Abstract
Wheeze in infancy is very common, but, little is known about airway function in this age group. We have adapted a technique (Taussig et al, J Appl Physiol 1982; 53: 1220-27) for producing partial maximum expiratory flow-volume curves in infants after light sedation. The infant sleeps supine inside an inflatable jacket which, when inflated rapidly to 3-4kPa (<100m.sec) at end inspiration, leads to forced expiration with flow limitation. Flow (integrated digitally to provide a volume signal) is measured at the facemask by pneumotachography. From the flow-volume curve, two indices are derived: (i) peak expiratory flow rate (PEF); (ii) maximum expiratory flow rate at the previously stable end-expiratory volume (VmaxFRC). The median within-subject coefficients of variation of PEF and VmaxFRC for normal infants were 6% and 11% and for wheezy infants were 8% and 11% respectively.
Histamine responsiveness was measured as the change in PEF and VmaxFRC after doubling concentrations of histamine acid phosphate solution, administered for 1 min by Acorn nebuliser at 5 min intervals in 10 infants with recurrent or persistent wheeze. Where possible, tests were repeated after 24 hours. Rapidly reversible dose-dependent responses to histamine were shown at concentrations of about 4 g.1−1. The responses were reproducible and were partly preventable by nebulised salbutamol (2.5mg). Acute reversible airways obstruction, modified by bronchodilators, may play a part in the pathophysiology of wheezy infants.
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Prendiville, A., Green, S. & Silverman, M. USE OF FLOW VOLUME CURVES IN INFANCY TO STUDY AIRWAYS RESPONSIVENESS TO HISTAMINE. Pediatr Res 19, 1094 (1985). https://doi.org/10.1203/00006450-198510000-00153
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DOI: https://doi.org/10.1203/00006450-198510000-00153