Normative Data of Infant Pulmonary Function Testing: A Prospective Birth Cohort Study from India
Prawin Kumar1, Aparna Mukherjee1, Shivani Randev1
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Insights
This study establishes normal infant pulmonary function test (IPFT) ranges for Indian children up to 36 months. The findings provide crucial normative data for pediatric respiratory health assessments in this population.
Area of Science:
- Pediatric Pulmonology
- Neonatal Physiology
- Respiratory Medicine
Background:
- Establishing normal reference ranges for infant pulmonary function tests (IPFT) is essential for diagnosing respiratory conditions in neonates and young children.
- Previous studies may not adequately represent the diverse Indian pediatric population.
Purpose of the Study:
- To develop a normal reference range of infant pulmonary function test (IPFT) indices specifically for Indian children.
- To provide normative data for evaluating lung function in healthy neonates and children up to 36 months of age in India.
Main Methods:
- A prospective birth cohort study was conducted over five years in a tertiary-care Indian institute.
- Infant pulmonary function tests (IPFT) using tidal breathing flow-volume loop (TBFVL), rapid thoracoabdominal compression (RTC), and raised volume RTC (RVRTC) were performed at baseline and every six months until 36 months of age.
- 310 newborns were enrolled, with 281 completing the 36-month follow-up.
Main Results:
- Tidal volume per unit body weight (VT/kg) significantly increased from birth to 36 months.
- The peak expiratory flow rate to expiratory time ratio (tPTEF/tE) initially decreased and then returned to baseline by 36 months.
- No significant changes were observed in RTC indices, while the FEV0.5/FVC ratio in RVRTC significantly decreased over the study period.
Conclusions:
- Normal values for TBFVL, RTC, and RVRTC indices have been established for Indian neonates and children up to 36 months.
- These findings provide valuable normative data for the assessment of infant pulmonary function in the Indian context.
- The study highlights age-related changes in specific IPFT indices during early childhood.
Objective:
To develop a normal reference range of Infant pulmonary function test (IPFT) indices for Indian children.
Study Design:
Prospective birth cohort study.
Setting:
Division of Pediatric Pulmonology of a tertiary-care institute in India from August 2012 to March 2017.
Participants:
All neonates born at the institute during the study period were screened for eligibility.
Measurement:
IPFT at baseline and every 6-month until 36-months of age.
Main Outcome Measure(S):
Tidal breathing flow-volume loop (TBFVL), Rapid thoracoabdominal compression (RTC), and Raised volume RTC (RVRTC) indices at baseline and follow-up.
Results:
310 newborns were enrolled in the cohort; 281 of them (169 male) had completed 36-months of follow-up at the end of the study period. There was no influence of gender on the baseline IPFT indices. Tidal volume per unit body weight (VT/kg) significantly increased from baseline to 36 months of age (P<0.001) while the peak ratio (tPTEF/tE) initially decreased in first 18-months of age (P<0.001), after that returned to the baseline value by 36 months of age. RTC indices did not change significantly from baseline values. In RVRTC, the ratio of forced expiratory volume in 0.5s to forced vital capacity (FEV0.5/FVC) was significantly decreased from baseline to 36 months of age (P=0.002).
Conclusions:
Normal values for various IPFT indices for TBFVL, RTC, and RVRTC from neonates to the age of 36-month are provided. These data may be used as normative data for healthy neonates and children of Indian origin.
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