Pulmonary function testing in children and infants

Vogt, Barbara; Falkenberg, Christian; Weiler, Norbert; Frerichs, Inéz

doi:10.1088/0967-3334/35/3/r59

Cited by 31 publications

(31 citation statements)

References 192 publications

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“…Like in adults, pulmonary function testing has been playing an important role in measurement of respiratory conditions in infants. Estimates of infant pulmonary function are being used increasingly in clinical and epidemiological studies (15). Guidelines regarding the methodology and equipment have been developed by the ATS and ERS Task Force (16), but there remains a shortage of reference equations for interpreting results.…”

Section: Discussionmentioning

confidence: 99%

Reference values for resistance and compliance based on the single occlusion technique in healthy infants from Southeast China

Huang

Zhang

Zhang³

et al. 2016

J. Thorac. Dis.

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Background: Respiratory disease is a major cause of morbidity and mortality in infants and has a large impact on health care. The aim of this study was to present the reference values of resistance and compliance by using a single occlusion technique (SOT) in healthy infants in Southeast China.Methods: Respiratory compliance (Crs) and respiratory resistance (Rrs) were measured in healthy infants, aged 1-96 weeks, by using SOT in the Children's Hospital of FuDan University (Shanghai, China).For comparison, the infants were grouped by age as follows: 1-24, 25-48, 49-72 and 73-96 weeks. Multiple regression analysis was performed using age, length, weight, and body mass index (BMI) as the independent variables to obtain predictive equations, separated according to sex. Results:We measured 205 healthy infants from birth up to 96 weeks of age (112 boys, 93 girls). Height and weight increased significantly with age. The Rrs declined with length, whereas the Crs increased. The median Rrs was 5.04 kPa/L/sec (range, 3.73-6.82 kPa/L/sec), and the mean Crs was 119.52±60.47 mL/kPa.Regression equations for Rrs and Crs were obtained. Conclusions:We obtained reference values for passive respiratory mechanics by using SOT in healthy infants from Southeast China. These data provide references for assessing the normality of SOT measurements in infants.

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Section: Discussionmentioning

confidence: 99%

Reference values for resistance and compliance based on the single occlusion technique in healthy infants from Southeast China

Huang

Zhang

Zhang³

et al. 2016

J. Thorac. Dis.

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“…16 There is a good correlation between Gold Standard techniques and the ability to detect changes in airway caliber. The total maximum interruption time is never greater than 100milliseconds.…”

Section: Interruptor Technique (Rint)mentioning

confidence: 99%

“…The latter is more appropriate because preschoolers have proportionally larger airways to their lung volumes, so during expiratory maneuvers, they are able to perform forced expiration in less than 1s. 3,4,7,10,16 Recent studies suggest that they can perform appropriate and reproducible spirometric maneuvers. 15 In terms of acceptability, the extrapolated volume (EV)≤80mL or ratio EV/VFC<12.5% and should always report FEV 0.5 , FEV 0.75 and FEV 1 .…”

Section: Spirometrymentioning

confidence: 99%

“…2,3,[10][11][12][13][14] Children must feel comfortable and for that reason, health professionals should establish a friendly conversation or use distraction techniques, such as videos, music, books or games incentives linked to the pulmonary function equipment. 10,[14][15][16] The American Thoracic Society (ATS) and the European Respiratory Society (ERS) published in 2007 recommendations for the criteria for acceptability and reproducibility for preschool children, reference values being currently available for spirometry and specific airway resistance (sRaw). 2,15 This age group can perform spirometry, peak flow referenced to functional residual capacity ( )…”

Section: Introductionmentioning

confidence: 99%

“…10,14,19,21 It is regarded as a complementary method to spirometry. 16 The simplicity of the measurement has led to its widespread use in preschoolers. 7…”

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confidence: 99%

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Functional Respiratory Study in Preschool Children: A Review

