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Respiratory Mechanics in Children

A. Charles Bryan, Mary Ellen B. Wohl

10.1002/cphy.cp030312

Source: Supplement 12: Handbook of Physiology, The Respiratory System, Mechanics of Breathing

Originally published: 1986

Published online: January 2011

Full Article on Wiley Online Library



Abstract

The sections in this article are:

1 Mechanical Properties of Chest Wall
1.1 Structural Changes in Rib Cage
1.2 Changes in Respiratory Muscles
1.3 Compliance of Chest Wall
1.4 Functional Residual Capacity
1.5 Ventilation
1.6 Cost of Rib Cage Distortion
1.7 Respiratory Muscle Fatigue
1.8 Pleural Pressure and Distortion
2 Mechanical Properties of the Lung
2.1 General Considerations
2.2 Elastic Properties of the Lung
2.3 Flow‐Resistive Properties of the Lung
2.4 Influences of Sex, Race, and Genetic Factors on Lung Mechanics
Figure 1. Figure 1.

Static pressure‐volume curve of lung (right dashed line), chest wall (left dashed line), and total respiratory system (solid line) in newborn and adult.

From Agostoni 3
Figure 2. Figure 2.

Changes in thoracic gas volume at end expiration in 6 normal human newborn infants (indicated by different symbols) from quiet (NREM) sleep to active (REM) sleep.

From Henderson‐Smart and Read 49
Figure 3. Figure 3.

Left: volume‐pressure curves obtained from excised lungs. Curves are grouped by body length. Lengths of 30–45, 46–55, 56–65, and 66–90 cm correspond to premature infants, 1 mo, 4.4 mo, and 16 mo, respectively. [From Fagan 30,31.] Right: volume‐pressure curves obtained from children. Heights of 115, 150, and 180 cm correspond to ∼6, 12–13, and 17 yr as estimated from growth charts. Vmax, maximum volume; TLC, total lung capacity; PL, elastic recoil pressure of lung.

From Zapletal et al. 124
Figure 4. Figure 4.

A: elastic recoil pressure of lung at 90% of Vmax, volume at distending pressure of 30 cmH2O, vs. body length in cm. [Adapted from Fagan 31.] B: elastic recoil pressure of lung at 90% TLC vs. height in cm. •, Males; ○, females.

Adapted from Zapletal et al. 124
Figure 5. Figure 5.

Comparison of regression lines of airway conductance during mouth breathing from infancy to adulthood. Regression lines were obtained from the following studies: line a, data on infants from Stocks and Godfrey 108; line b, data on children 1–5 yr from Doershuk et al. 23, calculated by assuming that 49% of airway resistance obtained during nose breathing was due to nasal resistance; line c, data on children and adolescents from Zapletal et al. 123; line d, data on adult males from Briscoe and DuBois 12.

From Stocks and Godfrey 108
Figure 6. Figure 6.

Retrograde‐catheter data showing change in conductance (G) of central (•) and peripheral (○) airways per gram of predicted lung weight with age.

From Hogg et al. 52
Figure 7. Figure 7.

Solid line connecting squares represents predicted upstream conductance (Gus)/TLC vs. TLC if Gus/TLC changes proportionally to TLC to −2/3 power during growth. The Gus/TLC and TLC for 8‐yr‐old child are used to develop the prediction. Dashed line, observed relationship. [Data from Mansell 77.] Solid line connecting circles represents similar predictions developed from Gus/TLC vs. TLC for a 120‐cm (6–8 yr) child. Dashed line, observed relationship.

From De Troyer et al. 22


Figure 1.

Static pressure‐volume curve of lung (right dashed line), chest wall (left dashed line), and total respiratory system (solid line) in newborn and adult.

From Agostoni 3


Figure 2.

Changes in thoracic gas volume at end expiration in 6 normal human newborn infants (indicated by different symbols) from quiet (NREM) sleep to active (REM) sleep.

From Henderson‐Smart and Read 49


Figure 3.

