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Assessment of tidal breathing parameters in infants with cystic fibrosis

¹ Portex Anaesthesia, Intensive Therapy and Respiratory Medicine Unit, Institute of Child Health, and ² Neonatal Unit, Homerton University Hospital, London, UK

CORRESPONDENCE: S. Ranganathan, Portex Unit, 6th Floor, Cardiac Wing, Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK. Fax: 44 2078298634. E-mail: drsarath@clara.net

Keywords: cystic fibrosis, early intervention, forced expiration, infant, respiratory function, tidal breathing

Received: March 5, 2003
Accepted June 11, 2003

This work was supported by the Cystic Fibrosis Trust, the Foundation for the Study of Sudden Infant Death, the Dunhill Medical Trust and Portex Ltd. Research at the Institute of Child Health benefits from research and development funding received from the National Health Service executives.

Simple methods are needed to assess lung function in infants with cystic fibrosis (CF). This study determined the relationship between simple measurements obtained from tidal breathing with those from more complicated forced expiratory manoeuvres.

Healthy infants and infants with CF were recruited from two maternity units and five specialist CF hospitals, respectively. Respiratory rate, tidal volume, minute ventilation and the tidal breathing ratio (T_PTEF:T_E) were measured in sedated infants and compared with forced expiratory volume in 0.4 seconds (FEV_0.4) measured by the raised volume technique.

Altogether, 95 healthy infants and 47 infants with CF of similar age, sex, ethnicity and proportion exposed to maternal smoking were recruited. There was no difference in T_PTEF:T_E and tidal volume between healthy infants and those with CF. Minute ventilation was significantly greater in infants with CF due to a mean (95% confidence interval) increase in respiratory rate of 5.8 (3.2–8.4) min^–1. Thirteen (28%) infants with CF had a respiratory rate elevated by >2 sd. However, no association between respiratory rate and FEV_0.4 could be identified.

Tidal breathing ratio was not useful in identifying diminished airway function in infants with cystic fibrosis. An elevated respiratory rate may be due in part to ventilation heterogeneity but is poorly predictive of diminished airway function measured by forced expiration.

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				S. Lum, P. Gustafsson, H. Ljungberg, G. Hulskamp, A. Bush, S. B Carr, R. Castle, A.-f. Hoo, J. Price, S. Ranganathan, et al. Early detection of cystic fibrosis lung disease: multiple-breath washout versus raised volume tests Thorax, April 1, 2007; 62(4): 341 - 347. [Abstract] [Full Text] [PDF]