| 1. |
|
|
| 2. |
- Bains, KES, et al.
(author)
-
Infant lung function: criteria for selecting tidal flow-volume loops
- 2022
-
In: ERJ open research. - : European Respiratory Society (ERS). - 2312-0541. ; 8:4
-
Journal article (peer-reviewed)abstract
- Tidal flow–volume (TFV) loops are commonly recorded in infants during sleep, due to the more regular breathing patterns compared to the awake state. Standardised deselection of loops outside pre-specified ranges are based on periods of regular breathing, while criteria and available software for visual evaluation of TFV loops are lacking. We aimed to determine the reliability of standardised criteria for manual selection of infant TFV loops.MethodsUsing a pre-defined set of criteria, three independent raters manually evaluated TFV loops among 57 randomly selected awake healthy 3-month-old infants with available TFV measurements in the Scandinavian Preventing Atopic Dermatitis and ALLergies in children (PreventADALL) study. The TFV loops were sampled using the Eco Medics Exhalyzer D. Criteria for selecting TFV loops included reproducible shape and volume with only one peak in tidal expiratory flow (PTEF), excluding loops with no clear or uneven flow towards PTEF. By intraclass coefficient (ICC), the reliability of agreement between raters was determined for the time to PTEF (tPTEF) to expiratory time (tE) and other TFV loop parameters.ResultsFive infants had unsuccessful tests. Among the remaining 52 infants, the raters selected a median of 25, 26 and 15 loops per test. The ICCs (95% CI) were 0.97 (0.92–0.98) fortPTEF/tE, 0.99 (0.99–1.00) for respiratory rate, 0.98 (0.97–0.99) for tidal volume per kg and 0.98 (0.97–0.99) for expiratory volume, reflecting excellent agreement in all categories.ConclusionManual TFV loop selection using standardised criteria provides a reliable alternative for lung function measures in awake infants with interrupted breathing cycles in a real-life setting.
|
|
| 3. |
|
|
| 4. |
- Bains, KES, et al.
(author)
-
Infant tidal flow-volume parameters and arousal state
- 2022
-
In: ERJ open research. - : European Respiratory Society (ERS). - 2312-0541. ; 8:4
-
Journal article (peer-reviewed)abstract
- 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.MethodsFrom 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 (tPTEF) to expiratory time (tE) and the corresponding volume ratio (VPTEF/VE), as well as tidal volume (VT) and respiratory rate were compared using nonparametric tests.ResultsThe mean (95% CI)tPTEF/tEwas significantly higher while awake compared to the sleeping state: 0.39 (0.37–0.41)versus0.28 (0.27–0.29); with the correspondingVPTEF/VEof 0.38 (0.36–0.40)versus0.29 (0.28–0.30). TheVTwas similar, while the respiratory rate was higher while awake compared to the sleeping state: 53 (51–56) breaths·min−1versus38 (36–40) breaths·min−1.ConclusionHighertPTEF/tE,VPTEF/VEand respiratory rate, but similarVTwhile awake compared to the sleeping state suggests that separate normative TFV loop values according to arousal state may be required in early infancy.
|
|
| 5. |
- Bonamy, AKE, et al.
(author)
-
Patent Ductus Arteriosus Treatment in Very Preterm Infants: A European Population-Based Cohort Study (EPICE) on Variation and Outcomes
- 2017
-
In: Neonatology. - : S. Karger AG. - 1661-7819 .- 1661-7800. ; 111:4, s. 367-375
-
Journal article (peer-reviewed)abstract
- <b><i>Background:</i></b> Spontaneous closure of patent ductus arteriosus (PDA) occurs frequently in very preterm infants and despite the lack of evidence for treatment benefits, treatment for PDA is common in neonatal medicine. <b><i>Objectives:</i></b> The aim of this work was to study regional variations in PDA treatment in very preterm infants (≤31 weeks of gestation), its relation to differences in perinatal characteristics, and associations with bronchopulmonary dysplasia (BPD) and survival without major neonatal morbidity. <b><i>Methods:</i></b> This was a population-based cohort study in 19 regions in 11 European countries conducted during 2011 and 2012. A total of 6,896 infants with data on PDA treatment were included. The differences in infant characteristics were studied across regions using a propensity score derived from perinatal risk factors for PDA treatment. The primary outcomes were a composite of BPD or death before 36 weeks postmenstrual age, or survival without major neonatal morbidity. <b><i>Results:</i></b> The proportion of PDA treatment varied from 10 to 39% between regions (<i>p</i> < 0.001), and this difference could not be explained by differences in perinatal characteristics. The regions were categorized according to a low (<15%, <i>n</i> = 6), medium (15-25%, <i>n</i> = 9), or high (>25%, <i>n</i> = 4) proportion of PDA treatment. Infants treated for PDA, compared to those not treated, were at higher risk of BPD or death in all regions, with an overall propensity score adjusted risk ratio of 1.33 (95% confidence interval 1.18-1.51). Survival without major neonatal morbidity was not related to PDA treatment. <b><i>Conclusions:</i></b> PDA treatment varies largely across Europe without associated variations in perinatal characteristics or neonatal outcomes. This finding calls for more uniform guidance for PDA diagnosis and treatment in very preterm infants.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Fardig, M, et al.
(author)
-
Skin Barrier Function and Infant Tidal Flow-Volume Loops-A Population-Based Observational Study
- 2023
-
In: Children (Basel, Switzerland). - : MDPI AG. - 2227-9067. ; 10:1
-
Journal article (peer-reviewed)abstract
- Background: The relationship between the skin barrier- and lung function in infancy is largely unexplored. We aimed to explore if reduced skin barrier function by high transepidermal water loss (TEWL), or manifestations of eczema or Filaggrin (FLG) mutations, were associated with lower lung function in three-month-old infants. Methods: From the population-based PreventADALL cohort, 899 infants with lung function measurements and information on either TEWL, eczema at three months of age and/or FLG mutations were included. Lower lung function by tidal flow-volume loops was defined as a ratio of time to peak tidal expiratory flow to expiratory time (tPTEF/tE) <0.25 and a tPTEF <0.17 s (<25th percentile). A high TEWL >8.83 g/m2/h (>75th percentile) denoted reduced skin barrier function, and DNA was genotyped for FLG mutations (R501X, 2282del4 and R2447X). Results: Neither a high TEWL, nor eczema or FLG mutations, were associated with a lower tPTEF/tE. While a high TEWL was associated with a lower tPTEF; adjusted OR (95% CI) 1.61 (1.08, 2.42), the presence of eczema or FLG mutations were not. Conclusions: Overall, a high TEWL, eczema or FLG mutations were not associated with lower lung function in healthy three-month-old infants. However, an inverse association between high TEWL and tPTEF was observed, indicating a possible link between the skin barrier- and lung function in early infancy.
|
|
| 9. |
|
|
| 10. |
|
|