Left: volume‐pressure curves obtained from excised lungs. Curves are grouped by body length. Lengths of 30–45, 46–55, 56–65, and 66–90 cm correspond to premature infants, 1 mo, 4.4 mo, and 16 mo, respectively. [From Fagan 30,31.] Right: volume‐pressure curves obtained from children. Heights of 115, 150, and 180 cm correspond to ∼6, 12–13, and 17 yr as estimated from growth charts. Vmax, maximum volume; TLC, total lung capacity; PL, elastic recoil pressure of lung.

From Zapletal et al. 124


Figure 4.

A: elastic recoil pressure of lung at 90% of Vmax, volume at distending pressure of 30 cmH2O, vs. body length in cm. [Adapted from Fagan 31.] B: elastic recoil pressure of lung at 90% TLC vs. height in cm. •, Males; ○, females.

Adapted from Zapletal et al. 124


Figure 5.

Comparison of regression lines of airway conductance during mouth breathing from infancy to adulthood. Regression lines were obtained from the following studies: line a, data on infants from Stocks and Godfrey 108; line b, data on children 1–5 yr from Doershuk et al. 23, calculated by assuming that 49% of airway resistance obtained during nose breathing was due to nasal resistance; line c, data on children and adolescents from Zapletal et al. 123; line d, data on adult males from Briscoe and DuBois 12.

From Stocks and Godfrey 108


Figure 6.

Retrograde‐catheter data showing change in conductance (G) of central (•) and peripheral (○) airways per gram of predicted lung weight with age.

From Hogg et al. 52


Figure 7.

Solid line connecting squares represents predicted upstream conductance (Gus)/TLC vs. TLC if Gus/TLC changes proportionally to TLC to −2/3 power during growth. The Gus/TLC and TLC for 8‐yr‐old child are used to develop the prediction. Dashed line, observed relationship. [Data from Mansell 77.] Solid line connecting circles represents similar predictions developed from Gus/TLC vs. TLC for a 120‐cm (6–8 yr) child. Dashed line, observed relationship.

