Chest deformity, residual airways obstruction and hyperinflation, and growth in children with asthma. II. Significance of chronic chest deformity.

Gillam, G. L., McNicol, K. N., and Williams, H. E. (1970). Archives of Disease in Childhood, 45, 789. Chest deformity, residual airways obstruction and hyperinflation, and growth in children with asthma. Part II: Significance of chronic chest deformity. Studies were made on 56 10-11-year-old asthmatic children with onset of symptoms before 3 years of age, frequent and persistent attacks, and objective evidence of their disease with barrel chest deformity and/or reduction of the FEV 0.5/VC ratio to 50% or less, by clinical, physiological, and radiological techniques in an interval phase between their attacks. There was a significant correlation between barrel chest deformity and (a) elevation of lung volumes (FRC, RV, TLC, FRC/TLC, and RV/TLC), and (b) reduction of the FEV1.0/VC ratio, indicating chronic hyperinflation and airways obstruction in the interval phase between attacks. Radiological evidence of hyperinflation also correlated significantly with barrel chest deformity, increased lung volumes, and airways obstruction. These parameters were found to be important criteria for assessing chronicity in asthma. The group showed evidence of growth retardation particularly for weight and to a lesser extent for height, these changes being most marked in subjects with barrel chest deformity. Corticosteroid therapy was not a significant factor in the growth retardation observed. There was a preponderance of males over females in the group (7:3).