RT Journal Article
SR Electronic
T1 Infant lung function: criteria for selecting tidal flow–volume loops
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00165-2022
DO 10.1183/23120541.00165-2022
VO 8
IS 4
A1 Karen Eline Stensby Bains
A1 Hrefna Katrín Gudmundsdóttir
A1 Martin Färdig
A1 Erik Amnö
A1 Christine M. Jonassen
A1 Björn Nordlund
A1 Eva Maria Rehbinder
A1 Håvard O. Skjerven
A1 Corina Silvia Rueegg
A1 Riyas Vettukattil
A1 Karin C. Lødrup Carlsen
YR 2022
UL http://openres.ersjournals.com/content/8/4/00165-2022.abstract
AB Background 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.Methods Using 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.Results Five 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) for tPTEF/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.Conclusion Manual 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.A pre-defined set of inclusion and exclusion criteria provide a reliable and standardised procedure for manual selection of tidal flow–volume loops in infants, which may be useful in clinical and research settings https://bit.ly/3NYMlp0