Variation of Nasal Respiratory Pattern With Age During Growth and Development

Laine-Alava, Maija T.; Minkkinen, Ulla K.

doi:10.1097/00005537-199703000-00021

Cited by 22 publications

(22 citation statements)

References 26 publications

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“…As a result, only a small pressure gradient exists between the upper airways beyond the point of collapse and the intrathoracic cavity. Nasal resistance is higher in children and decreases with age (26). It can be hypothesized that the nasal collapse during sniffs is more complete in children, and that Pn sn reflects intrathoracic pressure even more closely than in adults.…”

Section: Discussionmentioning

confidence: 99%

Sniff Nasal Inspiratory Pressure

Stefanutti

1999

Am J Respir Crit Care Med

111

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Like in adults, normal values of maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax) span a large range in children, making interpretation of low values difficult. Recently, sniff nasal inspiratory pressure (Pnsn) was developed as a new noninvasive test of inspiratory muscle strength. In healthy adults, Pnsn is most often higher than PImax. The aim of this study was to establish reference values of Pnsn in children and to compare them with PImax. A group of 180 unselected healthy children age 6 to 17 yr was studied in a school setting. All had a forced vital capacity (FVC) > 80% of predicted and a ratio of forced expiratory volume in one second/forced vital capacity (FEV1/ FVC) > 85% of predicted. All maneuvers were performed in the sitting position. The Pnsn was measured using a catheter occluding one nostril during maximal sniffs performed through the contralateral nostril from FRC. The PImax was measured from FRC and residual volume, and PEmax from FRC and total lung capacity. All children were able to perform the Pnsn maneuver easily. Pnsn was 104 +/- 26 cm H2O in boys and 93 +/- 23 cm H2O in girls (p < 0.005). These values were similar to those previously measured in healthy adults. Pnsn correlated with age, weight, and height in boys, but not in girls. In both sexes, Pnsn was higher than PImax measured at the same lung volume (FRC) (p < 0. 0001). Pnsn was >= PImaxFRC in 73 of 93 boys and 79 of 87 girls. We conclude that Pnsn can be easily used to assess inspiratory muscle strength in children age 6 yr or more, providing values higher than PImax. Normal values are independent of age in girls, and can be predicted from age by a first-degree equation in boys. Being easy and noninvasive, Pnsn may prove useful to assess inspiratory muscle strength in children with neuromuscular disorders.

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Section: Discussionmentioning

confidence: 99%

Sniff Nasal Inspiratory Pressure

Stefanutti

1999

Am J Respir Crit Care Med

111

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“…Bogdanffy (7) indicates that critical factors in assessing risk from exposure to nasal carcinogens include anatomical and air-ow dynamics (17)(18), biochemical and molecular factors (47), and changes in epithelial types (31). Children may be especially predisposed to the toxic effects of air pollutants due to the anatomy of their airways, an increase in minute ventilation rates, nasal respiratory pattern changes during growth and their limited awareness of potentially harmful ambient exposures (35,37,46). Ozone (O 3 ), the main pollutant for SWMMC is a highly reactive molecule that interacts with a wide variety of organic molecules including unsaturated fatty acids, proteins and nucleic acids to produce free radicals intermediates.…”

Section: Histopathologymentioning

confidence: 99%

Nasal Biopsies of Children Exposed to Air Pollutants

et al. 2001

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Southwest Metropolitan Mexico City (SWMMC) atmosphere is a complex mixture of air pollutants, including ozone, particulate matter, and aldehydes. Children in SWMMC are exposed chronically and sequentially to numerous toxicants, and they exhibit signi cant nasal damage. The objective of this study was to assess p53 accumulation by immunohistochemistr y in nasal biopsies of SWMMC children. We evaluated 111 biopsies from 107 children (83 exposed SWMMC children and 24 control children residents in a pollutant-compliant Caribbean island). Complete clinical histories and physical examinations, including an ear-nose-throat (ENT) exam were done. There was a signi cant statistical difference in the upper and lower respiratory symptomatolog y and ENT ndings between control and exposed children ( p < 0.001). Control children gave no respiratory symptomatolog y in the 3 months prior to the study; their biopsies exhibited normal ciliated respiratory epithelium and were p53-negative . SWMMC children complained of epistaxis, nasal obstruction, and crusting. Irregular areas of whitish-gray recessed mucosa over the inferior and middle turbinates were seen in 25% of SWMMC children, and their nasal biopsies displayed basal cell hyperplasia, decreased numbers of ciliated and goblet cells, neutrophilic epithelial in ltrates, squamous metaplasia, and mild dysplasia. Four of 21 SWMMC children with grossly abnormal mucosal changes exhibited strong transmural nuclear p53 staining in their nasal biopsies (p 0.005, odds ratio 26). In the context of lifetime exposures to toxic and potentially carcinogenic air pollutants, p53 nasal induction in children could potentially represent. a) a checkpoin t response to toxic exposures, setting up a selective condition for p53 mutation, or b) a p53 mutation has already occurred as a result of such selection. Because the biological signi cance of p53 nuclear accumulation in the nasal biopsies of these children is not clear at this point, we strongly suggest that children with macroscopic nasal mucosal abnormalities should be closely monitored by the ENT physician. Parents should be advised to decrease the children's number of outdoor exposure hours and encourage a balanced diet with an important component of fresh fruits and vegetables.

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“…These differences are likely to influence lung deposition, shown by only Ͻ1% of nominal dose being delivered to the lungs of ventilated infants as opposed to 8 -22% in adults (17). Airway morphometrics change dramatically during the first months of life, as well as breathing patterns, airway resistance, and lung volume (18). Lung deposition of drugs is influenced by all of these parameters (19), altering the trajectory of an aerosol particle through the upper airways into the lungs.…”

mentioning

confidence: 99%

Development of the Premature Infant Nose Throat-Model (PrINT-Model)—An Upper Airway Replica of a Premature Neonate for the Study of Aerosol Delivery

et al. 2008

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Clinical efficacy of aerosol therapy in premature newborns depends on the efficiency of delivery of aerosolized drug to the bronchial tree. To study the influence of various anatomical, physical, and physiological factors on aerosol delivery in preterm newborns, it is crucial to have appropriate in vitro models, which are currently not available. We therefore constructed the premature infant nose throat-model (PrINT-Model), an upper airway model corresponding to a premature infant of 32-wk gestational age by three-dimensional (3D) reconstruction of a three-planar magnetic resonance imaging scan and subsequent 3D-printing. Validation was realized by visual comparison and comparison of total airway volume. To study the feasibility of measuring aerosol deposition, budesonide was aerosolized through the cast and lung dose was expressed as percentage of nominal dose. The airway volumes of the initial magnetic resonance imaging and validation computed tomography scan showed a relative deviation of 0.94%. Lung dose at low flow (1 L/min) was 61.84% and 9.00% at high flow (10 L/min), p Ͻ 0.0001. 3D-reconstruction provided an anatomically accurate surrogate of the upper airways of a 32-wk-old premature infant, making the model suitable for future in vitro testing. (Pediatr Res 64: 141-146, 2008)

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Variation of Nasal Respiratory Pattern With Age During Growth and Development

Cited by 22 publications

References 26 publications

Sniff Nasal Inspiratory Pressure

Sniff Nasal Inspiratory Pressure

Nasal Biopsies of Children Exposed to Air Pollutants

Development of the Premature Infant Nose Throat-Model (PrINT-Model)—An Upper Airway Replica of a Premature Neonate for the Study of Aerosol Delivery

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