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Respiratory inductance plethysmography in healthy 3- to 5-year-old children
Oscar H Mayer1, Russell G Clayton, Abbas F Jawad
1Division of Pulmonary Medicine, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. mayero@email.chop.edu
Insights
Respiratory inductive plethysmography (RIP) measurements in young children show significant positional dependence. For consistent tracking of respiratory function, measurements must be taken in the same position.
Area of Science:
- Pediatric respiratory physiology
- Noninvasive diagnostic techniques
Background:
- Spirometry poses challenges for assessing respiratory function in 3- to 5-year-old children.
- Respiratory inductive plethysmography (RIP) offers a noninvasive alternative requiring minimal cooperation.
Purpose of the Study:
- To establish normative values for thoracoabdominal motion and timing mechanics in 3- to 5-year-old children.
- To investigate the positional dependence of RIP measurements in this age group.
Main Methods:
- Utilized respiratory inductive plethysmography (RIP) in 50 healthy children aged 3-5 years.
- Measured thoracoabdominal motion (phase angle) and timing mechanics (TPTEF/TE ratio) in sitting and supine positions.
Main Results:
- Thoracoabdominal motion became more asynchronous in the supine position compared to sitting (p < 0.001).
- The TPTEF/TE ratio increased significantly from sitting to supine positions (p < 0.001).
- No significant changes in measurements were observed with age, weight, height, or gender.
Conclusions:
- Positional variations in respiratory mechanics influence RIP measurements in young children.
- Consistent positioning is crucial for the reliable longitudinal use of RIP in this age range.
Study Objectives:
Because of the challenges of using standard measurements such as spirometry to measure respiratory function in 3- to 5-year-old children, there may be a role for respiratory inductive plethysmography (RIP), which is noninvasive and requires minimal subject cooperation. In this study, we described normative values of thoracoabdominal motion and timing mechanics in 3- to 5-year-old children, and hypothesized positional dependence of these measurements in this age group.
Design:
We measured relative thoracoabdominal motion during tidal breathing using the phase angle (Phi), the labored breathing index, and the phase relation during the total breath and timing mechanics with the ratio of time to peak tidal expiratory flow to expiratory time (TPTEF/TE).
Setting:
Preschools within the greater Philadelphia area and the Pulmonary Office of The Children's Hospital of Philadelphia.
Patients Or Participants:
Fifty healthy children between 3 years and 5 years of age.
Interventions:
RIP.
Measurements And Results:
All measures varied with position. Thoracoabdominal motion was nearly synchronous in the sitting position and most asynchronous in the supine position (Phi, 15.7 +/- 4.0 degrees vs 56.1 +/- 4.3 degrees, respectively; p < 0.001). This also led to an increase in the TPTEF/TE from the sitting to the supine positions (30.3 +/- 1.4% vs 37.0 +/- 1.6%, respectively; p < 0.001). Measurements of thoracoabdominal motion and timing mechanics did not change with age, weight, height, or gender.
Conclusions:
We conclude that the positional dependence of these measurements is due to the alteration in respiratory mechanics between the sitting, standing, and supine positions. We further conclude that if RIP is to be a useful longitudinal measure of respiratory function in this age range, comparison measurements should be made in the same position.
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