Marques¹

2015

JLPRR

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Introduction: Children of preschool age have high chronic respiratory morbidity and a tendency to progressive increase. The pulmonary function tests (PFT) quantify objectively the lung commitment and are proving very useful in the diagnosis, therapeutic monitoring and prognostic evaluation of several pathologies.Purpose: The purpose of this literature review is to understand the relevance and value of PFT to this age group, taking into account the new criteria of the American Thoracic Society/European Respiratory Society (ATS/ERS) (2007). Methods:We conducted a literature review, based on the keywords: respiratory function test, pre-school, spirometry and asthma. We consulted the databases PubMed and B-on, from which 38 articles were selected. 18 of them were analyzed with respect to the keywords above.Results/discussion: PFT are valuable for the diagnostic evaluation of preschoolers, with high technically acceptable success rates and reproducible maneuvers. Conclusion:The evaluation of lung function is very important in the study of the genetic and environmental determinants of lung disease, as well as being a strong predictor of long-term illness. Keywords PlethysmographyIt is not possible to measure static lung volumes in young children because they do not tolerate valve occlusion in plethysmography. However the measurement of specific airway resistance (sRaw) does not require the use of a valve. sRaw is increased in asthmatic children at preschool age with wheezing and cystic fibrosis. 2,5,7,10,14 It is very useful in the assessment of bronchodilator response of young asthmatics and the effect of leukotriene antagonists and inhaled corticosteroids. 2,5,10,14 Tidal breathingThis technique includes the analysis of expiratory flow and thoracoabdominal motion. The analysis of expiratory flow at tidal breathing can be conducted through flow signals collected in the airway (with a mask/mouthpiece and pneumotachograph), or by volume changes collected at the thoracic wall (with bands at the thoracic and abdominal zone) by respiratory inductance plethysmography (RIP). 14,19 Interruptor technique (Rint)This is based on the rapid equilibration between the alveolar pressure and the pressure measured at the mouth during the sudden debt interruption, reflecting the static elastic traction of the respiratory system. 16 There is a good correlation between Gold Standard techniques and the ability to detect changes in airway caliber. The total maximum interruption time is never greater than 100milliseconds. 10,14,19,20 It may be more easily performed in the preschooler than spirometry.7 This technique has not gained broad clinical acceptance yet. It is mostly used in clinical research. Forced oscillation technique (FOT)It is a simple tidal breathing technique, non-invasive and easy to perform in preschoolers. Consists of applying an external wave of pressure in the mouth, through a pneumotachograph with mask or mouthpiece and nose clips, allowing the calculation of the respiratory system impedance (Zrs).This identi...

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Cord blood group 2 innate lymphoid cells are associated with lung function at 6 weeks of age

et al. 2021

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Objective. Offspring born to mothers with asthma in pregnancy are known to have lower lung function which tracks with age. Human group 2 innate lymphoid cells (ILC2) accumulate in foetal lungs, at 10-fold higher levels compared to adult lungs. However, there are no data on foetal ILC2 numbers and the association with respiratory health outcomes such as lung function in early life. We aimed to investigate cord blood immune cell populations from babies born to mothers with asthma in pregnancy. Methods. Cord blood from babies born to asthmatic mothers was collected, and cells were stained in whole cord blood. Analyses were done using traditional gating approaches and computational methodologies (t-distributed stochastic neighbour embedding and PhenoGraph algorithms). At 6 weeks of age, the time to peak tidal expiratory flow as a percentage of total expiratory flow time (tPTEF/tE%) was determined as well as Lung Clearance Index (LCI), during quiet natural sleep. Results. Of 110 eligible infants (March 2017 to November 2019), 91 were successfully immunophenotyped (82.7%). Lung function was attempted in 61 infants (67.0%), and 43 of those infants (70.5% of attempted) had technically acceptable tPTEF/tE% measurements. Thirty-four infants (55.7% of attempted) had acceptable LCI measurements. Foetal ILC2 numbers with increased expression of chemoattractant receptorhomologous molecule (CRTh2), characterised by two distinct analysis methodologies, were associated with poorer infant lung function at 6 weeks of age." Conclusion. Foetal immune responses may be a surrogate variable for or directly influence lung function outcomes in early life.

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Pulmonary function testing in children and infants

Cited by 31 publications

References 192 publications

Reference values for resistance and compliance based on the single occlusion technique in healthy infants from Southeast China

Reference values for resistance and compliance based on the single occlusion technique in healthy infants from Southeast China

Functional Respiratory Study in Preschool Children: A Review

Cord blood group 2 innate lymphoid cells are associated with lung function at 6 weeks of age

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