Infant lung function: criteria for selecting tidal flow–volume loops

What is it about?

What is the context? Lung function measurements in infancy by tidal breathing have been used both in research to understand lung development and physiology of airways, as well as in the clinical setting to detect forms of obstructive airway disease. Tidal flow-volume (TFV) measurements examine flow and volume when breathing calmly in and out through an airtight mask covering nose and mouth. The test reveals a visual loop of expiration and inspiration as well as parameters reflecting mechanics of breathing. The test can be performed in awake and sleeping infants and requires a manual evaluation of each test, however in awake infants the breathing loops tends to be more irregular. Standardized criteria for evaluation of tidal breathing loops are lacking and available software for selection of acceptable loops is inadequate. What is new? We developed a predefined set of criteria for manual evaluation of TFV loops which three raters used to independently evaluate the tidal breathing tests of 57 infants in the PreventADALL (Preventing Atopic Dermatitis and Allergies) study. By comparing the results, we found excellent agreement between the three raters. What is the impact? Manual TFV loops selection using standardized criteria provides a reliable alternative for lung function measures in awake infants with interrupted breathing cycles in a real-life setting.

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