Forced expiratory flows and lung volumes in normal infants

Tepper, Robert S.; Reister, Teresa K.; Angelicchio‐Keller, C.; Kisling, Jeffrey

doi:10.1002/ppul.1950150608

Cited by 80 publications

(47 citation statements)

References 18 publications

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“…Male infants wheeze more frequently than female infants [26±28] and this has been explained by male infants having smaller airways relative to lung size in comparison to females [29,30]. Some demonstrate that a particular sex has higher flows in comparison to the other sex [15,31], whilst other investigators have not observed any difference between male and female infants [12,32,33]. The current authors found that, at the age of 1 and 6 months, males who never wheezed had lower flows than females who never wheezed.…”

Section: Discussionmentioning

confidence: 92%

The association between early life lung function and wheezing during the first 2 yrs of life

Young¹,

Arnott²,

O′keeffe³

et al. 2000

Eur Respir J

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The association between early life lung function and wheezing during the first 2 yrs of life. S. Young, J. Arnott, P.T. O'Keeffe, P.N. Le Souef, L.I. Landau. #ERS Journals Ltd 2000. ABSTRACT: Reports have suggested that certain infants are predisposed to wheezing in the first 2 yrs of life due to abnormal lung function, prior to the first wheezing illness. The authors investigated the association between infant lung function and wheeze during the first 2 yrs of life.A cohort of 253 infants was evaluated. Respiratory function assessment was performed at 1, 6, and 12 months of age. Parental history of asthma, atopy, and maternal antenatal smoking habits were recorded. An infant was identified as having wheezed on the basis of parental report and, where possible, physician diagnosis. One hundred and sixty infants (63%) had complete diary and questionnaire information on wheeze available for analysis. Of these: 79 infants (50%) had never wheezed (NW) during the first 2 yrs of life and 81 had reported wheeze (W) (50%).Of those with a report of wheeze, the distribution through the first 2 yrs of life was; 28 during the first year of life only (Y1), 21 in the second year of life only (Y2), and 32 wheezed in both the first and second years of life (Y1&2).At the age of 1 month, prior to any lower respiratory illness, the W group had impaired lung function in comparison to the NW group. In Y1 infants, the neonatal lung function differences resolved by 12 months of age. In Y2 and Y1&2 infants lung function differences persisted throughout the first year of life. Prevalence of parental asthma and maternal antenatal smoking was increased in the W group p=0.001, p=0.008, respectively), in comparison to the NW infants. Maternal antenatal smoking prevalence was increased in the Y2 and Y1&2 infants in comparison to the NW group (p=0.04), (p=0.01), respectively.Wheezing during the first year of life is often a transient condition which improves with time. It appears to be related to early life reduced small airway calibre. Wheezing that begins or persists into the second year of life is usually associated with a different abnormality of the airways. Commencement or persistence of wheeze into the second year of life may be part of the clinical entity recognized as asthma. Eur Respir J 2000; 15: 151±157.

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Section: Discussionmentioning

confidence: 92%

The association between early life lung function and wheezing during the first 2 yrs of life

Young¹,

Arnott²,

O′keeffe³

et al. 2000

Eur Respir J

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“…When adjusted for age, boys had higher alveolar volumes; however, this age-related difference could be accounted for by the greater somatic size of boys than girls. Previous studies of lung volumes in infants and toddlers also found no sex differences when volumes are adjusted for body size (14,15). Our physiologic data is also consistent with morphometric data of autopsied lungs, which found no sex differences from subjects less than 2 years of age (2).…”

