Eosinophil cationic protein and tidal flow volume loops in children 0-2 years of age

Carlsen, KC Lødrup; Halvorsen, Ragnhild; Ahlstedt, S.; Carlsen, K-H.

doi:10.1183/09031936.95.08071148

Cited by 55 publications

(23 citation statements)

References 27 publications

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“…This observation strengthens the likelihood that these lung function measurements reflect severity of OAD in young children, as has been previously reported [13,26]. Furthermore, it appears that the children who subsequently received ICS treatment had the greatest improvement in lung function by 2 yrs of age.…”

Section: Discussionsupporting

confidence: 69%

“…Although there is debate on the standardisation and measurements in the youngest children, TFV measurements have been documented in the present study, in previous studies from the current authors [13,16,26] and others9 studies [12,30], to be sensitive enough to differentiate between children with and without OAD, as well as to detect adverse effects of maternal smoking in pregnancy [31,32]. It is, therefore, suggested that the present findings are representative of changes in lung function through early childhood, and can be used to document changes related to ICS treatment in groups of these young children.…”

Section: Advantages and Limitations Of The Present Studysupporting

confidence: 51%

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Effect of inhaled steroids on lung function in young children: a cohort study

Devulapalli¹,

Haaland²,

Pettersen³

et al. 2004

Eur Respir J

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The objectives of the present study were to determine the use of inhaled corticosteroids (ICS) for treating recurrent bronchial obstruction (rBO) in young children up to 2 yrs of age and to assess possible modifying effects of ICS on lung function in young children with rBO. From an observational, noninterventional birth cohort of 3,754 newborn children (3,697 with complete questionnaire data by 2 yrs of age), 306 children with documented rBO by age 2 yrs (cases) were identified along with 306 matched controls.Two tidal flow/volume measurements were taken, one at presentation of disease (children were steroid naïve) and one at 2 yrs of age (mean age 11.2 and 25.6 months, respectively), from: 21 cases who subsequently received ICS (ICSz); 33 who did not (ICS-); and in 15 controls. The mean¡SD duration of ICS treatment was 10.3¡6.5 months. The main outcomes were treatment with ICS and baseline ratio of time to peak expiratory flow/total expiratory time (tPTEF/tE).From the entire cohort, 77 children (2.1%) and 21% of children with rBO had received ICS by 2 yrs of age. Baseline tPTEF/tE was significantly lower at the first visit only in ICSz as compared to ICS-subjects, as well as in ICSz and ICS-as compared to controls. The mean difference in baseline tPTEF/tE from first to second visit was borderline statistically significant in the ICSz group only and correlated significantly with duration of ICS treatment.The present observational cohort study demonstrated that one-fifth of young children with recurrent bronchial obstruction had received inhaled corticosteroids. Early inhaled corticosteroid treatment improved lung function by age 2 yrs, mostly in those with the longest duration of treatment.

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Section: Discussionsupporting

confidence: 69%

Section: Advantages and Limitations Of The Present Studysupporting

confidence: 51%

Effect of inhaled steroids on lung function in young children: a cohort study

Devulapalli¹,

Haaland²,

Pettersen³

et al. 2004

Eur Respir J

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“…12 The most commonly used parameters to describe the shape of the TFV loop have been tPTEF/tE and the corresponding VPTEF/VE. Although the time ratio is most commonly reported, [1][2][3][4][5][6][7][8][9]12,19 there is no agreement regarding the optimal ratio to discriminate between lung diseases and health. 2,3,18 The aim of the present study was to review our published data and determine whether the observed changes in ratios tPTEF/tE and VPTEF/VE 2,10 could be related to changes in respiratory rates and/or other physiological mechanisms in normal neonates 10 and in children with asthma.…”

Section: Introductionmentioning

confidence: 99%

Determinants of tidal flow volume loop indices in neonates and children with and without asthma

