{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T13:19:37Z","timestamp":1774617577602,"version":"3.50.1"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2000,11,1]],"date-time":"2000-11-01T00:00:00Z","timestamp":973036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Flow\u2013volume loop evaluation yields considerable diagnostic information about adult patients with upper airway obstruction. No conclusive data support the reliability of this method in young children with noisy breathing. We used analysis of flow\u2013volume loops at tidal breathing (TB-FV) as a first diagnostic approach to young children presenting with persistent noisy breathing (chronic stridor and\/or wheezing). Flexible fiberoptic bronchoscopy was performed to establish a conclusive diagnosis and was used to verify the accuracy of the preliminary functional localization of the airway obstruction causing noisy breathing. The physician conducting pneumotachography was blinded to the bronchoscopic findings in the study, and the investigators conducting bronchoscopy were blinded to the pneumotachographic findings. Through a 6-yr period, 113 consecutive young children (ranging in age from 15 to 48 mo) with noisy breathing were enrolled in the study. Three morphologically abnormal TB\u2013FV patterns, as compared with the normal round-shaped TB\u2013FV loops obtained with 15 healthy children, were identified in 110 patients. A TB\u2013FV pattern of inspiratory fluttering was found in 26 subjects and in the first 3 yr of the study was always associated with an endoscopic diagnosis of isolated laryngomalacia. Subsequently, this pattern was used to diagnose isolated laryngomalacia in 18 other infants, in whom endoscopy was avoided. Of infants with endoscopic evidence of airway obstruction ranging from the glottis to the mainstem bronchi (49 subjects), all but three showed a TB\u2013FV loop pattern characterized by expiratory-limb flattening. A concave expiratory loop, with early expiratory peak flow and low flow at low volume, was invariably associated with peripheral bronchoconstriction, without endoscopic evidence of anatomic abnormalities (20 cases). In conclusion, TB\u2013 FV loop analysis is a noninvasive, accurate method of establishing the site of airway obstruction in young children with recurrent stridor and\/or wheezing. Clinical use of this method may provide interesting pathophysiologic information and may be useful in addressing the diagnostic management of such children.<\/jats:p>","DOI":"10.1164\/ajrccm.162.5.9912008","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T14:25:08Z","timestamp":1365085508000},"page":"1795-1800","source":"Crossref","is-referenced-by-count":27,"title":["Functional Approach to Infants and Young Children with Noisy Breathing"],"prefix":"10.1093","volume":"162","author":[{"given":"MARCO","family":"FILIPPONE","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Padua, Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SURENDRA","family":"NARNE","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Padua, Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ANDREA","family":"PETTENAZZO","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Padua, Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"FRANCO","family":"ZACCHELLO","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Padua, Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"EUGENIO","family":"BARALDI","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Padua, Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2000,11,1]]},"reference":[{"key":"2026032708340716200_B1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1164\/ajrccm\/145.1.233","article-title":"Flexible endoscopy of pediatric airway.","volume":"145","author":"Green","year":"1992","journal-title":"Am Rev Respir 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