Section: Discussionmentioning

confidence: 99%

Growth of the Lung Parenchyma Early in Life

Balinotti¹,

Tiller²,

Llapur³

et al. 2009

Am J Respir Crit Care Med

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Rationale: Early in life, lung growth can occur by alveolarization, an increase in the number of alveoli, as well as expansion. We hypothesized that if lung growth early in life occurred primarily by alveolarization, then the ratio of pulmonary diffusion capacity of carbon monoxide (DL CO ) to alveolar volume (V A ) would remain constant; however, if lung growth occurred primarily by alveolar expansion, then DL CO /V A would decline with increasing age, as observed in older children and adolescents. Objectives: To evaluate the relationship between alveolar volume and pulmonary diffusion capacity early in life. Methods: In 50 sleeping infants and toddlers, with equal number of males and females between the ages of 3 and 23 months, we measured DL CO and V A using single breath-hold maneuvers at elevated lung volumes. Measurements and Main Results: DL CO and V A increased with increasing age and body length. Males had higher DL CO and V A when adjusted for age, but not when adjusted for length. DL CO increased with V A ; there was no gender difference when DL CO was adjusted for V A . The ratio of DL CO /V A remained constant with age and body length. Conclusions: Our results suggest that surface area for diffusion increases proportionally with alveolar volume in the first 2 years of life. Larger DL CO and V A for males than females when adjusted for age, but not when adjusted for length, is primarily related to greater body length in boys. The constant ratio for DL CO /V A in infants and toddlers is consistent with lung growth in this age occurring primarily by the addition of alveoli rather than the expansion of alveoli.Keywords: pulmonary diffusion capacity; alveolar volume; lung development The lung, which provides surface area for gas exchange, begins alveolarization of the lung parenchyma in late gestation; however, the number of alveoli present at birth is estimated to be less than 20% of the number in adults (1-3). In addition, alveolar size of an infant is smaller than the alveolar size of an adult (1-3). Therefore, postnatal growth and development of the lung parenchyma includes increases in number as well as size of alveoli. Lung volume early in life is thought to occur primarily by the addition of alveoli during the rapid phase of somatic growth, and then, following alveolarization of the lung parenchyma, lung volume increases by the expansion of existing alveoli. However, from the limited number of morphometric studies of relatively few autopsied lungs from infants and toddlers, which have used differing morphometric techniques to estimate alveolar number, it remains unclear whether the addition of alveoli is complete by 6 months, 2 to 3 years, or 8 years of age (2, 4-6).In vivo physiologic measurements of alveolar volume (V A ) and pulmonary diffusing capacity for carbon monoxide (DL CO ) can provide a functional assessment of the volume and surface area available for gas exchange, which indirectly reflects the cumulative effects of alveolar number and size. In older subjects from 8 years of age to...

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“…As a preliminary first approach, data from 279 infants studied by TEPPER et al [8], and STOCKS and coworkers [19,20], including some delivered prematurely, have been pooled. No interlaboratory differences were detected in the relationship between V'max,FRC and age or body size, although the majority of the younger and preterm infants were studied in London, UK by STOCKS and coworkers [19,20] and the majority of the older infants were studied by TEPPER et al [8] [8,19,20].)…”

Section: Appendix: Reference Datamentioning

confidence: 99%

“…No interlaboratory differences were detected in the relationship between V'max,FRC and age or body size, although the majority of the younger and preterm infants were studied in London, UK by STOCKS and coworkers [19,20] and the majority of the older infants were studied by TEPPER et al [8] [8,19,20].) postnatal age (taking gestational age into account) -4±139 weeks (term was taken to be 40 weeks gestational age) and crown-heel length 40±90 cm.…”

Section: Appendix: Reference Datamentioning

confidence: 99%

Tidal forced expirations

Sly

Tepper

Henschen³

et al. 2000

Eur Respir J

127

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The progress of infant lung function testing has been retarded by both the lack of user‐friendly, widely available and affordable equipment and the lack of standardized methodology. The European Respiratory Society/American Thoracic Society Task Force on Standards for Infant Respiratory Function Testing was formed in an attempt to address these deficiencies. This document represents the consensus of investigators with vast experience in the measurement of lung function in infants. The present recommendations deal with equipment requirements, study procedures and reporting of data for measurements of forced expiration at end‐tidal inspiration. They represent the “state of the art” in 1999. They are not meant to inhibit further developments in this technique. The authors anticipate that these guidelines will be updated regularly as knowledge progresses.

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Forced expiratory flows and lung volumes in normal infants

Cited by 80 publications

References 18 publications

The association between early life lung function and wheezing during the first 2 yrs of life

The association between early life lung function and wheezing during the first 2 yrs of life

Growth of the Lung Parenchyma Early in Life

Tidal forced expirations

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