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Tidal breathing flow measurement in awake young children by using impedance pneumography
Ville-Pekka Seppä1, Anna S Pelkonen, Anne Kotaniemi-Syrjänen
1Department of Electronics and Communications Engineering, Tampere University of Technology, Tampere, Finland.
Insights
Impedance pneumography (IP) accurately measures tidal breathing (TB) flow in young children, even with airway obstruction. This method shows excellent agreement with traditional pneumotachography (PNT) for assessing lung function in children with wheezing disorders.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Medical Device Technology
Background:
- Tidal breathing (TB) characteristics are linked to lung function and can be measured in young children.
- The accuracy of impedance pneumography (IP) for assessing TB flow in children, particularly those with bronchial obstruction, remains unevaluated.
Purpose of the Study:
- To evaluate the agreement between IP and pneumotachography (PNT) in measuring TB flow and related airway obstruction indices in young children.
- To assess the reliability of IP in capturing changes in airflow during bronchial challenge tests.
Main Methods:
- Simultaneous recording of tidal flow using IP and PNT in 21 wheezy children (3-7 years) during a methacholine bronchial challenge test.
- Comparison of direct flow signals and calculation of obstruction-related tidal flow indices (T PTEF/T E, V PTEF/V E, S) between the two methods.
- Correlation analysis of tidal flow index changes with respiratory system mechanical impedance.
Main Results:
- Excellent agreement between IP and PNT for direct flow signals (mean deviation 2.4-3.1% of tidal peak inspiratory flow).
- High agreement and repeatability for obstruction-related indices (ICC for T PTEF/T E: 0.94, V PTEF/V E: 0.91, S: 0.68).
- Significant association between methacholine-induced changes in tidal flow indices and respiratory impedance, particularly for V PTEF/V E (r = -0.54 to -0.55).
Conclusions:
- Impedance pneumography (IP) is a valid and accurate method for recording tidal airflow profiles in young children with wheezing disorders.
- IP demonstrates excellent agreement with PNT for direct flow measurement and obstruction-related indices, even during induced bronchoconstriction/dilation.
- IP offers a reliable, non-invasive tool for assessing respiratory function in pediatric populations.
Abstract:
Characteristics of tidal breathing (TB) relate to lung function and may be assessed even in young children. Thus far, the accuracy of impedance pneumography (IP) in recording TB flows in young children with or without bronchial obstruction has not been evaluated. The aim of this study was to evaluate the agreement between IP and direct flow measurement with pneumotachograph (PNT) in assessing TB flow and flow-derived indices relating to airway obstruction in young children. Tidal flow was recorded for 1 min simultaneously with IP and PNT during different phases of a bronchial challenge test with methacholine in 21 wheezy children aged 3 to 7 years. The agreement of IP with PNT was found to be excellent in direct flow signal comparison, the mean deviation from linearity ranging from 2.4 to 3.1% of tidal peak inspiratory flow. Methacholine-induced bronchoconstriction or consecutive bronchodilation induced only minor changes in the agreement. Between IP and PNT, the obstruction-related tidal flow indices were equally repeatable, and agreement was found to be high, with intraclass correlation coefficients for T PTEF/T E, V PTEF/V E, and parameter S being 0.94, 0.91, and 0.68, respectively. Methacholine-induced changes in tidal flow indices showed significant associations with changes in mechanical impedance of the respiratory system assessed by the oscillometric technique, with the highest correlation found in V PTEF/V E (r = -0.54; P < 0.005 and r = -0.55; P < 0.005 by using IP or PNT, respectively). The results indicate that IP can be considered as a valid method for recording tidal airflow profiles in young children with wheezing disorders.
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