Flow limitation in infants assessed by negative expiratory pressure

Marcus H. Jones, Stephanie D. Davis, Jeffrey A. Kisling, John M. Howard, Robert Castile, Robert S. Tepper

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Forced expiratory flows by the rapid compression technique are often used to assess airway function in infants; however, it remains unclear as to whether flow limitation (FL) is achieved. Studies in adults have used negative expiratory pressure (NEP) at the airway opening as a noninvasive technique to assess whether FL is achieved. An increase in flow with NEP indicates that FL has not been achieved, whereas no increase in flow with NEP indicates FL has been achieved. In the adult studies, the change in flow was assessed by visual inspection of the flow-volume curve. We evaluated whether NEP could be used to assess FL during forced expiration in infants. In addition, we quantified the change in flow secondary to NEP. We applied -5 cm H2O NEP to four infants during forced expiratory maneuvers. The step increase in flow with NEP was always less than 5% at high jacket compression pressures and consistent with FL. For one subject, FL was also confirmed from isovolume pressure flow-curves measured with an esophageal catheter. We conclude that NEP can be used in infants to assess FL during forced expiratory maneuvers by the rapid compression technique.

Original languageEnglish (US)
Pages (from-to)713-717
Number of pages5
JournalAmerican journal of respiratory and critical care medicine
Volume161
Issue number3 I
DOIs
StatePublished - Jan 1 2000

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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