Improved agreement between N2 and SF6 multiple breath washout in healthy infants and toddlers with improved EXHALYZER D® sensor performance

2021 ◽  
Author(s):  
Rikke Mulvad Sandvik ◽  
Per Magnus Gustafsson ◽  
Anders Lindblad ◽  
Paul David Robinson ◽  
Kim Gjerum Nielsen
Keyword(s):  
Gas Sensors ◽  
Healthy Children ◽  
Correction Factors ◽  
Infants And Toddlers ◽  
Sulphur Hexafluoride ◽  
Quiet Sleep ◽  
Sensor Performance ◽  
Healthy Infants ◽  
Multiple Breath Washout ◽  
Residual Capacity

Introduction: Recent studies indicate limited utility of nitrogen multiple breath washout (N2MBW) in infancy and advocate for using sulphur hexafluoride (SF6)MBW in this age group. Modern N2MBW systems, such as EXHALYZER D® (ECO MEDICS AG, Duernten, Switzerland), use O2 and CO2 sensors to calculate N2 concentrations (in principle: N2%=100-CO2%-O2%). High O2 and CO2 concentrations have now been shown to significantly suppress signal output from the other sensor, raising apparent N2 concentrations. We examined whether improved Exhalyzer D® N2-signal, accomplished after thorough examination of this CO2 and O2 interaction on gas sensors and its correction, leads to better agreement between N2MBW and SF6MBW in healthy infants and toddlers. Method: Within the same session 52 healthy children aged 1-36 months (mean 1.30 (SD 0.72) years) completed SF6MBW and N2MBW recordings (EXHALYZER D®, SPIROWARE® version 3.2.1) during supine quiet sleep. SF6 and N2 SPIROWARE® files were re-analyzed off-line with in-house software using identical algorithms as in SPIROWARE® with or without application of the new correction factors for N2MBW provided by ECO MEDICS AG. Results Applying the improved N2-signal significantly reduced mean (95% CI) differences between N2- and SF6MBW recorded functional residual capacity (FRC) and lung clearance index (LCI): for FRC, from 26.1 (21.0; 31.2) mL p<0.0001 to 1.18 (-2.3; 4.5) mL p=0.5, and for LCI, from 1.86 (1.68; 2.02) p<0.001 to 0.44 (0.33; 0.55) p<0.001. Conclusion: Correction of N2-signal, for CO2 and O2 interactions on gas sensors resulted in markedly closer agreement between N2MBW and SF6MBW outcomes in healthy infants and toddlers.

scholarly journals The effect of inert gas choice on multiple breath washout in healthy infants: differences in lung function outcomes and breathing pattern

2017 ◽  
Vol 123 (6) ◽  
pp. 1545-1554 ◽  
Author(s):  
Per M. Gustafsson ◽  
Lovisa Bengtsson ◽  
Anders Lindblad ◽  
Paul D. Robinson
Keyword(s):  
Functional Residual Capacity ◽  
Sulfur Hexafluoride ◽  
Breathing Pattern ◽  
Inert Gas ◽  
Respiratory Drive ◽  
Quiet Sleep ◽  
Lung Clearance ◽  
Healthy Infants ◽  
Lung Clearance Index ◽  
Residual Capacity

The detrimental effects on breathing pattern during multiple breath inert gas washout (MBW) have been described with different inhaled gases [100% oxygen (O2) and sulfur hexafluoride (SF6)] but detailed comparisons are lacking. N2- and SF6-based tests were performed during spontaneous quiet sleep in 10 healthy infants aged 0.7–1.3 yr using identical hardware. Differences in breathing pattern pre and post 100% O2 and 4% SF6 exposure were investigated, and the results obtained were compared [functional residual capacity (FRC) and lung clearance index (LCI)]. During 100% O2 exposure. mean inspiratory flow (“respiratory drive”) decreased transiently by mean (SD) 28 (9)% ( P < 0.001), and end-tidal CO2 (carbon dioxide) increased by mean (SD) 0.3 (0.4)% units ( P < 0.05) vs. air breathing prephase. During subsequent N2 washin (i.e., recovery phase), the pattern of change reversed. No significant effect on breathing pattern was observed during SF6 testing. In vitro testing confirmed that technical artifacts did not explain these changes. Mean (SD) FRC and LCI in vivo were significantly higher with N2 vs. SF6 washout: 216 (33) vs. 186 (22) ml ( P < 0.001) and 8.25 (0.85) vs. 7.55 (0.57) turnovers ( P = 0.021). Based on these results, SF6 based MBW is the preferred methodology for tests in this age range. NEW & NOTEWORTHY Inert gas choice for multiple breath inert gas washout (MBW) in infants has important consequences on both breathing pattern during test performance and the functional residual capacity and lung clearance index values obtained. Data suggest the detrimental effect of breathing pattern of 100% O2 and movement of O2 across the alveolar capillary membrane, with direct effects on MBW outcomes. SF6 MBW during infancy avoids this and can be further optimized by addressing the sources of technical artifact identified in this work.

