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Vol. 48. Issue 4.
Pages 355-359 (July - August 2020)
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Vol. 48. Issue 4.
Pages 355-359 (July - August 2020)
Original Article
DOI: 10.1016/j.aller.2019.12.002
Predicting the outcome of respiratory disease in wheezing infants using tidal flow-volume loop shape
E. Keklikiana,
Corresponding author

Corresponding author.
, P. Cornesd, C.J. Celaa, M. Sanchez Solisb, L. García Marcosb, J.A. Castro-Rodriguezc
a Paediatric Pulmonology Unit, Paediatric Department, Hospital Quirón Palmaplanas, Palma de Mallorca, Spain
b Paediatric Pulmonology Unit, Virgen de la Arrixaca University Children’s Hospital, Murcia, Spain
c Paediatric Pulmonology Unit, Division of Pediatrics, Pontificia Universidad Católica de Chile, Santiago, Chile
d Universidad Favaloro, Buenos Aires, Argentina
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Figures (1)
Tables (3)
Table 1. Characteristics of patients enrolled who completed first visit.
Table 2. Number of episodes and patients with higher risk for each shape of Tidal F/V loop.
Table 3. Values (mean+/−sd) for TPEFT/tE, Respiratory Rate and Vt/kg for each shape of the loop.
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Introduction and objectives

Wheezing (RW) infants with a positive asthma predictive index (API+) have a lower lung function as measured by forced expiratory techniques. Tidal flow-volume loops (TFVL) are easy to perform in infants, and sedation is not necessary.

Materials and methods

A total of 216 wheezing infants were successfully measured, and 183 of them were followed for over a year. TFVL loops were classified into one of three categories depending of their geometric shape (symmetric, convex, and concave). Respiratory rate (Rr), presence of API+, and the number of exacerbations during the following year were also recorded.


Children with concave loops had more exacerbations in the following year (OR = 6.8 [IC95% 3.33;13.91]). Infants API + were also significantly more related to concave loops (OR = 10.02 [IC 95% 4.53; 22.15]). Rr was higher in infants with concave loops (44+/−15.5 vs. 36.6 +/−12.6; p < 0.01).


Infants with a concave TFVL have a higher probability of experiencing exacerbations in the following year, and are at a higher risk of suffering asthma.

Respiratory function test


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