Impaired Lung Functions Using Tidal Breath Analysis in High-risk Infants with Recurrent Wheezing

Anık, Ayşe; Uysal, Pınar

doi:10.5222/tp.2020.43153

Cited by 3 publications

(12 citation statements)

References 15 publications

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“…Therefore, the authors are unable to establish whether the differences in TFV loop parameters, including the time and volume ratios, between the awake and sleeping states will remain stable or change with increasing age and decreasing respiratory rate. In a study by A nık and U ysal [ 32 ], the authors found a positive correlation between age and t PTEF / t E ratio among awake infants and children aged 8–23 months with recurrent wheeze, with or without high risk of atopy. Therefore, the generalisability of our findings, differences and similarities, may be limited to TFV loop measurements in young infants.…”

Section: Discussionmentioning

confidence: 99%

Infant tidal flow–volume parameters and arousal state

et al. 2022

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BackgroundInfant lung function can be assessed with tidal flow-volume (TFV) loops. While TFV loops can be measured in both awake and sleeping infants, the influence of arousal state in early infancy is not established.AimTo determine if TFV loop parameters in healthy infants differed while awake compared to the sleeping state at 3 months of age.MethodsFrom the population-based Scandinavian PreventADALL birth cohort, 91 infants had reproducible TFV loops measured with Exhalyzer® D in both the awake and sleeping state at 3 months of age. The TFV loops were manually selected according to a standardised procedure. The ratio of time to peak tidal expiratory flow to expiratory time (tPTEF/tE) and the corresponding volume ratio (VPTEF/VE), as well as tidal volume (VT) and respiratory rate (RR) were compared using non-parametric tests.ResultsThe mean (95% CI) tPTEF/tE was significantly higher while awake compared to the sleeping state, 0.39 (0.37, 0.41) versus 0.28 (0.27, 0.29), with the corresponding VPTEF/VE of 0.38 (0.36, 0.40) versus 0.29 (0.28, 0.30), respectively. The VT was similar, while the RR was higher while awake compared to the sleeping state, 53 (51, 56) versus 38 (36, 40).ConclusionHigher tPTEF/tE, VPTEF/VE and RR, but similar VT while awake compared to the sleeping state suggests that separate normative TFV loop values according to arousal state may be required in early infancy.

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Section: Discussionmentioning

confidence: 99%

Infant tidal flow–volume parameters and arousal state

et al. 2022

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“…In relation to asthma in adolescents and adults, a previous study of 95 individuals found no differences in TEWL between allergic asthmatics and healthy controls [50]. Infants and children with obstructive airway diseases generally reach tPTEF earlier in the expiratory phase with a subsequent lower tPTEF/tE ratio, compared to healthy children [39][40][41], providing an important rationale for including tPTEF as an outcome in this study. Although reduced skin barrier function was not associated with lower lung function measured by tPTEF/tE, the inverse association with tPTEF, where high TEWL increased the risk for having shorter time before reaching peak expiratory flow, suggests that lung function and skin barrier function may share a common developmental origin, be manifestations of barrier dysfunction observed in two different organ systems, or infer a causal link between the two.…”

Section: Tewl and Lung Functionmentioning

confidence: 83%

“…Lower tPTEF: a tPTEF <0.17 s (below the 25th percentile) was chosen, as lower values have previously found in infants and children with airway obstruction and asthma [39][40][41].…”

Section: Secondary Outcomementioning

confidence: 99%

“…While a tPTEF/tE below 0.25 in infancy has been related to future obstructive lung diseases [37,[46][47][48], we are not aware of any defined cut-off values for tPTEF in infancy. Infants with obstructive airway diseases generally reach tPTEF faster in the expiratory phase compared to healthy children [39][40][41], therefore, as we were interested in the lower range of tPTEF, a tPTEF below the 25 th percentile (<0.17 s) was selected as secondary outcome. Furthermore, the continuous tPTEF was used in our sensitivity analysis.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Lower lung function, determined by tidal breath flow-volume (TFV) loops, is associated with higher risk for developing asthma in childhood [37], and reduced lung function from birth to adolescence has been observed in children with allergic asthma and AD [38]. Compared to healthy children, infants and children with obstructive airway diseases generally reach peak tidal expiratory flow (tPTEF) earlier in the expiratory phase with a subsequent lower ratio of time to peak tidal expiratory flow to expiratory time (tPTEF/tE) [39][40][41].…”

Section: Introductionmentioning

confidence: 99%

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Skin Barrier Function and Infant Tidal Flow-Volume Loops—A Population-Based Observational Study

et al. 2022

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Background: The relationship between skin barrier- and lung function in infancy is largely unexplored. We aimed to explore if reduced skin barrier function by high transepidermal water loss (TEWL), or manifestations of eczema or Filaggrin (FLG) mutations, were associated with lower lung function in three-month-old infants. Methods: From the population-based PreventADALL cohort, 899 infants with lung function measurements and information on either TEWL, eczema at three months of age and/or FLG mutations were included. Lower lung function by tidal flow-volume loops was defined as the ratio of time to peak tidal expiratory flow to expiratory time (tPTEF/tE) <0.25 and a tPTEF <0.17 s (<25th percentile). A high TEWL >8.83 g/m2/h (>75th percentile) denoted reduced skin barrier function, and DNA was genotyped for FLG mutations (R501X, 2282del4 and R2447X). Results: Neither a high TEWL, nor eczema or FLG mutations, were associated with lower tPTEF/tE. While a high TEWL was associated with a lower tPTEF; adjusted OR (95% CI) 1.61 (1.08, 2.42), the presence of eczema or FLG mutations were not. Conclusions: Overall, a high TEWL, eczema or FLG mutations were not associated with lower lung function in healthy three-month-old infants. However, an inverse association between high TEWL and tPTEF was observed, indicating a possible link between the skin barrier- and lung function in early infancy.

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Infant lung function and early skin barrier impairment in the development of asthma at age 3 years

Färdig,

Hoyer,

Almqvist

et al. 2024

Allergy

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BackgroundLargely unexplored, we investigated if lower lung function, impaired skin barrier function by transepidermal water loss (TEWL), eczema, and filaggrin (FLG) mutations in infancy were associated with asthma in early childhood.MethodsFrom the factorially designed randomized controlled intervention study PreventADALL, we evaluated 1337/2394 children from all randomization groups with information on asthma at age 3 years, and at age 3 months either lung function, TEWL, eczema, and/or FLG mutations. Lower lung function was defined as the time to peak tidal expiratory flow to expiratory time (tPTEF/tE) <0.25, and skin barrier impairment as a high TEWL >9.50 g/m2/h. Eczema was clinically observed, and DNA genotyped for FLG mutations. Asthma was defined as asthma‐like symptoms (≥3 episodes of bronchial obstruction) between age 2–3 years as well as a history of doctor‐diagnosed asthma and/or asthma medication use. Associations were analyzed in logistic regression models, presented with adjusted ORs (aOR) and 95% confidence intervals (CI).ResultsLower lung function and skin barrier impairment were associated with asthma in general; aOR (95% CI) 5.4 (2.1, 13.7) and 1.6 (1.1, 2.5), while eczema and FLG mutations were associated with asthma in children with atopic dermatitis or allergic sensitization only. Stratifying for sex, the risk of asthma was only increased in boys with lower lung function; aOR (95% CI) 7.7 (2.5, 23.6), and in girls with FLG mutations; aOR (95% CI) 3.5 (1.5, 8.2).ConclusionLower lung function and impaired skin barrier function in infancy may increase the risk of asthma at age 3 years.

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Impaired Lung Functions Using Tidal Breath Analysis in High-risk Infants with Recurrent Wheezing

Cited by 3 publications

References 15 publications

Infant tidal flow–volume parameters and arousal state

Infant tidal flow–volume parameters and arousal state

Skin Barrier Function and Infant Tidal Flow-Volume Loops—A Population-Based Observational Study

Infant lung function and early skin barrier impairment in the development of asthma at age 3 years

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