Lung function measurements in children - copsac

More documents

Recommendations

Info

Children less than 7 years were tested with dry air hyperventilation as previously described and validated in this age-group (18, 36, 132). Fractional exhaled nitric oxide Fractional exhaled nitric oxide (F E NO) was measured by the online single breath method according to European Respiratory Society/American Thoracic Society task force (40) using the NIOX equipment (Nitric Oxide Monitoring System; Aerocrine, Sweden). Study III: Lung function measurement in neonates Lung function was assessed during sedation by infant spirometry at 1 month applying the raised volume rapid thoracic compression technique (RVRTC). The method, equipment, data collection and analysis was performed in agreement with ATS/ERS standards (2). Equipment was calibrated and tested prior to every lung function test. An inflatable “squeeze”-jacket was wrapped around the infant's chest and abdomen. A subsequent inflation of the jacket provided the passive expiration and flow was measured using a pneumotachograph with an aircushion facemask (123, 133, 134). The infant was administered three inflations reaching a transrespiratory pressure of 2 kPa with passive deflations between each. A compression force transmitting an additional pressure of 2 kPa was then applied via the squeeze-jacket to the thorax and abdomen, leading to an airway opening of pressure of 4 kPa for forced expirations. Baseline flow was measured as the Forced Expiratory Volume at the first 0.5 second (FEV 0.5 ) (123, 133). Other parameters not reported in this thesis comprised FVC, forced expiratory flow at 25% of FVC (FEF 25 ), forced expiratory flow at 50% of FVC (FEF 50 ) and forced expiratory flow at 75% of FVC (FEF 75 ). All parameters were measured five times at baseline and three times at each challenge step, using the median value for FEV 0.5 to decide on the continued provocation. Tidal flow was also measured but not reported in this thesis; indexes comprised tidal volume (V T ), respiratory frequency, peak tidal expiratory flow (PTEF), expiratory time as ratio of respiratory cycle time, time to reach PTEF (T PTEF ), and T PTEF /expiratory time ratio (T PTEF /T E ) (123, 133). The software defined FVC as the first plateau on the volume-time curve, and only measurements with FVC appearing after 0.5 seconds, and with FEV 0.5 being smaller 36
than or equal to FVC were accepted. In addition, FVC was only accepted if correctly defined as the plateau appearing after a full expiration. The aim was collecting 3-5 curves at each dose step. The curve containing the median value for the FEV 0.5 was used for the analyses of both volume and flow parameters. Bronchial responsiveness to methacholine was assessed by FEV 0.5 as well as continuous measurements of trans-cutaneuos oxygen (PTcO 2 ) (TCM3; Radiometer; Copenhagen, Denmark). The methacholine was administered in quadrupling dose-steps by a dosimeter attached to a nebulizer (SPIRA 08 TSM 133; Respiratory Care Center; Hämeenlinna, Finland) as previously detailed (133). The result was assessed by PTcO2 in accordance with previous sensitivity analyses (10, 133) and the provocative dose causing a 15% drop in PTcO2 was estimated from the dose response curves fitted with a logistic function. Statistical analyses SAS version 9.1 was used for statistical analyses. Study II: The continuous data were log-transformed and presented as geometric means in the table. Odds ratios were calculated for the dichotomous data with 95% confidence intervals. Data were analyzed with a paired t-test for continuous outcome measures, Fisher's exact test for dichotomous outcomes and Wilcoxon's (paired) test for dry-air hyperventilation outcome. All hypotheses tests were 2-sided and used a significance level of 0.05. Study III: Lung function measurement data (FEV 0.5 and PD15) were calibrated with lifespan and birth length in accordance with previous lung function analyses of the newborn (135) calculated by a generalized linear model. Lifespan at examination date was calculated as the sum of estimated gestational age in weeks and weeks since birth. The lung function measurements were log transformed and we used a multivariable logistic regression model to calculate adjusted odds ratios and 95% confidence intervals. Outcome variable was RSV bronchiolitis compared to control group. Confounder adjustment included mothers smoking during 3 rd trimester (dichotomized) and gender. 37
Page 1: Lung function measurements in child
Page 4 and 5: Contents Acknowledgements .........
Page 6 and 7: Acknowledgements The thesis was wri
Page 8 and 9: Introduction Symptoms of chronic re
Page 10 and 11: pulmonary function test obtained by
Page 12 and 13: I. Accuracy of Wholebody Plethysmog
Page 14 and 15: Methods Designs Study I: Six center
Page 16 and 17: "Loops" on the screen showed the re
Page 18 and 19: We included age in the analysis of
Page 20 and 21: Normative data (study I) Mean sRaw
Page 22 and 23: Additional results sRaw measurement
Page 24 and 25: After correcting the factory settin
Page 26 and 27: Normative data In the second part o
Page 28 and 29: II. -III. Lung function measurement
Page 30 and 31: of a diagnosis of asthma: Frequent
Page 32 and 33: Figure 8: Familial predisposition t
Page 34 and 35: Total twins 12.349 twin pairs Born
Page 36 and 37: Methods Designs Study II: Hospital
Page 40 and 41: Ethics The two studies were approve
Page 42 and 43: FEV 0.5 (ml) Table 4: Baseline char
Page 44 and 45: lung symptoms, 19% said it was the
Page 46 and 47: symptoms in response to verified RS
Page 48 and 49: epigenetic factors. Acute environme
Page 50 and 51: detection changes in lung function
Page 52 and 53: that small airways were not the dis
Page 54 and 55: onciolitis. There is an increasing
Page 56 and 57: further studies are needed to inves
Page 58 and 59: Summary The Ph.D. thesis is based o
Page 60 and 61: Danish summary (Dansk resumé) Denn
Page 62 and 63: References Reference List (1) Lum S
Page 64 and 65: (25) Aurora P, Gustafsson P, Bush A
Page 66 and 67: (50) Klug B, Bisgaard H. Repeatabil
Page 68 and 69: (76) Meissner HC. Economic impact o
Page 70 and 71: (101) Young S, Arnott J, O'Keeffe P
Page 72 and 73: (125) Bisgaard H, Hermansen MN, Lol
Page 74 and 75: (151) Walton RP, Johnston SL. Role
Page 76 and 77: disease in otherwise healthy infant
Page 78 and 79: changes in asthma control. Am J Res
Page 81: Paper I
Page 84 and 85: CHEST Original Research Accuracy of
Page 86 and 87: Figure 1. Center agreement study: l
Page 88 and 89:
observer as well as a common observ
Page 90 and 91:
sRaw (kPa*s) Figure 1 Online: Cente
Page 93 and 94:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Page 95 and 96:
54 55 56 57 INTRODUCTION Respirator
Page 97 and 98:
97 98 99 100 Lung function test Chi
Page 99 and 100:
141 142 143 144 Mean gestational ag
Page 101 and 102:
186 187 188 189 190 The discordant
Page 103 and 104:
232 233 234 235 236 237 viruses and
Page 105 and 106:
278 ACKNOWLEDGMENTS 279 280 281 282
Page 107 and 108:
335 336 (21) Bisgaard H, Nielsen KG
Page 109 and 110:
394 395 396 (42) Wu P, Dupont WD, G
Page 111 and 112:
455 456 457 (64) Bisgaard H, Herman
Page 113 and 114:
488 489 Table 1: Comparison of clin
Page 115:
Paper III
Page 118 and 119:
Abstract Background: Two-three perc
Page 120 and 121:
RA 08 TSM 133; Respiratory Care Cen
Page 122 and 123:
prospectively if baseline lung func
Page 124 and 125:
who do not develop RSV bronchioliti
Page 126 and 127:
Acknowledgements We thank all the c
Page 128 and 129:
(24) ATS/ERS statement: raised volu
Page 130 and 131:
(53) Stein RT, Sherrill D, Morgan W
Page 132 and 133:
Figure 1: Flow chart COPSAC cohort
show all

Lung function measurements in children - copsac

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?