scholarly journals A Combined Analysis of Gut and Skin Microbiota in Infants with Food Allergy and Atopic Dermatitis: A Pilot Study

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1682
Author(s):  
Ewa Łoś-Rycharska ◽  
Marcin Gołębiewski ◽  
Marcin Sikora ◽  
Tomasz Grzybowski ◽  
Marta Gorzkiewicz ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Food Allergy ◽  
Gut Microbiota ◽  
Bacterial Species ◽  
Rrna Gene ◽  
Healthy Children ◽  
Skin Microbiota ◽  
Fecal Samples ◽  
Healthy Infants ◽  
Α Diversity

The gut microbiota in patients with food allergy, and the skin microbiota in atopic dermatitis patients differ from those of healthy people. We hypothesize that relationships may exist between gut and skin microbiota in patients with allergies. The aim of this study was to determine the possible relationship between gut and skin microbiota in patients with allergies, hence simultaneous analysis of the two compartments of microbiota was performed in infants with and without allergic symptoms. Fifty-nine infants with food allergy and/or atopic dermatitis and 28 healthy children were enrolled in the study. The skin and gut microbiota were evaluated using 16S rRNA gene amplicon sequencing. No significant differences in the α-diversity of dermal or fecal microbiota were observed between allergic and non-allergic infants; however, a significant relationship was found between bacterial community structure and allergy phenotypes, especially in the fecal samples. Certain clinical conditions were associated with characteristic bacterial taxa in the skin and gut microbiota. Positive correlations were found between skin and fecal samples in the abundance of Gemella among allergic infants, and Lactobacillus and Bacteroides among healthy infants. Although infants with allergies and healthy infants demonstrate microbiota with similar α-diversity, some differences in β-diversity and bacterial species abundance can be seen, which may depend on the phenotype of the allergy. For some organisms, their abundance in skin and feces samples may be correlated, and these correlations might serve as indicators of the host’s allergic state.

Volume history and effect on airway reactivity in infants and adults

2002 ◽  
Vol 93 (3) ◽  
pp. 1069-1074 ◽  
Author(s):  
A. Weist ◽  
T. Williams ◽  
J. Kisling ◽  
C. Clem ◽  
R. S. Tepper
Keyword(s):  
Vital Capacity ◽  
Healthy Adults ◽  
Airway Hyperreactivity ◽  
Airway Reactivity ◽  
Maximal Expiratory Flow ◽  
Healthy Infants ◽  
Forced Expiratory Flow ◽  
Residual Capacity ◽  
Expiratory Flow ◽  
Volume History

Volume history is an important determinant of airway responsiveness. In healthy adults undergoing airway challenge, deep inspiration (DI) provides bronchodilating and bronchoprotective effects; however, the effectiveness of DI is limited in asthmatic adults. We hypothesized that, when assessed under similar conditions, healthy infants have heightened airway reactivity compared with healthy adults and that the effectiveness of DI is limited in infants. We compared the effect of DI on reactivity by using full (DI) vs. partial (no DI) forced-expiratory maneuvers on 2 days in supine, healthy nonasthmatic infants (21) and adults (10). Reactivity was assessed by methacholine doses that decreased forced expiratory flow after exhalation of 75% forced vital capacity during a full maneuver and maximal expiratory flow at functional residual capacity during a partial maneuver by 30% from baseline. Reactivity in adults increased when DI was absent, whereas infants' reactivity was unchanged. Infants were more reactive than adults in the presence of DI; however, adult and infant reactivity was similar in its absence. Our findings indicate that healthy infants are more reactive than adults and, like asthmatic adults, do not benefit from DI; this difference may be an important characteristic of airway hyperreactivity.

