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Paper of the day - Vocal cord narrowing may cause breathing problems

Children with acute breathing difficulties but normal oxygen levels are more likely to be suffering from vocal cord dysfunction (VCD) than asthma, say US researchers.

VCD is the sudden, abnormal narrowing of vocal cords and is characterised by wheezing but does not respond to asthma medication. Spirometry during an acute attack can differentiate it from asthma.

Researchers studied 17 adolescents presenting to an A&E departments with acute respiratory distress but normal oxygen levels over the course of a year.

Spirometry identified 12 of them as having VCD.

Treatment of VCD uses breathing and relaxation techniques to help the vocal cords relax.

The authors say emergency departments should make more use of spirometry to avoid misdiagnosis and treatment.

Pediatric Pulmonology 2007 42; 605-609.

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