Raised-Volume Forced Expiratory Flow-Volume Curve in Healthy Taiwanese Infants

Lai, Shen‐Hao; Liao, Sui‐Ling; Yao, Tsung‐Chieh; Tsai, Ming‐Han; Hua, Mau‐Sun; Chiu, Chih‐Yung; Yeh, Kuo‐Wei; Huang, Jing‐Long

doi:10.1038/s41598-017-06815-7

Cited by 6 publications

(14 citation statements)

References 36 publications

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“…1 present the scores and trends of the respiratory function of infants with BPD of various severity levels obtained after z-score transformation of the aforementioned indexes by using the local healthy refs. 14,15 . Children with severe BPD in their infancy persistently exhibited poor performance; their z-scores of respiratory function (V'max FRC , FEV 0.5 , FVC, and FEF ) deteriorated with age (18 and 24 months of age).…”

Section: Resultsmentioning

confidence: 99%

“…Study population and data collection. The present study was part of an ongoing larger, prospective, population-based birth cohort study called the Prediction of Allergies in Taiwanese Children (PATCH) 14,15,37,38 , which was initiated in 2013. Data collection is during the period of 2014 to 2018.…”

Section: Methodsmentioning

confidence: 99%

“…Infants with major birth defects or congenital structural anomalies of the upper airway, those who were haemodynamically unstable, and those with a history of severe lower airway infection were excluded. Control participants, for the establishment of normal healthy reference, were simultaneously enrolled in the same period 14,15 . This study was approved by the Institutional Table 5.…”

Section: Methodsmentioning

confidence: 99%

“…Because this technique relies on functional residual capacity (FRC) as a landmark, the measurement results may vary widely among young infants 25 . Nevertheless, such variation can be controlled if the techniques are executed by experienced laboratory professionals following strict quality control measures 15,26 . Filippone and Owens et al reported that the z-scores of V'max FRC in infancy were highly related with those of spirometry in school-age children till young adults 27,28 .…”

Section: Momentioning

confidence: 99%

“…Sanchez-Solis et al recently also shown that the gain of body length is associated with increase in lung function (exam of raised-volume forced expiration) 33 . This may related to the fact that body length is the dominant determinant of lung function in infants and preschool children 14,15,34 . Furthermore, our study found that postnatal respiratory morbidity (ventilator days) is significantly related to the performance of lung function (especially in exams of forced expiratory flow) in their later life up to preschool age.…”

Section: Momentioning

confidence: 99%

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Evolution and Determinants of Lung Function until Late Infancy among Infants Born Preterm

Lai

Chiang

Chu

et al. 2020

Sci Rep

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to investigate the evolution of lung function in preterm infants with and without bronchopulmonary dysplasia (BpD) and to determine the perinatal characteristics associated with indexes of lung function in later infancy. Longitudinal lung function assessments were performed at approximately 6, 12, 18, and 24 months of corrected age in preterm infants. Perinatal characteristics were further analyzed to ascertain the determinants of lung function indexes. Although all preterm infants (n = 121; 61 without BPD and 60 with BPD) exhibited decreased lung function in early infancy (6 months of age), after body length was adjusted for, only infants with BPD exhibited poor performance. Furthermore, the lung function of infants with mild to moderate BPD caught up gradually, but the generally poor lung function performance of infants with severe BPD, especially in forced expiratory flow, persisted until later age (24 months). Regarding perinatal characteristics, the z-score of body length at the time of examination and total number of days on positive-pressure ventilation are the major determinants of lung function in later infancy.Bronchopulmonary dysplasia (BPD) is a chronic lung disease that develops in preterm infants, namely less than 37 weeks' gestational age, who were exposed to mechanical ventilation and oxygen supplementation. Dysplasia of microvessels, airways, and alveoli have been observed in lungs of such premature infants 1 . The "new" form of BPD, deemed a developmental disorder, differs pathologically and clinically from the "old" form 2 . Before the period of antenatal steroid and intratracheal surfactant, the "old" BPD occurred in preterm infants (usually late preterm) who suffered from surfactant deficiency. These infants required high-ratio oxygen and ventilatory support, which trigger a heterogenous lung injury and remodeling. The sequels of lung damage marks with regions of atelectasis and hyperinflation, hyperplasia of airway smooth muscle, lung fibrosis, and pulmonary vascular hypertensive changes 3 . After the period of prenatal steroid and postnatal surfactant intervention, the mortality of BPD significantly decreased, and shifted the demographics of BPD to more extreme preterm infants. "New" BPD then occurred and being characterized by arrested alveolar-capillary development, namely fewer and larger alveoli develop, reducing the overall surface available for gas exchange 4 . The airways are relatively less affected, and inflammation is usually less prominent than in the old form of BPD 1 .Although previous studies have showed that infants with BPD have significant decline in lung function till third decade of life 5 , it's uncertain whether this defect is a consequence of prematurity and/or BPD. Long-term studies on the lung function of survivors of old BPD have reported that abnormalities in forced expiratory flow persisted over time [6][7][8] . However, the results from these studies may differ from children with new BPD, which usually develops in more preterm infants, who might have received mar...

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Momentioning

confidence: 99%

Section: Momentioning

confidence: 99%

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Evolution and Determinants of Lung Function until Late Infancy among Infants Born Preterm

Lai

Chiang

Chu

et al. 2020

Sci Rep

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Forced expiratory flows and volumes in a Swedish cohort of healthy term infants

Kosma

Palme-Kilander

Bottai

et al. 2019

Pediatric Pulmonology

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BackgroundThe use of pulmonary function tests (PFTs) in infants has increased during the last decades, making the need for equipment‐ and ethnic‐specific reference data mandatory for appropriate interpretation of the results.AimOur aim was to investigate how well the already published reference equations for infant spirometry fit a healthy population of Swedish infants.MethodWe performed forced tidal and raised volume expiratory maneuvers in healthy infants using Jaeger BabyBody equipment.ResultsPFT data were collected from 91 healthy infants aged between 3 months to 2 years at 143 occasions. Mean (standard deviation) z‐scores were 0.68(1.33) for maximal flow at functional residual capacity (V'maxFRC), −0.15(0.96) for forced vital capacity (FVC), 0.40(1.33) for the forced expired volume in the initial 0.5 seconds (FEV0.5) and 0.52(0.93) for the ratio FEV0.5/FVC, respectively. Z‐scores for all indices but FEV0.5/FVC were highly dependent on length.ConclusionsWe have shown that the use of previously published reference equations may result in an age‐related misinterpretation of lung function measure in a Swedish infant population.

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Special Considerations for Pediatric Patients

Hall

Weiner

2018

Pulmonary Function Testing

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Raised-Volume Forced Expiratory Flow-Volume Curve in Healthy Taiwanese Infants

Cited by 6 publications

References 36 publications

Evolution and Determinants of Lung Function until Late Infancy among Infants Born Preterm

Evolution and Determinants of Lung Function until Late Infancy among Infants Born Preterm

Forced expiratory flows and volumes in a Swedish cohort of healthy term infants

Special Considerations for Pediatric Patients

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