From De Troyer et al. 22
References
 1. Adler, S. M., B. T. Thach, and I. D. Frantz. III. Maturational changes of effective elastance in the first 10 days of life. J. Appl. Physiol. 40: 539–542, 1976.
 2. Adler, S. M., and M. E. B. Wohl. Flow‐volume relationship at low lung volumes in healthy term newborn infants. Pediatrics 61: 636–640, 1978.
 3. Agostoni, E. Volume‐pressure relationships of the thorax and lung in the newborn. J. Appl. Physiol. 14: 909–913, 1959.
 4. Agostoni, E., and J. Mead. Statics of the respiratory system. In: Handbook of Physiology. Respiration, edited by W. O. Fenn and H. Rahn. Washington, DC: Am. Physiol. Soc., 1964 sect. 3, vol. I, chapt. 13, p. 387–409.
 5. Avery, M. E., and C. D. Cook. Volume‐pressure relationships of lungs and thorax in fetal, newborn, and adult goats. J. Appl. Physiol. 16: 1034–1038, 1961.
 6. Bachofen, H., and G. Duc. Lung tissue resistance in healthy children. Pediatr. Res. 2: 119–124, 1968.
 7. Baran, D., and M. Englert. La conductance des voies aériennes chez l'enfant et l'adolescent normaux. Bull. Physio‐Pathol. Respir. 7: 125–135, 1971.
 8. Beardsmore, C. S., P. Helms, J. Stocks, D. J. Hatch, and M. Silverman. Improved esophageal balloon technique for use in infants. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 49: 735–742, 1980.
 9. Berend, N., C. Skoog, and W. M. Thurlbeck. Pressure‐volume characteristics of excised human lungs: effects of sex, age, and emphysema. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 49: 558–565, 1980.
 10. Binder, R. E., C. A. Mitchell, J. B. Schoenberg, and A. Bouhuys. Lung function among black and white children. Am. Rev. Respir. Dis. 114: 955–959, 1976.
 11. Boychuk, R. B., M. M. K. Seshia, and H. Rigatto. The effect of gestational age on the effective elastance of the respiratory system in neonates. Pediatr. Res. 11: 791–793, 1977.
 12. Briscoe, W. A., and A. B. DuBois. The relationship between airway resistance, airway conductance and lung volume in subjects of different age and body size. J. Clin. Invest. 37: 1279–1285, 1958.
 13. Bucher, U., and L. Reid. Development of the intrasegmental bronchial tree: the pattern of branching and development of cartilage at various stages of intrauterine life. Thorax 16: 207–218, 1961.
 14. Burnard, E. D., P. Grattan‐Smith, C. G. Picton‐Warlow, and A. Grauaug. Pulmonary insufficiency in prematurity. Aust. Paediatr. J. 1: 12–38, 1965.
 15. Cogswell, J. J. Forced oscillation technique for determination of resistance to breathing in children. Arch. Dis. Child. 48: 259–266, 1973.
 16. Cogswell, J. J., D. Hull, A. D. Milner, A. P. Norman, and B. Taylor. Lung function in childhood. III. Measurement of airflow resistance in healthy children. Br. J. Dis. Chest 69: 177–187, 1975.
 17. Cook, C. D., J. Mead, and M. M. Orzalesi. Static volume‐pressure characteristics of the respiratory system during maximal efforts. J. Appl. Physiol. 19: 1016–1022, 1964.
 18. Cook, C. D., J. M. Sutherland, S. Segal, R. B. Cherry, J. Mead, M. B. McIlroy, and C. A. Smith. Studies of respiratory physiology in the newborn infant. III. Measurements of mechanics of respiration. J. Clin. Invest. 36: 440–448, 1957.
 19. Croteau, J. R., and C. D. Cook. Volume‐pressure and length‐tension measurements in human tracheal and bronchial segments. J. Appl. Physiol. 16: 170–172, 1961.
 20. D'Angelo, E., G. Sant'Ambrogio, and E. Agostoni. Effect of diaphragm activity or paralysis on distribution of pleural pressure. J. Appl. Physiol. 37: 311–315, 1974.
