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. 2022 Oct 17;8(4):00163-2022.
doi: 10.1183/23120541.00163-2022. eCollection 2022 Oct.

Infant tidal flow-volume parameters and arousal state

Karen Eline Stensby Bains  1   2   3 , Martin Färdig  4   5   3 , Hrefna Katrín Gudmundsdóttir  1   2 , Catarina Almqvist  5   6 , Gunilla Hedlin  4   5 , Live S Nordhagen  7 , Eva M Rehbinder  2   8 , Håvard O Skjerven  1   2 , Cilla Söderhäll  4   5 , Riyas Vettukattil  1   2 , Björn Nordlund  4   5 , Karin C Lødrup Carlsen  1   2
Affiliations

Infant tidal flow-volume parameters and arousal state

Karen Eline Stensby Bains et al. ERJ Open Res. .

Abstract

Background: Infant lung function can be assessed with tidal flow-volume (TFV) loops. While TFV loops can be measured in both awake and sleeping infants, the influence of arousal state in early infancy is not established. The aim of the present study was to determine whether TFV loop parameters in healthy infants differed while awake compared to the sleeping state at 3 months of age.

Methods: From the population-based Scandinavian Preventing Atopic Dermatitis and ALLergies in children (PreventADALL) birth cohort, 91 infants had reproducible TFV loops measured with Exhalyzer® D in both the awake and sleeping state at 3 months of age. The TFV loops were manually selected according to a standardised procedure. The ratio of time to peak tidal expiratory flow (t PTEF) to expiratory time (t E) and the corresponding volume ratio (V PTEF/V E), as well as tidal volume (V T) and respiratory rate were compared using nonparametric tests.

Results: The mean (95% CI) t PTEF/t E was significantly higher while awake compared to the sleeping state: 0.39 (0.37-0.41) versus 0.28 (0.27-0.29); with the corresponding V PTEF/V E of 0.38 (0.36-0.40) versus 0.29 (0.28-0.30). The V T was similar, while the respiratory rate was higher while awake compared to the sleeping state: 53 (51-56) breaths·min-1 versus 38 (36-40) breaths·min-1.

Conclusion: Higher t PTEF/t E, V PTEF/V E and respiratory rate, but similar V T while awake compared to the sleeping state suggests that separate normative TFV loop values according to arousal state may be required in early infancy.

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Conflict of interest statement

Conflicts of interest: The authors have no conflicts of interest to disclose. The authors have no conflict of interest relating to or relationship with Exhalyzer® D or its manufacturer.

Figures

FIGURE 1
FIGURE 1
Distributions of a) the ratio of time to peak tidal expiratory flow (tPTEF) to expiratory time (tE) and b) the volume at peak tidal expiratory flow (VPTEF) to expiratory volume (VE) in awake and sleeping tidal flow–volume loop measurements (n=91).
FIGURE 2
FIGURE 2
OR (95% CI) for ratios of time to peak tidal expiratory flow (tPTEF) to expiratory time (tE) and volume at peak tidal expiratory flow (VPTEF) to expiratory volume (VE) <0.25 among sleeping compared to awake tidal flow–volume loop measurements (n=91).
See this image and copyright information in PMC

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