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Infant Pulmonary Function Tests in Children with Airway Anomalies and Correlation with Bronchoscopy Findings
Amit Pathania1, Kana Ram Jat2, Jhuma Sankar1
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Insights
Tidal Breathing Flow Volume Loops (TBFVL) can identify specific airway anomalies in infants. TBFVL patterns may also show improvement in infant airway conditions over time.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Neonatal Medicine
Background:
- Airway anomalies in infants present diagnostic challenges.
- Pulmonary function tests are crucial for assessing respiratory health in young children.
Purpose of the Study:
- To assess the utility of Tidal Breathing Flow Volume Loops (TBFVL) in diagnosing infant airway anomalies.
- To correlate TBFVL findings with bronchoscopy results in children aged 0-2 years.
- To identify characteristic TBFVL patterns associated with specific airway anomalies.
Main Methods:
- Prospective cohort study involving 53 children aged 0-2 years with diagnosed airway anomalies.
- Performance of TBFVL and bronchoscopy for each participant.
- Analysis of TBFVL graphic patterns, focusing on laryngomalacia, and comparison with controls.
Main Results:
- Laryngomalacia was present in 52.3% of enrolled children.
- The most frequent TBFVL pattern in laryngomalacia was Pattern 3 (inspiratory limb fluttering).
- Significantly elevated inspiratory time to expiratory time ratio (Ti/Te) and tPTEF/tE were observed in isolated laryngomalacia compared to controls.
- At six months, TBFVL Pattern 1 (normal) became the most common finding.
Conclusions:
- Specific airway anomalies in infants may exhibit distinct TBFVL graphic patterns.
- TBFVL patterns show potential for monitoring improvement in infant airway anomalies during follow-up.
Objectives:
To evaluate the role infant pulmonary function tests (Tidal Breathing Flow Volume Loops, TBFVL) in children with airway anomalies and to correlate the TBFVL so obtained with bronchoscopy findings.
Methods:
In this prospective cohort study, we enrolled children aged 0-2 years with airway anomalies and performed TBFVL and bronchoscopy. The primary outcome measure was graphic pattern of TBFVL in laryngomalacia. Secondary outcome measures were types of TBFVL results in various airway anomalies and controls.
Results:
Out of 53 children enrolled, 28 (52.3%) had laryngomalacia. Pattern 3 (fluttering of inspiratory limb) was commonest TBFVL pattern in laryngomalacia. Among TBFVL parameters, the ratio of inspiratory time to expiratory time (Ti/Te) and tPTEF/tE was significantly high in children with isolated laryngomalacia compared to controls. At six months of follow-up, TBFVL pattern 1 (normal) became the commonest pattern.
Conclusion:
A particular type of airway anomaly may have a characteristic graphic pattern in TBFVL and TBFVL pattern may indicate improvement in airway anomalies in follow-up.
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