Research of Supporting Platform of Machine Olfaction

2013 ◽  
Vol 475-476 ◽  
pp. 550-553
Author(s):  
Hua Fang ◽  
Yun Xiang Liu ◽  
Wan Jun Yu ◽  
Wen Ju Li ◽  
Ming Lei Shu
Keyword(s):  
Gas Sensors ◽  
Sensor Array ◽  
Database Systems ◽  
Monitoring Systems ◽  
Distributed Monitoring ◽  
Sensor Performance ◽  
Sensors Array ◽  
Industrial Monitoring ◽  
Machine Olfaction ◽  
The Web

A template technology has been applied to the platform of machine olfaction. The simulation sensor array template receives field odor data or simulates the data via recorders in database, and transmits to the platform. The platform consists of several distributed monitoring subsystems based on the simulation template. Each subsystem matches a set of gas sensors array, and has functions of logging data, communicating and simulating industry application. The data from the subsystem and the preprocessed data are sent to the web server center and stored in the databases. The data has been collected, and sensor performance analyzing are performed by several layer algorithms. While the exchanging algorithms convert the field odor data to gas concentrations with ppm values, the expert systems or recognition algorithms analyze the ppm values and show the application results. All data of each layer are stored in server database systems, and each layer algorithms can been updated and saved. Finally, the supporting platform that applied to industrial monitoring systems, was developed with a kind of industrial configuration softwares, web MIS and databases, and was utilized to realize monitor to the environmental systems by the simulation template.

scholarly journals Acetone Sensing and Catalytic Conversion by Pd-Loaded SnO2

Materials ◽  
2021 ◽  
Vol 14 (20) ◽  
pp. 5921
Author(s):  
Pascal M. Gschwend ◽  
Florian M. Schenk ◽  
Alexander Gogos ◽  
Sotiris E. Pratsinis
Keyword(s):  
Gas Sensors ◽  
Tin Oxide ◽  
Operating Temperature ◽  
Packed Bed ◽  
Sensor Performance ◽  
Response Recovery ◽  
Recovery Times ◽  
Metal Additives ◽  
Metal Oxide Gas Sensors ◽  
Sensing Performance

Noble metal additives are widely used to improve the performance of metal oxide gas sensors, most prominently with palladium on tin oxide. Here, we photodeposit different quantities of Pd (0–3 mol%) onto nanostructured SnO2 and determine their effect on sensing acetone, a critical tracer of lipolysis by breath analysis. We focus on understanding the effect of operating temperature on acetone sensing performance (sensitivity and response/recovery times) and its relationship to catalytic oxidation of acetone through a packed bed of such Pd-loaded SnO2. The addition of Pd can either boost or deteriorate the sensing performance, depending on its loading and operating temperature. The sensor performance is optimal at Pd loadings of less than 0.2 mol% and operating temperatures of 200–262.5 °C, where acetone conversion is around 50%.

Embryos from "0PN" Zygotes May Be Most Likely 2PN Embryo in L-R-ICSI

2020 ◽  
Author(s):  
Caixia Liu ◽  
Dong Han ◽  
Jianguo Chen ◽  
Ying Liu ◽  
Dong Li ◽  
...  
Keyword(s):  
Case Report ◽  
Embryo Transfer ◽  
Intracytoplasmic Sperm Injection ◽  
Healthy Children ◽  
Healthy Infants ◽  
Infertile Couples

Abstract Although some zero pronuclei (0PN) zygotes cleave and develop into good embryos, they are usually discarded because they lack two distinct pronuclei (2PN). In this case report, we followed four couples to determine whether 0PN embryo could be used in late rescue intracytoplasmic sperm injection (L-R-ICSI). Here we report five healthy infants, including one set of twins, derived from "0PN" embryos from four frozen–warmed embryo transfer (FET) cycles in L-R-ICSI between 2015 and 2017. Of nine infants born from L-R-ICSI cycles in our center, five were "0PN" embryos, and all remain healthy. Embryos from "0PNs" such as 2PN can develop into healthy babies using L-R-ICSI. This finding suggests that embryos from "0PNs" in L-R-ICSI may be different from traditional 0PN gametes and more likely to originate from 2PN gametes and they may be used in those infertile couples who lack 2PN embryos, instead of discarding them. The use of "0PN" embryos increases the cycles reaching embryo transfer, allowing some infertile couples to have healthy children and to avoid mental anguish and wasted time and money.

