Alt solunum yolu enfeksiyonu tanısı ile takip edilen hastalarda pulmoner hipertansiyon prevelansı


Doç. Dr. YETER DÜZENLİ KAR

Tez Türü: Tıpta Uzmanlık

Tezin Yürütüldüğü Kurum: Diğer (Kurumlar,hastaneler Vb.), Konya Eğitim Araştıma Hastanesi , DAHİLİ Tıp Bilimleri, Türkiye

Tez Danışmanı: Şükrü Arslan

Tezin Onay Tarihi: 2014

Tezin Dili: Türkçe

Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu

Desteklendiği Program: Diğer

Özet:

Objective Lower respiratory tract infections (LRTI) are one of the most important

causes of morbidity and mortality in childhood. Hypoxemia, pulmonary hypertension

(PH) due to pulmonary vasoconstriction, and heart failure due to various causes are the

most important risk factors for mortality in LRTI. The aim of this study was to

investigate characteristics of the patients with LRTI and the frequency of PH that

developed secondary to LRTI.

Materials and Methods The study included 70 patients who were diagnosed as

having LRTI clinically and radiologically between January 2012 and March 2013 at

Department of Pediatrics, Konya Training and Research Hospital. Age, sex, risk factors

for LRTI, symptoms and physical examination findings, laboratory tests, and Doppler

echocardiography findings of the patients were retrospectively reviewed.

Results Of the patients, 44 (62.9%) weremale and 26 (37.1%) were female. Thirty-seven

(52.9%) patients were younger than 1 year, and the mean age was 2.53.11 years. The

most common symptoms of the patients were cough and fever. Rhonchus, retraction, and

crackleswere found to be themost common findings in physical examinations.Heart failure

was found in 10% of patients and PH was detected in 8.6% through Doppler echocardiography.

Development of heart failure and the presence of bilateral patch infiltration on

posteroanterior chest X-rays were significantly more frequent in patients with PH. Some

42.9% of patients had at least one viral agent in their nasopharyngeal swabs. The most

common viral agents were respiratory syncytial virus and rhinoviruses.

Conclusion PH may develop during the course of LRTI in children. Given that the

development of PH can cause life-threatening complications such as heart failure,

affected patients should be kept under close follow-up. It should be remembered that

PH is more likely to develop in patients with bilateral patch infiltration on chest X-ray.