 21. Davi, M., K. Sankaran, M. Maccallum, D. Cates, and H. Rigatto. Effect of sleep state on chest distortion and on the ventilatory response to CO2 in neonates. Pediatr. Res. 13: 982–986, 1979.
 22. De Troyer, A., J.‐C. Yernault, M. Englert, D. Baran, and M. Paiva. Evolution of intrathoracic airway mechanics during lung growth. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 44: 521–527, 1978.
 23. Doershuk, C. F., T. D. Downs, L. W. Matthews, and M. D. Lough. A method for ventilatory measurements in subjects 1 month‐5 years of age: normal results and observations in disease. Pediatr. Res. 4: 165–174, 1970.
 24. Doershuk, C. F., and L. W. Matthews. Airway resistance and lung volume in the newborn infant. Pediatr. Res. 3: 128–134, 1969.
 25. Dosman, J., A. Grassino, P. T. Macklem, and L. A. Engel. Factors influencing the esophageal pressure gradient in upright man (Abstract). Physiologist 18: 194, 1975.
 26. Dreyfus‐Brisac, C. Sleep ontogenesis in early human prematurity from 24 to 27 weeks of conceptional age. Dev. Psychobiol. 1: 162–169, 1968.
 27. Dunnill, M. S. Postnatal growth of the lung. Thorax 17: 329–333, 1962.
 28. Duomarco, J. L., and R. Rimini. La presion intra‐abdominal en el hombre. Buenos Aires: El Ateneo, 1947.
 29. Emery, J., and A. Mithal. The weight of the lungs. In: The Anatomy of the Developing Lung, edited by J. Emery. London: Heineman, 1969, p. 203–209.
 30. Fagan, D. G. Post‐mortem studies of the semistatic volume‐pressure characteristics of infants' lungs. Thorax 31: 534–543, 1976.
 31. Fagan, D. G. Shape changes in static V‐P loops for children's lungs related to growth. Thorax 32: 198–202, 1977.
 32. Fisher, J. T., J. P. Mortola, J. B. Smith, G. S. Fox, and S. Weeks. Respiration in newborns: development of the control of breathing. Am. Rev. Respir. Dis. 125: 650–657, 1982.
 33. Fox, W. W., M. A. Bureau, L. A. Taussig, R. R. Martin, and P. H. Beaudry. Helium flow‐volume curves in the detection of early small airway disease. Pediatrics 54: 293–299, 1974.
 34. Gaultier, C., L. Perret, M. Boule, A. Buvry, and F. Girard. Occlusion pressure and breathing pattern in healthy children. Respir. Physiol. 46: 71–80, 1981.
 35. Gaultier, C., and R. Zinman. Maximal static pressures in healthy children. Respir. Physiol. 51: 45–61, 1983.
 36. Gerhardt, T., and E. Bancalari. Chest wall compliance in full term and premature infants. Acta Paediatr. Scand. 69: 359–364, 1980.
 37. Gerhardt, T., and E. Bancalari. Components of effective elastance and their maturational changes in human newborns. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 53: 766–769, 1982.
 38. Godfrey, S., P. L. Kamburoff, and J. R. Nairn. Spirometry, lung volumes and airway resistance in normal children aged 5 to 18 years. Br. J. Dis. Chest 64: 15–24, 1970.
 39. Goldman, M. D., A. Grassino, J. Mead, and T. A. Sears. Mechanics of the human diaphragm during voluntary contraction: dynamics. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 44: 840–848, 1978.
 40. Goldman, M. D., G. Grimby, and J. Mead. Mechanical work of breathing derived from rib cage and abdominal V‐P partitioning. J. Appl. Physiol. 41: 752–763, 1976.
 41. Grassino, A., and F. Bellemare. Respiratory muscle fatigue and its effects on the breathing cycle. In: Central Nervous Control Mechanisms in Breathing, edited by C. von Euler and H. Lagercrantz. Oxford, UK: Pergamon, 1979, p. 465–472.
 42. Grassino, A., M. D. Goldman, J. Mead, and T. A. Sears. Mechanics of the human diaphragm during voluntary contraction: statics. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 44: 829–839, 1978.
