Analysis of tidal breathing parameters in infancy: how variable is TPTEF:TE?

During recent years there has been increasing interest in the measurement of tidal breathing parameters, such as the time to reach peak tidal expiratory flow as a proportion of total expiratory time (TPTEF:TE), and their application to population-based studies of the determinants of early respiratory morbidity. However, little is known about factors influencing the within and between-subject variability of these parameters. This study examines the influence of sedation on TPTEF:TE, estimates the optimal number of breaths and breath epochs required to measure TPTEF:TE, and assesses short-term repeatability of this parameter during the first year of life, taking account of age-related differences. Measurements were made in 266 healthy infants and young children (1 d to 19 mo old). Mean (SD) TPTEF:TE fell from 0.49 (0.11) in the first 2 wk of life to 0.34 (0.09) by 5 to 8 wk, remaining similar thereafter. Sedation with triclofos sodium (75 mg/kg) had no significant effect on TPTEF:TE, which was 0.33 (0.10) in 23 unsedated 6-wk-old infants and 0.32 (0.08) in 49 sedated infants of similar age and weight (95% CI for the difference: -0.05, 0.04). At least 10 breaths in each of two separate epochs from each infant were required to provide a representative estimate of TPTEF:TE. The mean (SD) difference between repeat measurements made 5 to 108 min apart was 0.02 (0.08) in 34 infants younger than 6 wk of age (95% limits of agreement: -0.15, 0.18) and -0.01 (0.04) (95% limits of agreement -0.09, 0.08) in 30 infants 6 wk and older.(ABSTRACT TRUNCATED AT 250 WORDS)