Negative expiratory pressure: A new tool for evaluating lung function in children?

Tauber, Erich; Fazekas, Tamás; Eichler, Irmgard; Eichstill, Christina; Gärtner, Ch.; Koller, D. Y.; Frischer, Thomas

doi:10.1002/ppul.10233

Cited by 17 publications

(14 citation statements)

References 19 publications

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“…This parameter is calculated as TIF50 SLP /TEF50 SLP and can be considered analogous to the traditional “flow/volume-based” tidal breathing parameter, IE50 (the ratio of inspiratory to expiratory flow at 50% of tidal volume [TIF50/TEF50]). The effects of the COPD disease state on IE50 SLP , IE50, or related parameters have not been reported before, as such parameters have mainly been described in children with asthma or other respiratory disease 21. The CLES associated with IE50 SLP (84.6%, approximately equivalent to an effect size of 1.4 had the distribution been normal) is very large, which is an indication of the ability of the parameter in distinguishing COPD from health.…”

Section: Discussionmentioning

confidence: 94%

Tidal breathing patterns derived from structured light plethysmography in COPD patients compared with healthy subjects

Motamedi-Fakhr¹,

Wilson²,

Iles³

2016

MDER

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PurposeDifferences in tidal breathing patterns have been reported between patients with chronic obstructive pulmonary disease (COPD) and healthy individuals using traditional measurement techniques. This feasibility study examined whether structured light plethysmography (SLP) – a noncontact, light-based technique – could also detect differences in tidal breathing patterns between patients with COPD and healthy subjects.Patients and methodsA 5 min period of tidal (quiet) breathing was recorded in each patient with COPD (n=31) and each healthy subject (n=31), matched for age, body mass index, and sex. For every participant, the median and interquartile range (IQR; denoting within-subject variability) of 12 tidal breathing parameters were calculated. Individual data were then combined by cohort and summarized by its median and IQR.ResultsAfter correction for multiple comparisons, inspiratory time (median tI) and its variability (IQR of tI) were lower in patients with COPD (p<0.001 and p<0.01, respectively) as were ratios derived from tI (tI/tE and tI/tTot, both p<0.01) and their variability (p<0.01 and p<0.05, respectively). IE50SLP (the ratio of inspiratory to expiratory flow at 50% tidal volume calculated from the SLP signal) was higher (p<0.001) in COPD while SLP-derived time to reach peak tidal expiratory flow over expiratory time (median tPTEFSLP/tE) was shorter (p<0.01) and considerably less variable (p<0.001). Thoraco–abdominal asynchrony was increased (p<0.05) in COPD.ConclusionThese early observations suggest that, like traditional techniques, SLP is able to detect different breathing patterns in COPD patients compared with subjects with no respiratory disease. This provides support for further investigation into the potential uses of SLP in assessing clinical conditions and interventions.

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Section: Discussionmentioning

confidence: 94%

Tidal breathing patterns derived from structured light plethysmography in COPD patients compared with healthy subjects

Motamedi-Fakhr¹,

Wilson²,

Iles³

2016

MDER

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“…; Tauber et al. ). A reduction in TEF50, without a reduction in TIF50, would increase IE50 and explain the higher median IE50 SLP observed in our study.…”

Section: Discussionmentioning

confidence: 97%

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

Hmeidi

Motamedi-Fakhr²,

Chadwick

et al. 2018

Physiol Rep

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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.

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“…The Tauber study demonstrated that reductions in airway resistance following bronchodilator administration increased expiratory flow (Tauber et al. ). TEF50, however, did not return to “normal.” In our study, mIE50 decreased after bronchodilator but remained higher than in healthy children.…”

Section: Discussionmentioning

confidence: 99%

Tidal breathing parameters measured using structured light plethysmography in healthy children and those with asthma before and after bronchodilator

Hmeidi

Motamedi-Fakhr²,

Chadwick

et al. 2017

Physiological Reports

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Structured light plethysmography (SLP) is a light‐based, noncontact technique that measures tidal breathing by monitoring displacements of the thoracoabdominal (TA) wall. We used SLP to measure tidal breathing parameters and their within‐subject variability (v) in 30 children aged 7–16 years with asthma and abnormal spirometry (forced expiratory volume in 1 sec [FEV1] <80% predicted) during a routine clinic appointment. As part of standard care, the reversibility of airway obstruction was assessed by repeating spirometry after administration of an inhaled bronchodilator. In this study, SLP was performed before and after bronchodilator administration, and also once in 41 age‐matched controls. In the asthma group, there was a significant increase in spirometry‐assessed mean FEV1 after administration of bronchodilator. Of all measured tidal breathing parameters, the most informative was the inspiratory to expiratory TA displacement ratio (IE50SLP, calculated as TIF50SLP/TEF50SLP, where TIF50SLP is tidal inspiratory TA displacement rate at 50% of inspiratory displacement and TEF50SLP is tidal expiratory TA displacement rate at 50% of expiratory displacement). Median (m) IE50SLP and its variability (vIE50SLP) were both higher in children with asthma (prebronchodilator) compared with healthy children (mIE50SLP: 1.53 vs. 1.22, P < 0.001; vIE50SLP: 0.63 vs. 0.47, P < 0.001). After administration of bronchodilators to the asthma group, mIE50SLP decreased from 1.53 to 1.45 (P = 0.01) and vIE50SLP decreased from 0.63 to 0.60 (P = 0.04). SLP‐measured tidal breathing parameters could differentiate between children with and without asthma and indicate a response to bronchodilator.

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Negative expiratory pressure: A new tool for evaluating lung function in children?

Cited by 17 publications

References 19 publications

Tidal breathing patterns derived from structured light plethysmography in COPD patients compared with healthy subjects

Tidal breathing patterns derived from structured light plethysmography in COPD patients compared with healthy subjects

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

Tidal breathing parameters measured using structured light plethysmography in healthy children and those with asthma before and after bronchodilator

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