Comparison of four methods of assessing airflow resistance before and after induced airway narrowing in normal subjects.
Four methods for assessing airflow resistance were compared in seven normal adults at baseline and after inducing airway narrowing with inhaled methacholine. Airway resistance (Raw) was measured during panting at 1-2 Hz within a body plethysmograph; total lung resistance was measured by using an esophageal balloon during quiet breathing (RLq) and with doubling of frequency while maintaining the original tidal volume; total respiratory resistance (Rrs) was measured at 6 Hz during forced oscillation applied at the airway opening, and interruption resistance (Rint) was measured at midtidal expiratory flow. Three methods of obtaining Rint after airflow interruption were compared [smooth curve fit of mouth pressure (Pm) back extrapolated to valve closure; two-point linear fit of Pm back extrapolated to 15 ms after closure; and Pm at 100 ms after valve closure]. We found similar basal median values (cmH2O.l-1.s) of Raw (1.3), RLq (1.4), RL of double resting frequency (1.9), Rrs (1.7), and smooth curve fit of Pm back extrapolated to valve closure (1.5); basal values of two-point linear fit of Pm back extrapolated to 15 ms after closure (2.4) and Pm at 100 ms after valve closure (4.4) were considerably larger. After induced airway narrowing, all methods of measuring resistance showed significant increases; these were largest with RLq (median %change of 265) and smallest with the three Rint methods (median %change of 62-72). Rint and Rrs methods had poorer sensitivity for detecting bronchoconstriction than lung resistance of Raw. Of the Rint methods, end interruption pressure was the most sensitive.(ABSTRACT TRUNCATED AT 250 WORDS)
Phagoo
S B
SB
Department of Paediatrics, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom.
Watson
R A
RA
Silverman
M
M
Pride
N B
NB
D000328:Adult; D000403:Airway Resistance; D016085:Bronchoconstrictor Agents / Q000494:pharmacology; D002404:Catheterization; D004947:Esophagus / Q000502:physiology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D016210:Methacholine Chloride / Q000494:pharmacology; D010993:Plethysmography, Whole Body; D012129:Respiratory Function Tests; D012143:Respiratory Physiological Phenomena; D012137:Respiratory System / Q000033:anatomy & histology*; D013147:Spirometry
D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride