Differences in Tidal Breathing Between Infants with Chronic Lung Diseases and Healthy Controls

Overview

Journal BMC Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2005 Sep 10

PMID 16150146

Citations 32

Authors

G Schmalisch

S Wilitzki

R R Wauer

Affiliations

Soon will be listed here.

Abstract

Background: The diagnostic value of tidal breathing (TB) measurements in infants is controversially discussed. The aim of this study was to investigate to what extent the breathing pattern of sleeping infants with chronic lung diseases (CLD) differ from healthy controls with the same postconceptional age and to assess the predictive value of TB parameters.

Methods: In the age of 36-42 postconceptional weeks TB measurements were performed in 48 healthy newborns (median age and weight 7d, 3100 g) and 48 infants with CLD (80d, 2465 g)) using the deadspace-free flow-through technique. Once the infants had adapted to the mask and were sleeping quietly and breathing regularly, 20-60 breathing cycles were evaluated. Beside the shape of the tidal breathing flow-volume loop (TBFVL) 18 TB parameters were analyzed using ANOVA with Bonferroni correction. Receiver-operator characteristic (ROC) curves were calculated to investigate the discriminative ability of TB parameters.

Results: The incidence of concave expiratory limbs in CLD infants was 31% and significantly higher compared to controls (2%) (p < 0.001). Significant differences between CLD infants and controls were found in 11/18 TB parameters. The largest differences were seen in the mean (SD) inspiratory time 0.45(0.11)s vs. 0.65(0.14)s (p < 0.0001) and respiratory rate (RR) 55.4(14.2)/min vs. 39.2(8.6)/min (p < 0.0001) without statistically significant difference in the discriminative power between both time parameters. Most flow parameters were strongly correlated with RR so that there is no additional diagnostic value. No significant differences were found in the tidal volume and commonly used TB parameters describing the expiratory flow profile.

Conclusion: The breathing pattern of CLD infants differs significantly from that of healthy controls. Concave TBFVL and an increased RR measured during quiet sleep and under standardized conditions may indicate diminished respiratory functions in CLD infants whereas most of the commonly used TB parameters are poorly predictive.

Citing Articles

The effects of flow settings during high-flow nasal cannula oxygen therapy for neonates and young children.

Li J, Deng N, He W, Yang C, Liu P, Albuainain F Eur Respir Rev. 2024; 33(171).

PMID: 38537946 PMC: 10966474. DOI: 10.1183/16000617.0223-2023.

Dose-dependent impact of human milk feeding on tidal breathing flow-volume loop parameters across the first 2 years of life in extremely low-birth-weight infants: a cohort study.

Lavizzari A, Esposito B, Pesenti N, Shaykhova A, Vizzari G, Ophorst M Eur J Pediatr. 2023; 182(11):4969-4976.

PMID: 37610435 DOI: 10.1007/s00431-023-05163-1.

Thoracoabdominal asynchrony in a virtual preterm infant: computational modeling and analysis.

Foster R, Smith B, Ellwein Fix L Am J Physiol Lung Cell Mol Physiol. 2023; 325(2):L190-L205.

PMID: 37338113 PMC: 10396271. DOI: 10.1152/ajplung.00123.2022.

A Comprehensive Survey on the Progress, Process, and Challenges of Lung Cancer Detection and Classification.

Mridha M, Prodeep A, Hoque A, Islam M, Lima A, Kabir M J Healthc Eng. 2022; 2022:5905230.

PMID: 36569180 PMC: 9788902. DOI: 10.1155/2022/5905230.

Infant lung function: criteria for selecting tidal flow-volume loops.

Bains K, Gudmundsdottir H, Fardig M, Amno E, Jonassen C, Nordlund B ERJ Open Res. 2022; 8(4).

PMID: 36299362 PMC: 9589321. DOI: 10.1183/23120541.00165-2022.