Parent-Reported Outcome Questionnaire for Swallowing Dysfunction in Healthy Infants and Toddlers: Construction and Content Validation

2020 ◽  
pp. 019459982097095
Author(s):  
Abdulsalam Baqays ◽  
Wendy Johannsen ◽  
Marghalara Rashid ◽  
Hussein Jaffal ◽  
Anne Hicks ◽  
...  
Keyword(s):  
Content Validity ◽  
Neurological Impairment ◽  
Outcome Questionnaire ◽  
Infants And Toddlers ◽  
Content Validation ◽  
Modified Delphi ◽  
Healthy Infants ◽  
Swallowing Dysfunction ◽  
Modified Delphi Technique ◽  
Epidemiological Information

Objectives There is limited epidemiological information on swallowing dysfunction (SwD) in otherwise healthy infants and toddlers (OHITs). Cost, invasiveness, expertise, and resources constrain the repeatability and utility of instrumental diagnostic tests. A parent-reported outcomes (PRO) tool has the potential to mitigate these disadvantages. Hence, we set out to develop and validate a novel PRO tool to assess SwD in OHITs. Study Design A mixed-method study. Setting Tertiary pediatric center. Methods We recruited parents of OHITs with SwD and excluded those with a confounding diagnosis (syndromes or neurological impairment). Interviews were conducted and thematically analyzed to extract the relevant domains and items. A similar analytical method was performed on the reports from a systematic review and literature search. Four verification sessions of parents and experts were conducted to maintain rigor. A panel of experts assessed and established the content validity of the items using a modified Delphi technique. Results We achieved information saturation after interviewing 10 parents and generated 7 domains with 72 items. Over the course of 3 rounds of modified Delphi content validation, the domains were reduced to 3 (swallowing, breathing, and illness) containing 21 items; a content validity index of 82.1% was achieved. Conclusion We validated the content of a new PRO instrument to assess SwD in OHITs. The instrument is composed of 3 primary domains representing 21 items. This tool has the potential to screen for swallowing dysfunction and can assess management outcomes specifically for this population at a community level.

scholarly journals Docosahexaenoic Acid and Neurodevelopmental Outcomes of Term Infants

2016 ◽  
Vol 69 (Suppl. 1) ◽  
pp. 22-28 ◽  
Author(s):  
Suzanne Meldrum ◽  
Karen Simmer
Keyword(s):  
Docosahexaenoic Acid ◽  
Observational Studies ◽  
Chain Polyunsaturated Fatty Acid ◽  
Normal Brain ◽  
Healthy Children ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Lactating Women ◽  
Healthy Infants ◽  
Normal Brain Development

Docosahexaenoic acid (DHA), a long-chain polyunsaturated fatty acid, is essential for normal brain development. DHA is found predominantly in seafood, fish oil, breastmilk and supplemented formula. DHA intake in Western countries is often below recommendations. Observational studies have demonstrated an association between DHA intake in pregnancy and neurodevelopment of offspring but cannot fully adjust for confounding factors that influence child development. Randomised clinical trials of DHA supplementation during pregnancy and/or lactation, and of term infants, have not shown a consistent benefit nor harm on neurodevelopment of healthy children born at term. The evidence does not support DHA supplementation of healthy pregnant and lactating women, nor healthy infants.

Effects of sleep deprivation on respiratory events during sleep in healthy infants

1989 ◽  
Vol 66 (3) ◽  
pp. 1158-1163 ◽  
Author(s):  
E. Canet ◽  
C. Gaultier ◽  
A. M. D'Allest ◽  
M. Dehan
Keyword(s):  
Sleep Deprivation ◽  
Total Duration ◽  
Periodic Breathing ◽  
Central Apnea ◽  
Quiet Sleep ◽  
Term Infants ◽  
Event Time ◽  
Respiratory Events ◽  
Healthy Infants ◽  
Respiratory Event

This study was designed to determine the effects of sleep deprivation on respiratory events during sleep in healthy infants. Ten unsedated full-term infants (1–6 mo) were monitored polygraphically during “afternoon naps” on a control day and on the day after sleep deprivation. Respiratory events, i.e., central apnea, obstructive apnea and hypopnea, and periodic breathing were tabulated. Results for respiratory events were expressed as 1) indexes of the total number of respiratory events and of specific respiratory events per hour of total sleep (TST), “quiet” sleep (QS) and “active” sleep (AS) times; 2) total duration of total and specific respiratory events, expressed as a percentage of TST, QS, and AS times. After sleep deprivation, significant increases were observed for 1) respiratory event (P less than 0.001), central apnea (P less than 0.05), and obstructive respiratory event (P less than 0.01) indexes; 2) respiratory event time as a percentage of TST (P less than 0.002) and as a percentage of AS time (P less than 0.001); 3) obstructive respiratory event time as a percentage of TST (P less than 0.01), QS (P less than 0.05), and AS times (P less than 0.002). The present study shows that short-term sleep deprivation in healthy infants increases the number and timing of respiratory events, especially obstructive events in AS.

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