Flow-pressure looping during plethysmography in wheezy infants.

Marked looping of the expiratory portion of the flow-pressure relationship was noted in some infants during measurements of airway resistance in a whole-body plethysmograph while the respired air was maintained at body temperature and humidity. An investigation of 13 infants who had varying degrees of airway obstruction showed that there was a negative correlation (r = 0.72) between the severity of the looping and specific airway conductance (SGaw). An even stronger correlation (r = 0.85) was found between the tangent of the angle of phase lag between flow and pressure (theta) and the forced expiratory time constant (t) obtained from the partial forced expiratory flow-volume curve. Such a relationship would be predicted from a model in which the lung behaved as a simple electrical resistance-capacitance network during expiration. It is suggested that the looping is the result of small airway closure during expiration in wheezy infants, with a consequent rise in resistance and prolongation of the time constant of the lung.