Analysis of the harmonic content of the tidal flow waveforms in infants

The aim of this study was to examine whether the spectral characteristics of tidal flow waveform reflect the interaction between the control of breathing and lung mechanics in 10 healthy infants (H), 10 infants with a history of wheezing disorders (W), and 10 infants with chronic lung disease (CLD). From the flow waveform, we calculated a shape index, the harmonic distortion (k(d)), which quantifies the extent to which a periodic signal deviates from a sine wave. The k(d) of the entire tidal flow waveform did not significantly discriminate between diagnostic groups. However, k(d) was sensitive to maturation: it increased from 0.26 at 1 mo to 0.37 at 6 mo of age (P < 0.002). Furthermore, the frequency (f) spectra of the flow (V) amplitudes between 0.13 and 10 Hz followed a power law: V(f) approximately f(-s), where s (slope) is the exponent in the power law. The exponent of the healthy infants s(H) was 4.24 [95% confidence interval (CI) = 0.2] at 1 mo, 4.39 (CI = 0.16) at 6 mo, and 4.35 (CI = 0.19) at 12 mo and not significantly changing with age. The mean value of s(W) was marginally lower (4.09 +/- 0.28; P < 0.05) than that of s(H). The mean s(CLD) was significantly lower (3.04 +/- 0.31; P < 0.001). Lower values of s and higher values of k(d) indicate an increased complexity of the feedback mechanisms determining tidal flow waveform and may be associated with disease.