title: Tidal flow variability measured by impedance pneumography relates to childhood asthma risk.
abstract: Lung function variability is a fundamental feature of asthma but has been difficult to quantify in children due to methodological limitations. We assessed the feasibility and clinical implications of overnight flow variability measurement at home using impedance pneumography in young children.44 children aged 3-7 years with recurrent or persistent lower airway symptoms were recruited. Patients were divided into high- or lower-risk groups (HR and LR groups) based on their risk of asthma (modified Asthma Predictive Index), and a third group was formed of children who had a history of wheeze and who were treated with inhaled corticosteroids (ICS group). Tidal volume and the derived flow were recorded through skin electrodes using impedance pneumography at home during sleep. Quantities describing overnight change in expiratory flow-volume minimum curve shape correlation (CSRmin) and respiratory chaoticity (minimum noise limit (NLmin)) were derived.Recordings were successful in 34 children. CSRmin differed between the HR and LR groups (p=0.002) and between the HR and ICS groups (p=0.003), indicating a stronger change in flow profile shape in the HR group. NLmin differed between the HR and LR groups (p=0.014), indicating momentarily lowered chaoticity in the HR group.Impedance pneumography was found feasible for quantifying nocturnal lung function variability and the measured variability was associated with risk of asthma in young children.
authors.affiliation: Dept of Electronics and Communications Engineering, Tampere University of Technology, BioMediTech, Tampere, Finland vps@iki.fi.
authors.forename: Ville-Pekka
authors.initials: VP
authors.lastname: Seppä
authors.affiliation: Dept of Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Anna S
authors.initials: AS
authors.lastname: Pelkonen
authors.affiliation: Dept of Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Kotaniemi-Syrjänen
authors.affiliation: Dept of Electronics and Communications Engineering, Tampere University of Technology, BioMediTech, Tampere, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Viik
authors.affiliation: Dept of Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Mika J
authors.initials: MJ
authors.lastname: Mäkelä
authors.affiliation: Dept of Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: L Pekka
authors.initials: LP
authors.lastname: Malmberg
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D017097:Electric Impedance; D004566:Electrodes; D045853:Exhalation; D005260:Female; D006801:Humans; D008297:Male; D009991:Oscillometry; D011336:Probability; D015203:Reproducibility of Results; D012135:Respiratory Sounds / Q000503:physiopathology; D012137:Respiratory System / Q000503:physiopathology; D012307:Risk Factors; D013990:Tidal Volume
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents