Multidimensional evaluation of clinical symptoms, pulmonary function, and imaging in long-term treatment of infants with post-infectious bronchiolitis obliterans.

OBJECTIVE: To investigate efficacy of standardized treatment for post-infectious bronchiolitis obliterans (PIBO) in infants and young children by evaluating changes in pulmonary function, and high-resolution computed tomography (HRCT) before and after treatment.

METHODS: Thirty infants diagnosed with PIBO were treated with a two-phase protocol consisting of an intensive phase and a maintenance phase, including budesonide, azithromycin, montelukast, fluticasone propionate, and terbutaline sulfate. Pulmonary function was evaluated using TPTEF/TE, VPEF/VE, and impulse oscillometry (IOS). Imaging evaluation was performed using HRCT.

RESULTS: Daytime respiratory symptoms significantly improved after 3 months of treatment (P < 0.05). Nocturnal symptoms and exercise-related limitations showed significant improvement after 6 months (P < 0.05) and 9 months (P < 0.05), respectively. The frequency of respiratory tract infections was significantly reduced after 12 months of continuous treatment (P < 0.05). Pulmonary function indices demonstrated significant improvement by the 9th month (P < 0.05). HRCT scores improved significantly, decreasing from 6 ± 1.08 at baseline to 4.5 ± 1.98 after 12 months of treatment (P < 0.05). Mosaic perfusion significantly improved at 6 months (P < 0.05), while emphysematous changes required 9 months of treatment to show significant improvement (P < 0.05). Structural abnormalities such as bronchiectasis, bronchial wall thickening, atelectasis, and peribronchial vascular bundle changes showed partial improvement after 12 months, but these differences did not reach statistical significance (P > 0.05).

CONCLUSION: Standardized treatment for PIBO should be maintained for at least 9-12 months to achieve significant improvements in clinical symptoms, pulmonary function, and HRCT findings.