 43. Green, M., J. Mead, and J. M. Turner. Variability of maximum expiratory flow‐volume curves. J. Appl. Physiol. 37: 67–74, 1974.
 44. Gribetz, I., N. R. Frank, and M. E. Avery. Static volume‐pressure relations of excised lung of infants with hyaline membrane disease, newborn and stillborn infants. J. Clin. Invest. 38: 2168–2175, 1959.
 45. Harding, R., P. Johnson, and M. E. McClelland. The expiratory role in the larynx during development and the influence of behavioral state. In: Central Nervous Control Mechanisms in Breathing, edited by C. von Euler and H. Lagercrantz. Oxford, UK: Pergamon, 1979, p. 357–358.
 46. Heldt, G. P., P. D. Goodrich, and M. B. McIlroy. Diaphragmatic ventilation, work, and chest wall distortion in premature infants (Abstract). Pediatr. Res. 15: 721, 1981.
 47. Helliesen, P. J., C. D. Cook, L. Friedlander, and S. Agathon. Studies of respiratory physiology in children. I. Mechanics of respiration and lung volumes in 85 normal children 5 to 17 years of age. Pediatrics 22: 80–93, 1958.
 48. Helms, P., C. S. Beardsmore, and J. Stocks. Absolute intraesophageal pressure at functional residual capacity in infancy. J. Appl. Physiol: Respirat. Environ. Exercise Physiol. 51: 270–275, 1981.
 49. Henderson‐Smart, D. J., and D. J. C. Read. Reduced lung volume during behavior active sleep in the newborn. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 46: 1081–1085, 1979.
 50. Hislop, A., D. C. F. Muir, M. Jacobsen, G. Simon, and L. Reid. Postnatal growth and function of the pre‐acinar airways. Thorax 27: 265–274, 1972.
 51. Hogg, J. C., P. T. Macklem, and W. M. Thurlbeck. Site and nature of airway obstruction in chronic obstructive lung disease. N. Engl. J. Med. 278: 1355–1360, 1968.
 52. Hogg, J. C., J. Williams, J. B. Richardson, P. T. Maclem, and W. M. Thurlbeck. Age as a factor in the distribution of lower‐airway conductance and in the pathologic anatomy of obstructive lung disease. N. Engl. J. Med. 282: 1283–1287, 1970.
 53. Howlett, G. Lung mechanics in normal infants and infants with congenital heart disease. Arch. Dis. Child. 47: 707–715, 1972.
 54. Jordanoglou, J. Vector analysis of rib movement. Respir. Physiol. 10: 109–120, 1970.
 55. Kaiser, E., and I. Petersen. Frequency analysis of muscle action potentials during tetanic contraction. Electromyogr. Clin. Neurophysiol. 3: 5–17, 1963.
 56. Karlberg, P., R. B. Cherry, F. E. Escardo, and G. Koch. Respiratory studies in newborn infants. II. Pulmonary ventilation and mechanics of breathing in the first minutes of life, including the onset of respiration. Acta Paediatr. 51: 121–136, 1962.
 57. Karlberg, P., and G. Koch. Respiratory studies in newborn infants. III. Development of mechanics of breathing during the first week of life: a longitudinal study. Acta Paediatr. Scand. Suppl. 135: 121–129, 1962.
 58. Keens, T. G., A. C. Bryan, H. Levison, and C. D. Ianuzzo. Developmental pattern of muscle fiber types in human ventilatory muscles. J. Appl. Physiol: Respirat. Environ. Exercise Physiol. 44: 909–913, 1978.
 59. Knill, R., W. Andrews, A. C. Bryan, and M. H. Bryan. Respiratory load compensation in infants. J. Appl. Physiol. 40: 357–361, 1976.
 60. Knudson, R. J., D. F. Clark, T. C. Kennedy, and D. E. Knudson. Effect of aging alone on mechanical properties of the normal adult human lung. J. Appl. Physiol: Respirat. Environ. Exercise Physiol. 43: 1054–1062, 1977.
 61. Knudson, R. J., R. C. Slatin, M. D. Lebowitz, and B. Burrows. The maximal expiratory flow‐volume curve. Am. Rev. Respir. Dis. 113: 587–600, 1976.
 62. Kogi, K., and T. Hakamada. Slowing of surface electromyogram and muscle strength in muscle fatigue. Rep. Inst. Sci. Labour Tokyo 60: 27–41, 1962.