References

Williams E, Madgwick R, Thomson A, Morris M . Expiratory airflow patterns in children and adults with cystic fibrosis. Chest. 2000; 117(4):1078-84. DOI: 10.1378/chest.117.4.1078. View

Hjalmarson O, Sandberg K . Lung function at term reflects severity of bronchopulmonary dysplasia. J Pediatr. 2005; 146(1):86-90. DOI: 10.1016/j.jpeds.2004.08.044. View

Lui K, Lloyd J, Ang E, Rynn M, Gupta J . Early changes in respiratory compliance and resistance during the development of bronchopulmonary dysplasia in the era of surfactant therapy. Pediatr Pulmonol. 2000; 30(4):282-90. DOI: 10.1002/1099-0496(200010)30:4<282::aid-ppul2>3.0.co;2-d. View

Bates J, Schmalisch G, Filbrun D, Stocks J . Tidal breath analysis for infant pulmonary function testing. ERS/ATS Task Force on Standards for Infant Respiratory Function Testing. European Respiratory Society/American Thoracic Society. Eur Respir J. 2001; 16(6):1180-92. DOI: 10.1034/j.1399-3003.2000.16f26.x. View

Fleming P, Levine M, Goncalves A . Changes in respiratory pattern resulting from the use of a facemask to record respiration in newborn infants. Pediatr Res. 1982; 16(12):1031-4. DOI: 10.1203/00006450-198212000-00013. View

Dolfin T, Duffty P, Wilkes D, England S, Bryan H . Effects of a face mask and pneumotachograph on breathing in sleeping infants. Am Rev Respir Dis. 1983; 128(6):977-9. DOI: 10.1164/arrd.1983.128.6.977. View

Tepper R, Morgan W, Cota K, Taussig L . Expiratory flow limitation in infants with bronchopulmonary dysplasia. J Pediatr. 1986; 109(6):1040-6. DOI: 10.1016/s0022-3476(86)80296-7. View

Gerhardt T, Hehre D, FELLER R, Reifenberg L, Bancalari E . Serial determination of pulmonary function in infants with chronic lung disease. J Pediatr. 1987; 110(3):448-56. DOI: 10.1016/s0022-3476(87)80516-4. View

Schmalisch G, Foitzik B, Wauer R, Stocks J . Effect of apparatus dead space on breathing parameters in newborns: "flow-through" versus conventional techniques. Eur Respir J. 2001; 17(1):108-14. DOI: 10.1183/09031936.01.17101080. View

10.

Bancalari E . Changes in the pathogenesis and prevention of chronic lung disease of prematurity. Am J Perinatol. 2001; 18(1):1-9. DOI: 10.1055/s-2001-12940. View

11.

Bancalari E, del moral T . Bronchopulmonary dysplasia and surfactant. Biol Neonate. 2001; 80 Suppl 1:7-13. DOI: 10.1159/000047170. View

12.

Jobe A, Bancalari E . Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001; 163(7):1723-9. DOI: 10.1164/ajrccm.163.7.2011060. View

13.

Schmalisch G, Schmidt M, Foitzik B . Novel technique to average breathing loops for infant respiratory function testing. Med Biol Eng Comput. 2002; 39(6):688-93. DOI: 10.1007/BF02345443. View

14.

Patzak A, Foitzik B, Mrowka R, Schmalisch G . Time of measurement influences the variability of tidal breathing parameters in healthy and sick infants. Respir Physiol. 2002; 128(2):187-94. DOI: 10.1016/s0034-5687(01)00277-8. View

15.

Schmalisch G, Wauer R, Foitzik B, Patzak A . Influence of preterm onset of inspiration on tidal breathing parameters in infants with and without CLD. Respir Physiol Neurobiol. 2003; 135(1):39-46. DOI: 10.1016/s1569-9048(03)00029-6. View

16.

Hislop A . Lung growth and computed tomography. Eur Respir J. 2003; 22(2):195-6. DOI: 10.1183/09031936.03.00040603. View

17.

Ranganathan S, Goetz I, Hoo A, Lum S, Castle R, Stocks J . Assessment of tidal breathing parameters in infants with cystic fibrosis. Eur Respir J. 2003; 22(5):761-6. DOI: 10.1183/09031936.03.00024703. View

18.

PRECHTL H . The behavioural states of the newborn infant (a review). Brain Res. 1974; 76(2):185-212. DOI: 10.1016/0006-8993(74)90454-5. View

19.

Durang M, Rigatto H . Tidal volume and respiratory frequency in infants with bronchopulmonary dysplasia (BPD). Early Hum Dev. 1981; 5(1):55-62. DOI: 10.1016/0378-3782(81)90070-0. View

20.

Hanley J, McNeil B . The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982; 143(1):29-36. DOI: 10.1148/radiology.143.1.7063747. View