Changes in breathing pattern upon 100% oxygen in children at early school age

Jost, Kerstin; Lenherr, Nina; Singer, Florian; Schulzke, Sven; Frey, Urs; Latzin, Philipp; Yammine, Sophie

doi:10.1016/j.resp.2016.03.006

Cited by 11 publications

(9 citation statements)

References 25 publications

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“…Our findings are thus consistent with two recent studies that compared the average pre-phase VT to the average VT during the washout phase in preschool [2] and school age children [6]. FOONG et al…”

supporting

confidence: 93%

“…This effect was observed in both healthy subjects and those with CF. The average VT of the entire washout was not significantly different when compared to the pre-phase in all groups (0.8% decrease in healthy preschool children, 3.2% and 3.9% decrease in preschool and school age children with CF, respectively, and a 1.6% decrease in healthy adults).Our findings are thus consistent with two recent studies that compared the average pre-phase VT to the average VT during the washout phase in preschool [2] and school age children [6]. FOONG et al[2] observed a 13 mL (4.8%) decrease in VT whereas JOST et al[6] observed a 9.7 mL (3.5%) decrease in VT.…”

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confidence: 91%

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The effects of 100% oxygen on breathing pattern are not limited to young children

et al. 2018

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Breathing 100% oxygen has been reported to decrease tidal volume (VT) in infants [1] and recent evidence published in the European Respiratory Journal suggest that transient less pronounced effects are also seen in preschool children [2]. It is unclear whether there is an age dependency beyond infancy in the response to 100% oxygen or whether it is limited to young children. Here we investigate the effects of 100% oxygen on breathing pattern across a spectrum of ages to identify the change in VT that occurs when subjects breathe 100% oxygen during a multiple breath nitrogen washout (MBNW) test.MBNW testing was performed [3] with the Exhalyzer® D using Spiroware 3.1 software (EcoMedics AG, Dürnten, Switzerland). Preschool children were tested using a mask whereas older children and adults used a mouth piece. All trials were re-run through Spiroware 3.2.0 to obtain breath-by-breath output of VT, respiratory rate (RR) and minute ventilation (V′E) for all pre-washout and washout breaths. The average VT , RR and V′E of the last 5 breaths of the pre-phase was compared to each washout breath to calculate a relative change in each parameter. We also compared the final 5 breaths of the pre-phase to the average all of breaths collected during the washout phase. A non-linear regression analysis was used to model the breath-by-breath changes. In total data collected from 112 preschool children (50 healthy and 62 with cystic fibrosis (CF)) [4], 18 school age children (all with CF) [5] and 10 adults (all healthy) were include in the analysis. Combined, the subjects ranged from 2.5 years to 29 years of age (median 4.8 years, interquartile range (3.7-17.5)) and 63% of participants were male.Exposure to 100% oxygen resulted in an initial decrease in VT, RR and V′E in all three age groups (figure 1), followed by a return to pre-phase levels. This effect was observed in both healthy subjects and those with CF. The average VT of the entire washout was not significantly different when compared to the pre-phase in all groups (0.8% decrease in healthy preschool children, 3.2% and 3.9% decrease in preschool and school age children with CF, respectively, and a 1.6% decrease in healthy adults).Our findings are thus consistent with two recent studies that compared the average pre-phase VT to the average VT during the washout phase in preschool [2] and school age children [6]. FOONG et al.[2] observed a 13 mL (4.8%) decrease in VT whereas JOST et al.[6] observed a 9.7 mL (3.5%) decrease in VT. In infants, breath-by-breath analysis demonstrated temporary hypoventilation driven by a decrease in VT after 2-4 breaths, which remained low for 10-25 breaths before returning to baseline [1]. Therefore, changes in tidal breathing in response to exposure to 100% oxygen observed in infants are not unique to this age group. Rather, they are a phenomena exhibited by subjects of all ages with the magnitude of the effect being small after early infancy. This is important for longitudinal studies with MBNW measurements, as breathing 100% oxygen is unlikely...

