Whole-body plethysmography in the clinical assessment of infants with bronchopulmonary diseases.

Abstract

Infant whole-body plethysmography offers a unique possibility of measuring end-expiratory resting level (thoracic gas volume; TGV), and hence lung volume in its close interrelationship to airway function (airway resistance; R(aw), its reciprocal value, airway conductance, Gaw). Therefore, this technique is a valuable aid for objective evaluation of lung diseases in infants. This article gives an overview of the physiological background of this particular measuring technique and its usefulness in the clinical routine. Plethysmographic data obtained in infant survivors of the infant respiratory distress syndrome (iRDS), in infants with cystic fibrosis (CF) and in the so-called 'wheezy infants' are presented. Special emphasis is given to the fact that in such infants the interrelationship between changes in end-expiratory resting level and the deficit in airway mechanics is of great importance and, consequently, for the determination of functional lung derangement in each particular case of lung disease, both TGV and the closely related R(aw) and Gaw have to be evaluated. This recommendation has to be kept in mind when the different diagnostic tools for evaluation of treatment facilities are applied in this particular young age group of patients with lung disease. In children as in adult patients, inhalative treatment must be considered the mainstay of all therapeutic measures. However, in infants, the efficacy of such treatment regimens must first be evaluated by adequate functional investigations. Infant whole-body plethysmography offers one such possibility.