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Assessment of prematurely born children at follow-up using a tidal breathing parameter
A Greenough1, Y X Zhang, B Yüksel
1Department of Child Health, King's College Hospital, London, UK. a.greenough@kcl.ac.uk
Insights
Evaluating the shape of the tidal breathing expiratory flow curve, specifically the time to peak tidal expiratory flow to total expiratory time ratio (tPTEF:tE), can help identify respiratory issues in prematurely born children.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Pulmonary Function Testing
Background:
- Prematurely born infants often experience respiratory complications.
- Non-invasive lung function tests are needed for evaluating these children.
- Tidal breathing expiratory flow curve analysis offers a potential solution.
Purpose of the Study:
- To assess the utility of the tidal breathing expiratory flow curve shape in prematurely born children.
- To determine if the time to peak tidal expiratory flow to total expiratory time ratio (tPTEF:tE) is informative.
Main Methods:
- Analysis of 120 plethysmographic traces from prematurely born children (median gestational age 29 weeks).
- Calculation of the mean time to reach peak tidal expiratory flow as a proportion of total expiratory time (tPTEF:tE).
- Statistical comparison of tPTEF:tE based on neonatal respiratory support and follow-up symptom status.
Main Results:
- Significant differences in median tPTEF:tE were observed between groups based on mechanical ventilation, oxygen requirements, and symptom status.
- A low tPTEF:tE ratio was independently associated with symptom status in prematurely born children.
- The findings suggest tPTEF:tE is a relevant indicator of respiratory health.
Conclusions:
- Tidal breathing parameter assessment, specifically tPTEF:tE, is a potentially useful tool for evaluating prematurely born children.
- This non-invasive, quick, and simple method could be applied to large populations.
- Further evaluation in non-sedated, young prematurely born children is recommended.
Abstract:
Prematurely born children frequently have respiratory problems at follow-up. A non-invasive and easily performed lung function test would greatly facilitate their evaluation and appropriate treatment. We have, therefore, assessed whether the shape of the tidal breathing expiratory flow curve would give useful information in such a population. One hundred and twenty traces were randomly selected from plethysmographic measurements of thoracic gas volume and airway resistance made during a follow-up study of a prematurely born population. The children had a median gestational age of 29 (range 23-35, interquartile range 27-31) weeks and postnatal age at the time of measurement of 11 (range 6-24, interquartile range 7-13) months. From the flow and volume signals, the mean time to reach peak tidal expiratory flow as a proportion of the total expiratory time (tPTEF : tE) was determined for each child. The median tPTEF : tE differed significantly between children who, in the neonatal period, had or had not required mechanical ventilation (p < 0.001) and had or had not had an increased inspired oxygen requirement (p < 0.01), and who were or were not symptomatic at follow-up (p < 0.001). Logistic regression analysis demonstrated that a low tPTEF : tE ratio was independently associated with symptom status. These results suggest that assessment of a tidal breathing parameter during follow-up of prematurely born children may be useful. As tPTEF : tE can be measured without sedation, relatively quickly and with simple equipment, potentially large study populations could be investigated, and this technique should now be evaluated in a non-sedated group of young prematurely born children.