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confidence: 93%

supporting

confidence: 91%

The effects of 100% oxygen on breathing pattern are not limited to young children

et al. 2018

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“…100% O 2 has been shown to change breathing dynamics and respiratory drive in infants and children [10] and could be problematic in advanced disease, when the respiratory response to hypercarbia may have been blunted [23]. It is unknown when such breathing changes are not relevant, but no change in breathing pattern with 100% O 2 was reported in children age 6–9 years [24]. Hence in the present study, the impact of the washout gas (room air versus 100% O 2 ) on the N 2 and SF 6 discrepancy is likely to be small.…”

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confidence: 99%

Simultaneous sulfur hexafluoride and nitrogen multiple-breath washout (MBW) to examine inherent differences in MBW outcomes

et al. 2019

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Multiple-breath washout (MBW) can be performed with different gases (sulfur hexafluoride (SF6) and nitrogen (N2)) and different devices, all of which give discrepant results. This study aimed to confirm previously reported differences and explore factors influencing discrepant results; equipment factors or the physical properties of gases used.MethodsHealthy controls (HCs) and participants with cystic fibrosis (CF) completed MBW trials on two commercially available devices (Exhalyzer D (N2) and Innocor (SF6)). Simultaneous washout of both gases at the same time on the commercial equipment and simultaneous washouts using a respiratory mass spectrometer (RMS) were completed in subsets. Primary outcomes were lung clearance index (LCI), breath number and time required to washout.ResultsBreath number was higher with N2 washout than SF6 in both HCs and patients with CF, whether washouts were completed individually or simultaneously. The difference was greater in more advanced disease, largely caused by differences in the final part of the washout. Results from commercial devices were similar to those obtained with the RMS.ConclusionsN2 MBW results were higher than SF6 MBW, with some of the largest differences reported to date being observed. The biggest impact was at the end of the washout and this was even the case when gases were washed out simultaneously. N2 and SF6 MBW results are inherently different and should be considered as independent measurements.

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“…However, while the decrease in VT was statistically significant, the mean decrease was not more than 10% of the VT, which is the cut-off thought to be physiologically relevant. This postulated 10% cut-off was chosen as simulated lung volumes in children of 3-8 years using a lung model resulted in a 10% variation from known values [6,8]. Six (of 43) children had a change in VT value that exceeded 10%, however there was no obvious effect of age or disease status in these individuals, and it is likely that the mean change in tidal breathing parameters was driven by a small number of individual children.…”

mentioning

confidence: 99%

“…Similar to our study, the authors reported heterogeneous responses independent of age and disease. More recently, JOST et al [6] compared changes in tidal breathing following MBN 2 W in healthy term-born and former preterm school-aged children (6-9 years), showing a small 3.5% decrease in VT. While the preterm children recorded a significantly larger decrease in VT value (8%) than did healthy children (0.7%) the study concluded that 100% oxygen had a minimal effect on tidal breathing.…”

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confidence: 99%

The effect of 100% oxygen on tidal breathing parameters in preschool children

et al. 2017

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The multiple-breath nitrogen washout (MBN 2 W) test assesses ventilation distribution by determining the number of functional residual capacity (FRC) lung turnovers required for tidal breathing of 100% oxygen to wash out resident nitrogen from the lungs [1]. In particular, the test has gained significant interest as a tool for monitoring disease progression and prognosis in children with lung disease, with a specific focus on cystic fibrosis (CF) due to its ability to discriminate between health and disease [2]. The use of 100% oxygen has become the preferred choice of inert gas in older children and adults. However, as discussed in the European Respiratory Society/American Thoracic Society consensus statement, there are disadvantages and unknowns as to how patient age, sedation and sleep state may interact with 100% oxygen to alter breathing patterns [3]. It is known that 100% oxygen alters breathing patterns in infants [4, 5] and therefore this approach is not recommended in this age group; however, it is assumed that the effect of 100% oxygen on respiration is diminished beyond infancy [3], with no reported impact of 100% oxygen on breathing parameters in school-aged children [6]. It remains unknown whether hyperoxia affects tidal breathing in young children, as there are no published studies in this age range. This study aimed to determine whether breathing 100% oxygen altered tidal breathing parameters in healthy young children and young children with CF.

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Changes in breathing pattern upon 100% oxygen in children at early school age

Cited by 11 publications

References 25 publications

The effects of 100% oxygen on breathing pattern are not limited to young children

The effects of 100% oxygen on breathing pattern are not limited to young children

Simultaneous sulfur hexafluoride and nitrogen multiple-breath washout (MBW) to examine inherent differences in MBW outcomes

The effect of 100% oxygen on tidal breathing parameters in preschool children

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