 63. Kosch, P. C., and A. R. Stark. Determination and homeostasis of functional residual capacity (FRC) in infants (Abstract). Physiologist 22 (4): 71, 1979.
 64. Krahl, V. E. Anatomy of the mammalian lung. In: Handbook of Physiology. Respiration, edited by W. O. Fenn and H. Rahn. Washington, DC: Am. Physiol. Soc, 1964, sect. 3, vol. I. chapt. 6, p. 213–284.
 65. Krieger, I. Studies on mechanics of respiration in infancy. Am. J. Dis. Child. 105: 51–60, 1963.
 66. Lacourt, G., and G. Polgar. Interaction between nasal and pulmonary resistance in newborn infants. J. Appl. Physiol. 30: 870–873, 1971.
 67. Landau, L. I., C. M. Mellis, P. D. Phelan, B. Bristowe, and L. McLennan. “Small airways disease” in children: no test is best. Thorax 34: 217–223, 1979.
 68. Leeder, S. R., A. V. Swan, J. K. Peat, A. J. Woolcock, and C. R. B. Blackburn. Maximum expiratory flow‐volume curves in children: changes with growth and individual variability. Bull. Eur. Physiopathol Respir. 13: 249–260, 1977.
 69. Lesouëf, P. N., J. M. Lopes, N. Muller, and A. C. Bryan. Effect of chest wall distortion on esophageal pressure (Abstract). Physiologist 24 (4): 95, 1981.
 70. Lopes, J. M., N. L. Muller, M. H. Bryan, and A. C. Bryan. Synergistic behavior of inspiratory muscles after diaphragmatic fatigue in the newborn. J. Appl. Physiol: Respirat. Environ. Exercise Physiol. 51: 547–551, 1981.
 71. Lopes, J., N. L. Muller, M. H. Bryan, and A. C. Bryan. Importance of inspiratory muscle tone in maintenance of FRC in the newborn. J. Appl. Physiol: Respirat. Environ. Exercise Physiol. 51: 830–834, 1981.
 72. Maclem, P. T., and J. Mead. Resistance of central and peripheral airways measured by a retrograde catheter. J. Appl. Physiol. 22: 395–401, 1967.
 73. Macklem, P. T., and C. S. Roussos. Respiratory muscle fatigue: a cause of respiratory failure? Clin. Sci. Mol. Med. 53: 419–422, 1977.
 74. Malsch, E. Maximal inspiratory force in infants and children. South. Med. J. 71: 428–429, 1978.
 75. Man, S. F. P., and N. Zamel. Genetic influence on normal variability of maximum expiratory flow‐volume curves. J. Appl. Physiol. 41: 874–877, 1976.
 76. Mansell, A., C. Bryan, and H. Levison. Airway closure in children. J. Appl. Physiol. 33: 711–714, 1972.
 77. Mansell, A. L., A. C. Bryan, and H. Levison. Relationship of lung recoil to lung volume and maximum expiratory flow in normal children. J. Appl. Physiol: Respirat. Environ. Exercise Physiol. 42: 817–823, 1977.
 78. Mansell, A., H. Levison, K. Kruger, and T. L. Tripp. Measurement of respiratory resistance in children by forced oscillations. Am. Rev. Respir. Dis. 106: 710–714, 1972.
 79. Martin, R. J., A. Okken, and D. Rubin. Arterial oxygen tension during active and quiet sleep in the normal neonate. J. Pediatr. 94: 271–274, 1979.
 80. Mead, J. Analysis of the configuration of maximum expiratory flow‐volume curves. J. Appl. Physiol: Respirat. Environ. Exercise Physiol. 44: 156–165, 1978.
 81. Mead, J. Dysanapsis in normal lungs assessed by the relationship between maximal flow, static recoil, and vital capacity. Am. Rev. Respir. Dis. 121: 339–342, 1980.
 82. Mead, J., J. M. Turner, P. T. Macklem, and J. B. Little. Significance of the relationship between lung recoil and maximum expiratory flow. J. Appl. Physiol. 22: 95–108, 1967.
 83. Michaelson, E. D., H. Watson, G. Silva, A. Zapata, S. M. Serafini‐Michaelson, and M. A. Sackner. Pulmonary function in normal children. Bull. Eur. Physiopathol. Respir. 14: 525–550, 1978.
