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Sources of Methodological Variability in Phase Angles from Respiratory Inductance Plethysmography in Preterm Infants.
MedLine Citation:
PMID:  24716708     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ABSTRACT Rationale: Better phenotypic descriptions are needed for chronic lung disease among surviving premature infants. Objectives: The purpose of this study was to evaluate the potential usefulness of respiratory inductance plethysmography in characterizing respiratory system mechanics in preterm infants at 32 weeks post-menstrual age. Methods: Respiratory inductance plethysmography was used to obtain the phase angle, ɸ, to describe rib cage and abdominal dyssynchrony in 65 infants born between 23 and 28 weeks gestation, all studied at 32 weeks post-menstrual age. Up to 60 breaths were evaluated for each subject. Sources of intra-subject variability in ɸ arising from our methods were explored using mechanical models and by evaluating inter-observer agreement. Measurements and Main Results: The mean ɸ from infants ranged from 5.8 to 162.9 degrees, with intra-subject coefficients of variation from 11% to 123%. Based on the mechanical model studies, respiratory inductance plethysmography recording and analysis software added < 2.3% to the intra-subject variability in ɸ. Potential inconsistencies in breaths selected could have contributed 8.1%, on average, to the total variability. The recording sessions captured 22.8 + 9.1 minutes of quiet sleep, and enough breaths were counted to adequately characterize the range of ɸ in the session. Conclusion: ɸ is quite variable during even short recording sessions among preterm infants sleeping quietly. The intra-subject variability described arises from the instability of the rib cage and abdominal phase relationship, not from the recording and analysis methods used. Despite the variability, ɸ measurements allowed the majority (80%) of infants to be reliably categorized as having relatively synchronous or dyssynchronous breathing. Respiratory inductance plethysmography is easy to use and should prove useful in quantifying respiratory mechanics in multicenter studies of preterm infants. Abstract word count: 277.
Authors:
Lara N Ulm; Aaron Hamvas; Thomas W Ferkol; Oscar M Rodriguez; Claudia M Cleveland; Laura A Linneman; Julie A Hoffmann; Maria J Sicard-Su; James S Kemp
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-4-9
Journal Detail:
Title:  Annals of the American Thoracic Society     Volume:  -     ISSN:  2325-6621     ISO Abbreviation:  Ann Am Thorac Soc     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-4-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101600811     Medline TA:  Ann Am Thorac Soc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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