Tidal breathing parameters measured by structured light plethysmography in children aged 2-12 years recovering from acute asthma/wheeze compared with healthy children

Abstract

Measurement of lung function can be difficult in young children. Structured light plethysmography (SLP) is a novel, noncontact method of measuring tidal breathing that monitors displacement of the thoraco–abdominal wall. SLP was used to compare breathing in children recovering from an acute exacerbation of asthma/wheeze and an age‐matched cohort of controls. Children aged 2–12 years with acute asthma/wheeze (n = 39) underwent two 5‐min SLP assessments, one before bronchodilator treatment and one after. SLP was performed once in controls (n = 54). Nonparametric comparisons of patients to healthy children and of pre‐bronchodilator to post‐bronchodilator were made for all children, and also stratified by age group (2–5 vs. 6–12 years old). In the asthma/wheeze group, IE50SLP (inspiratory to expiratory flow ratio) was higher (median 1.47 vs. 1.31; P = 0.002), thoraco–abdominal asynchrony (TAA) and left–right asynchrony were greater (both P < 0.001), and respiratory rate was faster (P < 0.001) than in controls. All other timing indices were shorter and displayed reduced variability (all P < 0.001). Variability in time to peak inspiratory flow was also reduced (P < 0.001). Younger children showed a greater effect than older children for TAA (interaction P < 0.05). After bronchodilator treatment, the overall cohort showed a reduction in within‐subject variability in time to peak expiratory flow only (P < 0.001). Younger children exhibited a reduction in relative contribution of the thorax, TAA, and variability in TAA (interaction P < 0.05). SLP can be successfully performed in young children. The potential of SLP to monitor diseases such as asthma in children is worthy of further investigation. ClinicalTrials.gov identifier: NCT02543333.

Mini review shows that structured light plethysmography provides a non‐contact method for evaluating breathing patterns in children

“…Interestingly, an increased degree of thoraco‐abdominal asynchrony in breathing patterns and lower variability of tidal breathing parameters were observed in the asthmatic children with acute obstruction compared to the controls. An age‐stratified analysis showed a greater reduction of thoraco‐abdominal asynchrony in asthmatic children aged two to five years than those aged 6–12 years . The data on the control populations used in these two studies were previously published as preliminary normative data for children aged 3–17 years .…”

“…The same group studied the use of SLP in a younger age cohort of 30 children aged 2–12 during hospital admissions for acute asthmatic exacerbation . Again, when this group were compared to 54 healthy controls, the SLP pre‐bronchodilator IE 50 was significantly higher in the asthmatic children.…”

“…The phrase structured light plethysmography identified a methodology paper published in 2010 and eight peer‐reviewed full publications in English. In three papers, the study groups were specifically children and one paper described a paediatric case report . Otherwise, the data for this mini review had to be drawn together from published studies and abstracts covering adults and a number of abstracts covering paediatrics .…”

“…The evidence for using SLP as a tidal breathing measurement for children is provided by the 2017 and 2018 studies by Hmeidi et al. . Firstly, 30 asthmatic 7–16‐year‐olds with abnormal spirometry were studied with SLP and compared to 41 healthy, age‐matched controls .…”

In vitro comparison of unit dose vs infusion pump administration of albuterol via high‐flow nasal cannula in toddlers

“…The two chambers were connected with a rigid bar so that the ventilator functioned as respiratory muscle in one chamber to drive the other chamber to simulate spontaneous breathing (Figure ). The “distressed” breathing profile with tidal volume (Vt) of 100 mL, respiratory rate of 40 breaths/min, inspiratory time of 0.6 seconds was confirmed by the NICO2 monitor (Respironics, Murrysville, PA), which was placed between the chamber and trachea. Ventilator settings were adjusted based on the feedback from the monitor.…”