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Small airway patency in infants with apparent life-threatening events

H Hartmann1, J Seidenberg, J P Noyes

  • 1Academic Department of Paediatrics, University of Keele, North Staffordshire Hospital Centre, Stoke-on-Trent, United Kingdom.

European Journal of Pediatrics
|February 14, 1998
PubMed

Insights

Infants with a history of apparent life-threatening events (ALTE) show reduced small airway patency. This finding suggests that lower airway issues may contribute to the development of ALTE in infants.

Area of Science:

  • Pediatric Pulmonology
  • Neonatal Medicine
  • Respiratory Physiology

Background:

  • Apparent life-threatening events (ALTE) in infants are concerning, with prior studies suggesting reduced specific airway conductance.
  • The precise location of airway narrowing (upper vs. lower) in infants with ALTE remains unclear.

Purpose of the Study:

  • To investigate small airway patency in infants with a history of ALTE.
  • To differentiate between upper and lower airway contributions to reduced conductance in ALTE.

Main Methods:

  • A controlled study involving 26 infants with ALTE history and 27 healthy controls.
  • Lung function tests including partial expiratory flow-volume curves (using rapid chest compression), whole body plethysmography (measuring thoracic gas volume and airway resistance), and single breath occlusion technique (measuring respiratory system compliance).

Main Results:

  • Infants with ALTE history exhibited significantly reduced maximal flow at functional residual capacity (VmaxFRC) compared to controls (median 85 ml/s vs. 123 ml/s, P=0.003).
  • VmaxFRC, when corrected for thoracic gas volume (TGV), was also significantly lower in the ALTE group (0.5 s⁻¹ vs. 0.9 s⁻¹, P=0.001).
  • No significant differences were found in TGV, expiratory airway resistance (RAW), or respiratory system compliance (Crs) between the groups.

Conclusions:

  • Reduced small airway patency is a significant finding in infants with a history of ALTE.
  • These results suggest that compromised small airway function may be implicated in the pathogenesis of apparent life-threatening events.
Abstract

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