1997

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The tidal flow volume (TFV) loop ratios of (1) time to peak flow (tPTEF) to total expiratory time (tE) [tPTEF/tE] and (2) volume to peak flow (VPTEF) to expired volume (VE) [VPTEF/VE] are reported to decrease with age in early life, and to decrease in subjects with obstructive airways disease (OAD). However, the mechanisms behind these changes are not well known. Thus, we reanalyzed data from 24 healthy neonates (mean birthweight: 3.49 kg ± 0.42 kg (SD)), 26 presently asymptomatic asthmatic children (age: 33 ± 21 months), and 26 controls (age: 34 ± 19 months) to elucidate what is responsible for the changes in these ratios in health and disease. Lung function was measured by TFV loops (SensorMedics 2600) at 1 hour of life and on the following day in the neonates, and before and after inhaled nebulized salbutamol (0.05 mg/kg) in the asthmatics and their controls. The observed decreases in mean tPTEF/tE and VPTEF/VE from 1 hour to 1 day of life (neonates) were entirely due to increased tE and VE, respectively secondary to a decrease in respiratory rate (P = 0.03). In asthmatics (young children), the decreased baseline tPTEF/tE and VPTEF/VE were due to lower tPTEF and VPTEF, with no significant differences in tEe and VE in asthmatics and controls. The improved ratios in asthmatic children following inhalation of a bronchodilator were mainly due to increased tPTEF and VPTEF. Our observations point out the importance of evaluating both tPTEF and either tPTEF/tE or VPTEF/VE when attempting to differentiate between changes in ratios that are related to age versus changes that reflect underlying obstructive airways disease. Pediatr. Pulmonol. 1997; 24:391–396. © 1997 Wiley‐Liss, Inc.

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“…Tidal breathing parameters were determined by the TFV ratios, t PEF/t E and VPEF/VE, which have been shown to differ according to obstructive airways disease; t PEF/t E [10][11][12] and VPEF/ VE [10,11,13,14] have also predicted wheeze in children under 3 yrs of age (t PEF/t E) [5]. Respiratory mechanics were determined as: compliance of the respiratory system (Crs) as a measure of tissue and airways elasticity; and resistance of the respiratory system (Rrs) as a measures of airways size.…”

Section: Outcome Measuresmentioning

confidence: 99%

In utero exposure to cigarette smoking influences lung function at birth

Carlsen

Jaakkola²,

Nafstad³

et al. 1997

Eur Respir J

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227

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To avoid the possible confounding effects of postnatal exposure to tobacco smoke, we investigated possible effects of uterine tobacco smoke (UTS) exposure upon infant lung function shortly after birth.Infants with no major disease, in one maternity ward in Oslo, Norway, participating in a cohort study established in 1992/1993, were included in the present study (n=803). Exposure information, assessed as maternal active and passive smoking during pregnancy and other personal and environmental factors, was obtained by questionnaire. Tidal flow-volume (TFV) loops (n=802) and compliance (Crs) and resistance (Rrs) of the respiratory system (n=663) were measured at a mean age of 2.7 days.In girls, the TFV ratio (time to reach peak expiratory flow to total expiratory time (t PEF/t E)), and Crs were significantly lower with active as well as passive maternal smoking compared to nonexposure to UTS. Respiratory rate and Rrs were not significantly influenced by UTS exposure. However, in linear regression analysis adjusted for confounding factors (including respiratory rate), t PEF/t E and Crs, but not Rrs, were related to maternal active but not passive daily smoking. One daily cigarette corresponded to a change in t PEF/t E of -0.0021 (95% confidence interval (95% CI) -0.0040 to -0.0002) and a change in Crs of -0.026 mL·cmH 2 O (95% CI -0.045 to -0.007 mL·cmH 2 O). The decrease was 0.023 and 0.29, respectively, in infants of an average smoker.Maternal smoking during pregnancy adversely affected tidal flow-volume ratios in healthy newborn babies, as well as the compliance of the respiratory system in girls, independently of the reduced body size also resulting from maternal smoking.

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Eosinophil cationic protein and tidal flow volume loops in children 0-2 years of age

Cited by 55 publications

References 27 publications

Effect of inhaled steroids on lung function in young children: a cohort study

Effect of inhaled steroids on lung function in young children: a cohort study

Determinants of tidal flow volume loop indices in neonates and children with and without asthma

In utero exposure to cigarette smoking influences lung function at birth

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