T Ti id da al l b br re ea at th hi in ng g a an na al ly ys si is s a an nd d r re es sp po on ns se e t to o s sa al lb bu ut ta am mo ol l i in n a aw wa ak ke e y yo ou un ng g c ch hi il ld dr re en n w wi it th h a an nd d w wi it th ho ou ut t a as st th hm ma a ABSTRACT: The purpose of the present study was to investigate: 1) whether tidal flow patterns can be used to discriminate between children with asthma and those without respiratory illness; and 2) whether reversibility to salbutamol in young children can be detected by tidal breathing analysis? Lung function was measured by tidal flow-volume loops (SensorMedics 2600) in 26 awake young children (13 males) with asthma (aged 7-85 months; mean age 33 months), and 26 (13 males) (aged 3-72 months; mean age 34 months) without respiratory illness, before and 15 min after inhalation of nebulized salbutamol, 0.05 mg·kg -1 .The ratios of the time and volume until peak expiratory flow to the total expiratory time and volume, respectively, (TPEF/TE and VPEF/VE), and the ratio of tidal expiratory flow at 25% remaining expiration to peak expiratory flow, TEF 25 /PEF, were significantly lower in asthmatic children than in controls, and increased significantly after salbutamol inhalation in the former. Conversely, TPEF/TE and VPEF/VE, but not TEF 25 /PEF decreased significantly in the controls after salbutamol inhalation. Respiratory rate and expiratory volume·kg -1 body weight did not differ significantly between the two groups before and after salbutamol inhalation.We conclude that tidal breathing analysis can discriminate young children with asthma from children without respiratory illness, both regarding baseline lung function and reversibility to salbutamol.
Duchenne's muscular dystrophy (DMD), characterized by gradually developing muscular weakness, leads to respiratory symptoms and reduced lung function. We aimed to assess lung function in 25 patients with DMD in relationship to age and muscular function. The 25 boys, mean age 13 years, comprized patients in southern Norway with DMD, taking part in an epidemiological follow-up study. None had chronic respiratory disease. Lung function was measured by maximum expiratory flow-volume loops and whole body plethysmography, and repeated after 1 year (n= 14). Lung function was reduced compared to predicted values for healthy children. Forced expiratory volume in 1 sec (FEV1)% predicted and forced vital capacity (FVC)% predicted correlated (significantly) inversely to age. FEV1 and FVC decreased annually 5.61 and 4.2% of predicted, respectively. Absolute values of FVC (litres) and FEV1 (1 sec(-1)) increased until mean age 14 years, decreasing thereafter. Values in % predicted decreased steadily throughout the age range (6-19 years). Lung function correlated closely to upper limb muscle function.
Results-Tidal expiratory volume (V E )and compliance of the respiratory system (CRS) tended to be higher in the sitting compared to the supine position, but this was not statistically significant. However, applying bracing in the sitting position significantly reduced V E . The highest values of CRS and V E were found in the sitting position without bracing. Conclusion-Impairment of tidal respiration must be considered when applying spinal bracing in very young children developing scoliosis with SMA. (Arch Dis Child 2001;84:521-524)
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