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Infant tidal flow–volume parameters and arousal state

Karen Eline Stensby Bains, Martin Färdig, Hrefna Katrín Gudmundsdóttir, Catarina Almqvist, Gunilla Hedlin, Live S. Nordhagen, Eva M. Rehbinder, Håvard O. Skjerven, Cilla Söderhäll, Riyas Vettukattil, Björn Nordlund, Karin C. Lødrup Carlsen
ERJ Open Research 2022 8: 00163-2022; DOI: 10.1183/23120541.00163-2022
Karen Eline Stensby Bains
1Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
2University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
8These authors contributed equally and share first authorship
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Martin Färdig
3Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
4Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
8These authors contributed equally and share first authorship
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  • For correspondence: martin.fardig@ki.se
Hrefna Katrín Gudmundsdóttir
1Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
2University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
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Catarina Almqvist
4Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
5Dept of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Gunilla Hedlin
3Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
4Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Live S. Nordhagen
6VID Specialized University, Oslo, Norway
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  • ORCID record for Live S. Nordhagen
Eva M. Rehbinder
2University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
7Dept of Dermatology, Oslo University Hospital, Oslo, Norway
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Håvard O. Skjerven
1Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
2University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
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  • ORCID record for Håvard O. Skjerven
Cilla Söderhäll
3Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
4Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Riyas Vettukattil
1Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
2University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
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Björn Nordlund
3Dept of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
4Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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Karin C. Lødrup Carlsen
1Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
2University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
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  • Article
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  • FIGURE 1
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    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
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    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).

Tables

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  • TABLE 1

    Outcomes and definitions

    Time parameters
     tPTEFTime to peak tidal expiratory flow (s)
     tEExpiratory time (s)
     tPTEF/tETime to peak tidal expiratory flow to expiratory time
    Volume parameters
     VPTEFVolume at peak tidal expiratory flow (mL)
     VEExpiratory volume (mL)
     VPTEF/VEVolume at peak tidal expiratory flow to expiratory volume
     VTTidal volume (mL)
  • TABLE 2

    Background characteristics of the study population (n=91) with tidal flow–volume loop measurements in both the awake and sleeping arousal state

    Birth characteristics
     Girls (n=91)51 (56.0)
     Gestational age at birth (weeks) (n=91)40.0±1.3
     Birth weight (kg) (n=91)3.5±0.5
     Birth length (cm) (n=82)50.3±2.0
    Infants at 3-month investigation
     Age (days) (n=91)91.0±7.3
     Weight (kg) (n=91)6.1±0.8
     Length (cm) (n=89)61.5±2.3
    Parents
     Mother's age (years) (n=91)32.7±3.6
     Nordic origin of mothers# (n=87)82 (94.3)
     Asthma reported in mother (n=87)19 (21.8)
     Asthma reported in father (n=85)8 (9.4)

    Data are presented as n (%) or mean±sd. #: based on maternal country of origin.

    • TABLE 3

      Tidal flow–volume loop parameters in the awake and sleeping state (n=91). The mean of the individual standard deviation is given to demonstrate variability related to arousal state and number of breaths

      AwakeSleepingp-value#
      Lung function parameters
       Number of loops included21 (18–24)33 (30–37)<0.001
       Respiratory rate (breaths·min−1)53 (51–56)38 (37–40)<0.001
        Standard deviation5.93 (5.26–6.61)4.27 (3.74–4.81)<0.001
       PTEF (mL)110 (105–116)84.1 (80.0–88.2)<0.001
        Standard deviation17.2 (15.3–19.0)12.1 (10.9–13.4)0.006
      Time parameters
       tPTEF/tE ratio0.39 (0.37–0.41)0.28 (0.27–0.29)<0.001
        Standard deviation0.06 (0.05–0.06)0.05 (0.05–0.05)0.006
       tPTEF (s)0.24 (0.23–0.26)0.25 (0.24–0.26)0.402
        Standard deviation0.04 (0.04–0.04)0.04 (0.04–0.04)0.332
       tE (s)0.65 (0.61–0.68)0.93 (0.88–0.98)<0.001
        Standard deviation0.08 (0.07–0.09)0.13 (0.12–0.14)<0.001
      Volume parameters
       VPTEF/VE ratio0.38 (0.36–0.40)0.29 (0.28–0.30)<0.001
        Standard deviation0.53 (0.48–0.58)0.52 (0.48–0.56)0.675
       VPTEF (mL)18.4 (17.2–19.6)14.2 (13.5–15.0)<0.001
        Standard deviation4.07 (3.69–4.45)2.89 (2.68–3.10)<0.001
       VE (mL)49.1 (46.4–51.7)49.7 (47.4–51.9)0.834
        Standard deviation8.16 (7.46–8.86)6.17 (5.60–6.73)<0.001
       VT (mL)49.4 (46.7–52.1)50.5 (48.2–52.8)0.598
        Standard deviation7.76 (7.07–8.46)6.00 (5.41–6.59)<0.001

      Data are presented as mean (95% CI), unless otherwise stated. PTEF: peak tidal expiratory flow; tPTEF: time to peak tidal expiratory flow; tE: expiratory time; VPTEF: volume at peak tidal expiratory flow; VE: expiratory volume; VT: tidal volume. Bold type represents statistical significance. #: Wilcoxon signed-rank test of paired samples.

      Supplementary Materials

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        Supplementary material 00163-2022.SUPPLEMENT

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      Infant tidal flow–volume parameters and arousal state
      Karen Eline Stensby Bains, Martin Färdig, Hrefna Katrín Gudmundsdóttir, Catarina Almqvist, Gunilla Hedlin, Live S. Nordhagen, Eva M. Rehbinder, Håvard O. Skjerven, Cilla Söderhäll, Riyas Vettukattil, Björn Nordlund, Karin C. Lødrup Carlsen
      ERJ Open Research Oct 2022, 8 (4) 00163-2022; DOI: 10.1183/23120541.00163-2022

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      Infant tidal flow–volume parameters and arousal state
      Karen Eline Stensby Bains, Martin Färdig, Hrefna Katrín Gudmundsdóttir, Catarina Almqvist, Gunilla Hedlin, Live S. Nordhagen, Eva M. Rehbinder, Håvard O. Skjerven, Cilla Söderhäll, Riyas Vettukattil, Björn Nordlund, Karin C. Lødrup Carlsen
      ERJ Open Research Oct 2022, 8 (4) 00163-2022; DOI: 10.1183/23120541.00163-2022
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