 84. Motoyama, E. K. Pulmonary mechanics during early postnatal years. Pediatr. Res. 11: 220–223, 1977.
 85. Muller, N., G. Gulston, D. Cade, J. Whitton, A. B. Froese, M. H. Bryan, and A. C. Bryan. Diaphragmatic muscle fatigue in the newborn. J. Appl Physiol: Respirat. Environ. Exercise Physiol 46: 688–695, 1979.
 86. Muller, N., G. Volgyesi, L. Becker, M. H. Bryan, and A. C. Bryan. Diaphragmatic muscle tone. J. Appl. Physiol: Respirat. Environ. Exercise Physiol. 47: 279–284, 1979.
 87. Muller, N., G. Volgyesi, M. H. Bryan, and A. C. Bryan. The consequence of diaphragmatic muscle fatigue in the newborn infant. J. Pediatr. 95: 793–797, 1979.
 88. Nelson, N. M., L. S. ProD'hom, R. B. Cherry, P. J. Lipsitz, and C. A. Smith. Pulmonary function in the newborn infant. V. Trapped gas in the normal infant's lung. J. Clin. Invest. 42: 1850–1857, 1963.
 89. Neuburger, N., H. Levison, A. C. Bryan, and K. Kruger. Transit time analysis of the forced expiratory spirogram in growth. J. Appl. Physiol. 40: 329–332, 1976.
 90. Nightingale, D. A., and C. C. Richards. Volume pressure relations of the respiratory system of curarized infants. Anesthesiology 26: 710–714, 1965.
 91. Olinsky, A., M. H. Bryan, and A. C. Bryan. Influence of lung inflation on respiratory control in neonates. J. Appl. Physiol. 36: 426–429, 1974.
 92. Phelan, P. D., and H. E. Williams. Ventilatory studies in healthy infants. Pediatr. Res. 3: 425–432, 1969.
 93. Polgar, G., and G. P. Kong. The nasal resistance of newborn infants. J. Pediatr. 67: 557–567, 1965.
 94. Polgar, G., and V. Promadhat. Pulmonary Function Testing in Children: Techniques and Standards. Philadelphia, PA: Saunders, 1971.
 95. Polgar, G., and S. T. String. The viscous resistance of the lung tissues in newborn infants. J. Pediatr. 69: 787–792, 1966.
 96. Polgar, G., and T. R. Weng. The functional development of the respiratory system. Am. Rev. Respir. Dis. 120: 625–695, 1979.
 97. Pride, N. B., S. Permutt, R. L. Riley, and B. Bromberger‐Barnea. Determinants of maximal expiratory flow from the lungs. J. Appl. Physiol. 23: 646–662, 1967.
 98. Radford, M. Measurement of airway resistance and thoracic gas volume in infancy. Arch. Dis. Child. 49: 611–615, 1974.
 99. Reynolds, R. N., and B. E. Etsten. Mechanics of respiration in apneic anesthetized infants. Anesthesiology 27: 13–19, 1966.
 100. Richard, C. C., and L. Bachman. Lung and chest wall compliance in apneic paralyzed infants. J. Clin. Invest. 40: 273–278, 1961.
 101. Roussos, C. S., and P. T. Macklem. Diaphragmatic fatigue in man. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 43: 189–197, 1977.
 102. Schoenberg, J. B., G. J. Beck, and A. Bouhuys. Growth and decay of pulmonary function in healthy blacks and whites. Respir. Physiol. 33: 367–393, 1978.
 103. Sharp, J. T., W. S. Druz, R. C. Balagot, V. R. Bandelin, and J. Danon. Total respiratory compliance in infants and children. J. Appl. Physiol. 29: 775–779, 1970.
 104. Sinclair‐Smith, C. C., J. L. Emery, D. Gadsdon, F. Dinsdale, and J. Baddeley. Cartilage in children's lungs: a quantitative assessment using the right middle lobe. Thorax 31: 40–43, 1976.
 105. Solymar, L., P. H. Aronsson, B. Bake, and J. Bjure. Nitrogen single breath test, flow‐volume curves and spirometry in healthy children, 7–18 years of age. Eur. J. Respir. Dis. 61: 275–286, 1980.
 106. Stänescu, D., N. E. Moavero, C. Veriter, and L. Brasseur. Frequency dependence of respiratory resistance in healthy children. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 47: 268–272, 1979.
 107. Stigol, L. C., G. F. Vawter, and J. Mead. Studies on elastic recoil of the lung in a pediatric population. Am. Rev. Respir. Dis. 105: 552–563, 1972.
