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Non-invasive tension time index in relation to severity of disease in children with cystic fibrosis.
Pediatr Pulmonol. 2008 Oct; 43(10):973-81.PP

Abstract

The non-invasive tension-time index of the inspiratory muscles at rest (TTMUS) can be used for assessing respiratory muscle function in children with cystic fibrosis (CF). This study aimed to investigate how TTMUS becomes altered with increasing pulmonary impairment, and which factors determine TTMUS changes in CF. We assessed TTMUS in 47 patients with stable CF ranging in age from 9 to 26 years and in 47 controls of same age and gender. Pulmonary impairment was assessed by the pulmonary function score (PFS) according to Cropp (PFS 0-2 = no, 3-7 = mild, 8-12 = moderate, and 13-18 = severe dysfunction). Median TTMUS was significantly higher in the entire CF-group than in controls ((0.112 (0.079-0.174) vs. 0.07 (0.052-0.094), P < 0.001)). It was nearly identical in CF-patients without (0.079 (0.056-0.114)) and mild (0.080 (0.059-0.128)) pulmonary dysfunction. It was non-significantly higher in subjects with moderate (0.118 (0.103-0.173)) and grossly elevated in individuals with severe (0.232 (0.211-0.31), P < 0.001)) respiratory impairment when compared to the other PFS-groups. TTMUS was significantly related to percent predicted airway resistance (Raw%pred) (r = 0.60, P < 0.001), percent predicted Forced Expiratory Volume in 1 sec (r = -0.49, P < 0.001), percent predicted Vital Capacity (-0.57, P < 0.001), Functional Residual Capacity in percent Total Lung Capacity (r = 0.42, P = 0.003), and transcutaneous oxygen saturation (r = -0.49, P < 0.001). By contrast, Raw%pred was the only variable that had a significant effect on TTMUS (P = 0.01), when a multivariate logistic regression was applied, using the median of the entire CF-cohort to dichotomise TTMUS. These findings suggest that subjects with stable CF and severe pulmonary dysfunction are prone to respiratory muscle fatigue, and that airway obstruction is an important factor contributing to the increase of TTMUS in CF. Regular determination of TTMUS may be clinically useful during course of disease, and may aid the decision to institute therapies like respiratory muscle training or non-invasive intermittent ventilation.

Authors+Show Affiliations

Department of Neuropediatrics, University of Giessen, Giessen, Germany. andreas.hahn@paediat.med.uni-giessen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18780334

Citation

Hahn, Andreas, et al. "Non-invasive Tension Time Index in Relation to Severity of Disease in Children With Cystic Fibrosis." Pediatric Pulmonology, vol. 43, no. 10, 2008, pp. 973-81.
Hahn A, Ankermann T, Claass A, et al. Non-invasive tension time index in relation to severity of disease in children with cystic fibrosis. Pediatr Pulmonol. 2008;43(10):973-81.
Hahn, A., Ankermann, T., Claass, A., Mann, M., Lindemann, H., & Neubauer, B. A. (2008). Non-invasive tension time index in relation to severity of disease in children with cystic fibrosis. Pediatric Pulmonology, 43(10), 973-81. https://doi.org/10.1002/ppul.20887
Hahn A, et al. Non-invasive Tension Time Index in Relation to Severity of Disease in Children With Cystic Fibrosis. Pediatr Pulmonol. 2008;43(10):973-81. PubMed PMID: 18780334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-invasive tension time index in relation to severity of disease in children with cystic fibrosis. AU - Hahn,Andreas, AU - Ankermann,Tobias, AU - Claass,Andreas, AU - Mann,Marion, AU - Lindemann,Hermann, AU - Neubauer,Bernd A, PY - 2008/9/10/pubmed PY - 2009/2/3/medline PY - 2008/9/10/entrez SP - 973 EP - 81 JF - Pediatric pulmonology JO - Pediatr. Pulmonol. VL - 43 IS - 10 N2 - The non-invasive tension-time index of the inspiratory muscles at rest (TTMUS) can be used for assessing respiratory muscle function in children with cystic fibrosis (CF). This study aimed to investigate how TTMUS becomes altered with increasing pulmonary impairment, and which factors determine TTMUS changes in CF. We assessed TTMUS in 47 patients with stable CF ranging in age from 9 to 26 years and in 47 controls of same age and gender. Pulmonary impairment was assessed by the pulmonary function score (PFS) according to Cropp (PFS 0-2 = no, 3-7 = mild, 8-12 = moderate, and 13-18 = severe dysfunction). Median TTMUS was significantly higher in the entire CF-group than in controls ((0.112 (0.079-0.174) vs. 0.07 (0.052-0.094), P < 0.001)). It was nearly identical in CF-patients without (0.079 (0.056-0.114)) and mild (0.080 (0.059-0.128)) pulmonary dysfunction. It was non-significantly higher in subjects with moderate (0.118 (0.103-0.173)) and grossly elevated in individuals with severe (0.232 (0.211-0.31), P < 0.001)) respiratory impairment when compared to the other PFS-groups. TTMUS was significantly related to percent predicted airway resistance (Raw%pred) (r = 0.60, P < 0.001), percent predicted Forced Expiratory Volume in 1 sec (r = -0.49, P < 0.001), percent predicted Vital Capacity (-0.57, P < 0.001), Functional Residual Capacity in percent Total Lung Capacity (r = 0.42, P = 0.003), and transcutaneous oxygen saturation (r = -0.49, P < 0.001). By contrast, Raw%pred was the only variable that had a significant effect on TTMUS (P = 0.01), when a multivariate logistic regression was applied, using the median of the entire CF-cohort to dichotomise TTMUS. These findings suggest that subjects with stable CF and severe pulmonary dysfunction are prone to respiratory muscle fatigue, and that airway obstruction is an important factor contributing to the increase of TTMUS in CF. Regular determination of TTMUS may be clinically useful during course of disease, and may aid the decision to institute therapies like respiratory muscle training or non-invasive intermittent ventilation. SN - 1099-0496 UR - https://www.unboundmedicine.com/medline/citation/18780334/Non_invasive_tension_time_index_in_relation_to_severity_of_disease_in_children_with_cystic_fibrosis_ L2 - https://doi.org/10.1002/ppul.20887 DB - PRIME DP - Unbound Medicine ER -