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使用体容积描记法测量幼儿的功能残气量。

FRC measurements using body plethysmography in young children.

作者信息

Vilozni Daphna, Efrati Ori, Hakim Fahed, Adler Adi, Livnat Galit, Bentur Lea

机构信息

Pediatric Pulmonary Unit, Meyer Children's Hospital of Haifa, Rambam Medical Center, Haifa, Israel.

出版信息

Pediatr Pulmonol. 2009 Sep;44(9):885-91. doi: 10.1002/ppul.21072.

Abstract

BACKGROUND

Measurement of FRC in whole body plethysmography (FRCpleth) is not performed in young children (aged 3-5 years) because it involves sitting alone in a closed box and breathing attempts against occlusion.

OBJECTIVE

To assess the feasibility of measuring FRCpleth in young children.

METHODS AND RESULTS

Seventy-one of 102 children (age range 3.3-6.9 years) performed spirometry and FRCpleth measurements. Twenty-six children had controlled asthma (Group-A); 26 children were tested during asthma exacerbation had uncontrolled asthma (Group-UA), and 19 children were tested after receiving chemotherapy treatment (Group-C). Tests according to adult recommendations were first taught outside the plethysmograph and then performed with minor technical adaptations. Each test included two consecutive FRC measurements obtained during 2-3 sec of occlusion. Total lung capacity (TLC) and residual volume (RV) were calculated. Values were compared to FRC measured by Helium-dilution (FRC-He) in healthy preschool children and to extrapolated FRCpleth values of school children, and between the groups.

RESULTS

Group-A showed normal spirometry and normal TLC values, with mildly elevated FRCpleth and RV values (125 +/- 20 and 153 +/- 33 %predicted, respectively; P < 0.0001 for both values). Group-UA showed obstructed flows combined with high FRCpleth and RV (146 +/- 26 and 189 +/- 38 %predicted; P < 0.0001) and normal TLC. Group-C showed a restrictive spirometry pattern combined with lower than normal TLC (86 +/- 15 %predicted; P < 0.0251).

CONCLUSIONS

Measuring absolute lung volumes by plethysmography in young children is feasible and can detect abnormal lung volumes. It is essential to study a larger group of healthy children for reference values and to allow for standardization of the procedure.

摘要

背景

由于在全身体积描记法(FRCpleth)中测量功能残气量(FRC)需要幼儿(3至5岁)独自坐在一个封闭的箱子里,并在气道阻塞的情况下进行呼吸尝试,因此该方法不适用于幼儿。

目的

评估在幼儿中测量FRCpleth的可行性。

方法与结果

102名儿童(年龄范围3.3至6.9岁)中的71名进行了肺活量测定和FRCpleth测量。26名儿童患有控制良好的哮喘(A组);26名在哮喘发作期间接受测试的儿童患有未控制的哮喘(UA组),19名儿童在接受化疗后接受测试(C组)。首先在体积描记器外按照成人的建议进行测试教学,然后进行一些小的技术调整后进行测试。每次测试包括在2至3秒的阻塞期间获得的两次连续FRC测量值。计算肺总量(TLC)和残气量(RV)。将这些值与健康学龄前儿童通过氦稀释法测量的FRC(FRC-He)以及学龄儿童外推的FRCpleth值进行比较,并在各组之间进行比较。

结果

A组肺活量测定和TLC值正常,FRCpleth和RV值轻度升高(分别为预测值的125±20和153±33%;两个值P<0.0001)。UA组显示气流阻塞,同时FRCpleth和RV升高(分别为预测值的146±26和189±38%;P<0.0001),TLC正常。C组显示限制性肺活量测定模式,同时TLC低于正常(为预测值的86±15%;P<0.0251)。

结论

通过体积描记法测量幼儿的绝对肺容量是可行的,并且可以检测到异常的肺容量。有必要研究更多健康儿童以获取参考值,并实现该程序的标准化。

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