [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES