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Feasibility of repetitive lung function measurements by raised volume rapid thoracoabdominal compression during
1Danish Pediatric Asthma Center, Department of Pediatrics, Copenhagen University Hospital, Gentofte, Niels Andersens Vej 65, DK-2900 Hellerup, Denmark.
Insights
The raised volume rapid thoracoabdominal compression (RVRTC) technique is a feasible and safe method for measuring lung function in infants during bronchial methacholine challenges. This study demonstrates its effectiveness in assessing infant respiratory health.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Infant Health Assessment
Background:
- Assessing infant lung function is crucial for early detection of respiratory issues.
- Standard lung function tests are challenging to perform in young infants.
- The raised volume rapid thoracoabdominal compression (RVRTC) technique offers a potential solution.
Purpose of the Study:
- To evaluate the feasibility and safety of RVRTC for lung function measurements.
- To assess RVRTC's utility during bronchial methacholine challenge in infants.
- To determine the appropriate methacholine dosage for infant testing.
Main Methods:
- Four hundred two healthy infants were tested at 1 month of age.
- Repeated methacholine challenges were administered with quadrupling doses.
- Lung function was measured using RVRTC, focusing on forced expiratory volume in 0.5 seconds (FEV(0.5)) and transcutaneous oxygen pressure.
Main Results:
- Lung function measurement was successful in 99% of infants.
- Provocative dose (PD) was achieved in 79% by FEV(0.5) and 87% by oxygen pressure.
- Minor adverse events like hypoxemia and bradycardia occurred in a small percentage; parental-reported changes in infant behavior were common but generally mild.
Conclusions:
- The RVRTC technique is feasible and safe for standardized lung function measurements in asymptomatic young infants.
- The methacholine challenge protocol is appropriate for this age group.
- The study provides comprehensive data supporting RVRTC's clinical application.
Background:
The aim of the study was to evaluate the feasibility of lung function measurements by the raised volume rapid thoracoabdominal compression (RVRTC) technique during bronchial methacholine challenge in young infants.
Method:
Four hundred two healthy infants were tested at 1 month of age with RVRTC during repeated methacholine challenges with quadrupling doses from 0.037 to 16.674 mumol.
Results:
Measurement of baseline lung function was successful in 99% and the provocative dose (PD) was achieved in 79% of infants by forced expiratory volume in 0.5 s (FEV(0.5)). Additionally, the PD was successfully measured in 87% by transcutaneous oxygen pressure. No serious adverse events were observed during testing or after discharge from the clinic. The methacholine dose range was appropriate as PD could be determined in the majority of infants. FEV(0.5) values in 21% of infants dropped > 40% during the test. Short-lasting, self-limiting episodes of hypoxemia of < 80% occurred in 1% of infants and bradycardia < 90 beats/min in 19% of infants. The most common observations by parents were changes in the patterns of sleeping (95%), eating (57%), and behavior (58%) of the infant after hospital discharge. The mean acceptability rating among parents was 8 on a scale from 1 to 10, with 13% rating < or = 5. It took one operator 3 h to complete the test, with the actual lung function testing accounting for half the time.
Conclusion:
This very comprehensive experience with standardized measurements of lung function by RVRTC during methacholine challenge in young infants in a single center leads us to conclude that the test is feasible and safe to perform in asymptomatic young infants.
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