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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Association of breastfeeding with tidal breathing analysis in infants with bronchiolitis
Evanthia Perikleous, Sotirios Fouzas, Athina Karageorgiou, Paschalis Steiropoulos, Evangelia Nena, Athanasios Chatzimichael, Aggelos Tsalkidis, Emmanouil Paraskakis
Evanthia Perikleous, Athina Karageorgiou, Athanasios Chatzimichael, Aggelos Tsalkidis, Department of Pediatrics, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupoli 68100, Greece
Sotirios Fouzas, Department of Paediatrics, University Hospital of Patras, University of Patras, Patra 26504, Greece
Paschalis Steiropoulos, Department of Pneumonology, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupoli 68100, Greece
Evangelia Nena, Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupoli 68100, Greece
Emmanouil Paraskakis, Paediatric Respiratory Unit, Paediatric Department, University of Crete, Heraklion 71500, Greece
Author contributions: Perikleous E and Paraskakis E designed the study, drafted the initial manuscript, and revised the manuscript; Fouzas S performed the analyses and data interpretation and drafted the initial manuscript; Perikleous E, Karageorgiou A and Paraskakis E participated in the data acquisition; Steiropoulos P, Nena E and Paraskakis E contributed to the initial conception of the study; Steiropoulos P, Nena E, Chatzimichael A, Tsalkidis A and Paraskakis E supervised the drafting of the initial manuscript and made critical revisions related to the intellectual content of the manuscript; all authors provided their approval for the final version to be published.
Institutional review board statement: The Institutional Review Board of University General Hospital of Alexandroupolis provided approval for this study (IRB No. 23927/2382/02.01.2017).
Informed consent statement: Parental approval was obtained prior to inclusion for all involved infants.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Data sharing statement: The authors confirm that the data supporting the findings of this study are available within the article and its tables/figures. Raw data, without patient's personal information, are available upon reasonable request from the corresponding author.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Evanthia Perikleous, MD, MSc, Consultant Physician-Scientist, Department of Pediatrics, University General Hospital of Alexandroupolis, Democritus University of Thrace, Dragana 68100, Alexandroupoli 68100, Greece.
eviperikleous@hotmail.com
Received: May 9, 2021
Peer-review started: May 9, 2021
First decision: June 17, 2021
Revised: June 30, 2021
Accepted: October 25, 2021
Article in press: October 25, 2021
Published online: November 9, 2021
Processing time: 183 Days and 8.4 Hours
BACKGROUND
Tidal breathing flow-volume (TBFV) analysis provides important information about lung mechanics in infants.
AIM
To assess the effects of breastfeeding on the TBFV measurements of infants who recover from acute bronchiolitis.
METHODS
In this cross-sectional study, TBFV analysis was performed in infants with bronchiolitis prior to hospital discharge. The ratio of time to peak expiratory flow to total expiratory time (tPEF/tE) at baseline and after the administration of 400 mcg salbutamol was evaluated.
RESULTS
A total of 56 infants (35 boys), aged 7.4 ± 2.8 mo, were included. Of them, 12.5% were exposed to tobacco smoke and 41.1% were breastfed less than 2 mo. There were no differences in baseline TBFV measurements between the breastfeeding groups; however, those who breastfed longer than 2 mo had a greater change in tPEF/tE after bronchodilation (12% ± 10.4% vs 0.9% ± 7.1%; P < 0.001). Moreover, there was a clear dose-response relationship between tPEF/tE reversibility and duration of breastfeeding (P < 0.001). In multivariate regression analysis, infants who breastfed less (regression coefficient -0.335, P = 0.010) or were exposed to cigarette smoke (regression coefficient 0.353, P = 0.007) showed a greater change in tPEF/tE after bronchodilation, independent of sex, prematurity, and family history of asthma or atopy.
CONCLUSION
Infants who recover from bronchiolitis and have a shorter duration of breastfeeding or are exposed to cigarette smoke, have TBFV measurements indicative of obstructive lung disease.
Core Tip: Assessment of lung function using tidal breathing could be beneficial for infants and preschoolers in whom forced respiratory maneuvers cannot be performed. We examined the correlation between breastfeeding and tidal breathing analysis in infants with bronchiolitis, and demonstrated that those who were exposed to cigarette smoke and/or had a shorter duration of breastfeeding showed tidal breathing alterations indicative of obstructive pulmonary disease.