 108. Stocks, J., and S. Godfrey. Specific airway conductance in relation to postconceptional age during infancy. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 43: 144–154, 1977.
 109. Stocks, J., and S. Godfrey. Nasal resistance during infancy. Respir. Physiol. 34: 233–246, 1978.
 110. Stocks, J., N. M. Levy, and S. Godfrey. A new apparatus for the accurate measurement of airway resistance in infancy. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 43: 155–159, 1977.
 111. Swyer, P. R., R. C. Reiman, and J. J. Wright. Ventilation and ventilatory mechanics in the newborn. J. Pediatr. 56: 612–622, 1960.
 112. Tabachnik, E., N. L. Muller, A. C. Bryan, and H. Levison. Changes in ventilation and chest wall mechanics during sleep in normal adolescents. J. Appl. Physiol: Respirat. Environ. Exercise Physiol. 51: 557–564, 1981.
 113. Takahashi, E., and H. Atsumi. Age differences in thoracic form as indicated by thoracic index. Hum. Biol. 27: 65–74, 1955.
 114. Taussig, L. M. Maximal expiratory flows at functional residual capacity: a test of lung function for young children. Am. Rev. Respir. Dis. 116: 1031–1038, 1977.
 115. Thach, B. T., I. F. Abroms, I. D. Frantz III, A. Sotrel, E. N. Bruce, and M. D. Goldman. Intercostal muscle reflexes and sleep breathing patterns in the human infant. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 48: 139–146, 1980.
 116. Thurlbeck, W. M. Postnatal human lung growth. Thorax 37: 564–571, 1982.
 117. Tusiewicz, K., H. Moldofsky, A. C. Bryan, and M. H. Bryan. Mechanics of the rib cage and diaphragm during sleep. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 43: 600–602, 1977.
 118. Weng, T. R., and H. Levison. Standards of pulmonary function in children. Am. Rev. Respir. Dis. 99: 879–894, 1969.
 119. Widdowson, E. M. Growth and composition of the fetus and newborn. In: Biology of Gestation. The Fetus and Neonate, edited by N. S. Assali. New York: Academic, 1968, vol. 2, p. 1–44.
 120. Wiesemann, H., and H. von der Hardt. Reliability of flow‐volume measurements in children. Respiration 41: 181–187, 1981.
 121. Williams, S. P., R. L. Pimmel, J. M. Fullton, M. J. Tsai, and A. M. Collier. Fractionating respiratory resistance in young children. J. Appl. Physiol: Respirat. Environ. Exercise Physiol. 47: 551–555, 1979.
 122. Wittenborg, M. H., M. T. Gyepes, and D. Crocker. Tracheal dynamics in infants with respiratory distress, stridor, and collapsing trachea. Radiology 88: 653–662, 1967.
 123. Wohl, M. E. B., L. C. Stigol, and J. Mead. Resistance of the total respiratory system in healthy infants and infants with bronchiolitis. Pediatrics 43: 495–509, 1969.
 124. Zapletal, A., E. K. Motoyama, K. P. van de Woestijne, V. R. Hunt, and A. Bouhuys. Maximum expiratory flow‐volume curves and airway conductance in children and adolescents. J. Appl. Physiol. 26: 308–316, 1969.
 125. Zapletal, A., T. Paul, and M. Samánek. Pulmonary elasticity in children and adolescents. J. Appl. Physiol. 40: 953–961, 1976.
 126. Zapletal, A., M. Samánek, and T. Paul. Upstream and total airway conductance in children and adolescents. Bull. Eur. Physiopathol. Respir. 18: 31–37, 1982.

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Article Title: Respiratory Mechanics in Children
 

How to Cite

A. Charles Bryan, Mary Ellen B. Wohl. Respiratory Mechanics in Children. Compr Physiol 2011, Supplement 12: Handbook of Physiology, The Respiratory System, Mechanics of Breathing: 179-191. First published in print 1986. doi: 10.1002/cphy.cp030312