A retrospective analysis of tidal breathing pulmonary function characteristics in infants and young children with recurrent wheezing
- 1epartment of Pediatric Respiratory Medicine II, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang, Hebei, China
Abstract
BackgroundRecurrent wheezing is common in infants and young children, but objective lung function assessment is limited because conventional spirometry is often not feasible. Tidal breathing pulmonary function testing may help characterize expiratory flow abnormalities in this age group.ObjectiveTo evaluate tidal breathing pulmonary function characteristics in infants and young children with recurrent wheezing.MethodsThis retrospective study included 178 children who underwent tidal breathing pulmonary function testing from March 2025 to March 2026, including 120 with recurrent wheezing and 58 non-wheezing controls. Core indices, abnormality patterns, multivariable logistic regression, sensitivity analyses, and exploratory ROC analysis were evaluated.ResultsChildren with recurrent wheezing had a lower ratio of time to peak tidal expiratory flow to total expiratory time (tPTEF/tE) than non-wheezing controls, with a mean difference of −0.041 and P < 0.001. The ratio of volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE) was also lower in the recurrent wheezing group, with a mean difference of −0.045 and P < 0.001. Any tidal breathing pulmonary function abnormality was more frequent in the recurrent wheezing group than in controls, at 75.8% and 27.6%, respectively, P < 0.001. In a combined multivariable model including both core indices, higher tPTEF/tE and VPTEF/VE were independently associated with lower odds of recurrent wheezing, with adjusted ORs of 0.746 and 0.746 per 0.01 increase, respectively, both P < 0.001. Sensitivity analyses excluding premature infants, pneumonia cases, oxygen therapy, bronchodilator exposure, and lower-quality but analyzable tests showed consistent results. Exploratory ROC analysis showed moderate discriminatory ability, with AUCs of 0.779 for tPTEF/tE and 0.792 for VPTEF/VE.ConclusionInfants and young children with recurrent wheezing showed lower tPTEF/tE and VPTEF/VE, suggesting altered tidal expiratory breathing mechanics. These indices may provide supportive objective information for evaluating recurrent wheezing, but they should not be used as standalone diagnostic markers.
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BibTeX
@article{ding2026retrospective,
title = {{A retrospective analysis of tidal breathing pulmonary function characteristics in infants and young children with recurrent wheezing}},
author = {Qian Ding and Huahua Tian and Yanmin Wang and Xiaowei Wang and Jiao Chen},
journal = {Frontiers in Pediatrics},
year = {2026},
month = oct,
doi = {10.3389/fped.2026.1966843},
url = {https://doi.org/10.3389/fped.2026.1966843},
note = {CC BY},
}
RIS
TY - JOUR
TI - A retrospective analysis of tidal breathing pulmonary function characteristics in infants and young children with recurrent wheezing
AU - Qian Ding
AU - Huahua Tian
AU - Yanmin Wang
AU - Xiaowei Wang
AU - Jiao Chen
PY - 2026
DA - 2026/10/26
JO - Frontiers in Pediatrics
DO - 10.3389/fped.2026.1966843
UR - https://doi.org/10.3389/fped.2026.1966843
AB - BackgroundRecurrent wheezing is common in infants and young children, but objective lung function assessment is limited because conventional spirometry is often not feasible. Tidal breathing pulmonary function testing may help characterize expiratory flow abnormalities in this age group.ObjectiveTo evaluate tidal breathing pulmonary function characteristics in infants and young children with recurrent wheezing.MethodsThis retrospective study included 178 children who underwent tidal breathing pulmonary function testing from March 2025 to March 2026, including 120 with recurrent wheezing and 58 non-wheezing controls. Core indices, abnormality patterns, multivariable logistic regression, sensitivity analyses, and exploratory ROC analysis were evaluated.ResultsChildren with recurrent wheezing had a lower ratio of time to peak tidal expiratory flow to total expiratory time (tPTEF/tE) than non-wheezing controls, with a mean difference of −0.041 and P < 0.001. The ratio of volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE) was also lower in the recurrent wheezing group, with a mean difference of −0.045 and P < 0.001. Any tidal breathing pulmonary function abnormality was more frequent in the recurrent wheezing group than in controls, at 75.8% and 27.6%, respectively, P < 0.001. In a combined multivariable model including both core indices, higher tPTEF/tE and VPTEF/VE were independently associated with lower odds of recurrent wheezing, with adjusted ORs of 0.746 and 0.746 per 0.01 increase, respectively, both P < 0.001. Sensitivity analyses excluding premature infants, pneumonia cases, oxygen therapy, bronchodilator exposure, and lower-quality but analyzable tests showed consistent results. Exploratory ROC analysis showed moderate discriminatory ability, with AUCs of 0.779 for tPTEF/tE and 0.792 for VPTEF/VE.ConclusionInfants and young children with recurrent wheezing showed lower tPTEF/tE and VPTEF/VE, suggesting altered tidal expiratory breathing mechanics. These indices may provide supportive objective information for evaluating recurrent wheezing, but they should not be used as standalone diagnostic markers.
SN - 2296-2360
ER -