Lum S, Hulskamp G, Hoo A-F, Ljungberg H, Stocks J
Portex Anesthesia, Intensive Therapy and Respiratory Medicine Unit, Institute of Child Health, London, United Kingdom.
Pediatr Pulmonol. 2004 Aug;38(2):146-54. doi: 10.1002/ppul.20039.
Partial and "full" forced expiratory maneuvers are both used to assess airway function in infants. Despite the increasing use of the raised volume technique, there is little information regarding the influence of lung inflations as are necessary for the raised volume technique on other measurements of lung function in infants. The aim of this study was to assess whether application of the raised volume technique influences subsequent tidal measurements of maximal expired flow at functional residual capacity (V'maxFRC). Paired measurements of V'maxFRC were obtained in 29 healthy infants (aged 6-65 weeks) before and after raised volume maneuvers, wherein a lung inflation pressure of 3 kPa was used. When compared with measurements prior to raising lung volume, there was a highly significant (P < 0.001) decrease in V'maxFRC by 40 ml.sec(-1) when measurements were repeated (95% CI, -59, -20 ml.sec(-1)), equivalent to a reduction of 20% or -0.6 SD scores in flows. There was no significant change in selected tidal breathing parameters, 95% CI of differences between the two sets of measurements being -1.5, 1.2 bpm for respiratory rate; -0.5, 0.2 ml.kg(-1) for weight corrected tidal volume, and -0.04, 0.01 for tidal breathing ratio (tPTEF:tE). In conclusion, although the mechanism remains unclear, raised volume maneuvers may influence subsequent measures of lung function in infants. Further research is needed to clarify the potential mechanisms. In the meantime, the potential impact of the order of lung function tests within any given study protocol should be considered carefully.
部分和“完全”用力呼气动作均用于评估婴儿的气道功能。尽管增加肺容量技术的使用越来越多，但关于该技术所需的肺充气对婴儿其他肺功能测量的影响，相关信息却很少。本研究的目的是评估增加肺容量技术的应用是否会影响随后在功能残气量（V'maxFRC）时最大呼气流量的潮气测量值。在29名健康婴儿（年龄6 - 65周）进行增加肺容量动作前后，获取了V'maxFRC的配对测量值，其中使用的肺充气压力为3 kPa。与增加肺容量之前的测量值相比，重复测量时V'maxFRC显著降低（P < 0.001），降低了40 ml·sec⁻¹（95% CI，-59，-20 ml·sec⁻¹），相当于流量降低了20%或-0.6个标准差分数。所选的潮气呼吸参数没有显著变化，两组测量值之间差异的95% CI为：呼吸频率为-1.5，1.2次/分钟；体重校正后的潮气量为-0.5，0.2 ml·kg⁻¹；潮气呼吸比（tPTEF:tE）为-0.04，0.01。总之，尽管机制尚不清楚，但增加肺容量动作可能会影响婴儿随后的肺功能测量。需要进一步研究以阐明潜在机制。同时，在任何给定的研究方案中，应仔细考虑肺功能测试顺序的潜在影响。
