@article{b20087d725ce4d9badf3a85d18946a40,
title = "Increasing severity of pectus excavatum is associated with reduced pulmonary function",
abstract = "Objective: To determine whether pulmonary function decreases as a function of severity of pectus excavatum, and whether reduced function is restrictive or obstructive in nature in a large multicenter study. Study design: We evaluated preoperative spirometry data in 310 patients and lung volumes in 218 patients aged 6 to 21 years at 11 North American centers. We modeled the impact of the severity of deformity (based on the Haller index) on pulmonary function. Results: The percentages of patients with abnormal forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory flow from 25% exhalation to 75% exhalation, and total lung capacity findings increased with increasing Haller index score. Less than 2% of patients demonstrated an obstructive pattern (FEV1/FVC <67%), and 14.5% demonstrated a restrictive pattern (FVC and FEV1 <80% predicted; FEV1/FVC >80%). Patients with a Haller index of 7 are >4 times more likely to have an FVC of ≤80% than those with a Haller index of 4, and are also 4 times more likely to exhibit a restrictive pulmonary pattern. Conclusions: Among patients presenting for surgical repair of pectus excavatum, those with more severe deformities have a much higher likelihood of decreased pulmonary function with a restrictive pulmonary pattern.",
author = "Lawson, {M. Louise} and Mellins, {Robert B.} and Paulson, {James F.} and Shamberger, {Robert C.} and Keith Oldham and Azizkhan, {Richard G.} and Hebra, {Andre V.} and Donald Nuss and Goretsky, {Michael J.} and Sharp, {Ronald J.} and Holcomb, {George W.} and Shim, {Walton K.T.} and Megison, {Stephen M.} and Moss, {R. Lawrence} and Fecteau, {Annie H.} and Colombani, {Paul M.} and Moskowitz, {Alan B.} and Joshua Hill and Kelly, {Robert E.}",
note = "Funding Information: Supported by a grant from the Children{\textquoteright}s Health Foundation of the Children{\textquoteright}s Health System (Children{\textquoteright}s Hospital of The King{\textquoteright}s Daughters) of Norfolk, VA. A subset of patients underwent exercise cardiopulmonary function studies at several centers (not completed or reported here). That substudy was underwritten by a grant from Walter Lorenz Surgical, Inc , now Biomet Microfixation, Inc. The funding sources played no role in the collection, analysis, or reporting of data. D.N. served as a consultant to Biomet Microfixation, Inc. The other authors declare no conflicts of interest. Funding Information: The primary study was funded by a grant from the Children{\textquoteright}s Health Foundation of the Children{\textquoteright}s Health System (Children{\textquoteright}s Hospital of The King{\textquoteright}s Daughters) of Norfolk, Virginia. A subset of patients underwent exercise cardiopulmonary function studies at several centers (not completed or reported here). That substudy was underwritten by a grant from Walter Lorenz Surgical, Inc, now Biomet Microfixation, Inc (Jacksonville, Florida). The funding sources played no role in the collection, analysis or reporting of data. ",
year = "2011",
month = aug,
doi = "10.1016/j.jpeds.2011.01.065",
language = "English (US)",
volume = "159",
pages = "256--261.e2",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
number = "2",
}