{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T20:52:17Z","timestamp":1773521537420,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T00:00:00Z","timestamp":1658102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Spirometry is easily accessible yet there is limited data in children with tracheomalacia. Availability of such data may inform clinical practice. We aimed to describe spirometry indices of children with tracheomalacia, including Empey index and flow\u2010volume curve pattern, and determine whether these indices relate with bronchoscopic features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From the database of children with tracheomalacia diagnosed during 2016\u20132019, we reviewed their flexible bronchoscopy and spirometry data in a blinded manner. We specially evaluated several spirometry indices and tracheomalacia features (cross\u2010sectional lumen reduction, malacic length, and presence of bronchomalacia) and determined their association using multivariable regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 53 children with tracheomalacia, the mean (SD) peak expiratory flow (PEF) was below the normal range [68.9 percent of predicted value\u00a0(23.08)]. However, all other spirometry parameters were within normal range [<jats:italic>Z<\/jats:italic>\u2010score forced expired volume in 1\u2009s\u00a0(FEV<jats:sub>1<\/jats:sub>)\u2009=\u2009\u22121.18 (1.39), forced vital capacity\u00a0(FVC)\u2009=\u2009\u22120.61 (1.46), forced expiratory flow between 25% and 75% of vital capacity\u200b\u200b\u200b\u200b\u200b\u200b\u00a0(FEF<jats:sub>25%\u201375%<\/jats:sub>)\u2009=\u2009\u22121.43 (1.10), FEV<jats:sub>1<\/jats:sub>\/FVC\u2009=\u2009\u22121.04 (1.08)], Empey Index\u2009=\u20098.21 (1.59). The most common flow\u2010volume curve pattern was the \u201cknee\u201d pattern (<jats:italic>n<\/jats:italic>\u2009=\u200939, 73.6%). Multivariable linear regression identified the presence of bronchomalacia was significantly associated with lower flows: FEV<jats:sub>1<\/jats:sub> [coefficient (95%\u00a0CI) \u22120.78 (\u22121.54, \u22120.02)], FEF<jats:sub>25%\u201375%<\/jats:sub> [\u22120.61 (\u22121.22, 0)], and PEF [\u221212.69 (\u221221.13, \u22124.25)], all <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.05. Other bronchoscopic\u2010defined tracheomalacia features examined (cross\u2010sectional lumen reduction, malacic length) were not significantly associated with spirometry indices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The \u201cknee\u201d pattern in spirometry flow\u2010volume curve is common in children with tracheomalacia but other indices, including Empey index, cannot be used to characterize tracheomalacia. Spirometry indices were not significantly associated with bronchoscopic tracheomalacia features but children with tracheobronchomalacia have significantly lower flow than those with tracheomalacia alone.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26054","type":"journal-article","created":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T08:23:03Z","timestamp":1656922983000},"page":"2437-2444","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Pulmonary function of children with tracheomalacia and associated clinical factors"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2942-9380","authenticated-orcid":false,"given":"Wicharn","family":"Boonjindasup","sequence":"first","affiliation":[{"name":"Menzies School of Health Research, Child Health Division, NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE) Charles Darwin University Casuarina Northern Territory Australia"},{"name":"Department of Pediatrics, Faculty of Medicine Chulalongkorn University Bangkok Thailand"},{"name":"Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation Queensland University of Technology Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie M.","family":"Marchant","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation Queensland University of Technology Brisbane Queensland Australia"},{"name":"Department of Respiratory &amp; Sleep Medicine Queensland Children's Hospital Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret S.","family":"McElrea","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation Queensland University of Technology Brisbane Queensland Australia"},{"name":"Department of Respiratory &amp; Sleep Medicine Queensland Children's Hospital Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie T.","family":"Yerkovich","sequence":"additional","affiliation":[{"name":"Menzies School of Health Research, Child Health Division, NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE) Charles Darwin University Casuarina Northern Territory Australia"},{"name":"Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation Queensland University of Technology Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation Queensland University of Technology Brisbane Queensland Australia"},{"name":"Department of Respiratory &amp; Sleep Medicine 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