The opening interrupter technique for respiratory resistance measurements in children.
OBJECTIVE
The interrupter resistance (Rint) can be calculated from various estimates of alveolar pressure based on mouth pressure during occlusion. We compared Rint, as measured by the opening interrupter technique (Rint1), and the linear back-extrapolation method (Rint2), with the 'gold standard' airway resistance measured by plethysmography (Raw).


METHODS
The study included 32 asthmatic children and 11 children with cystic fibrosis, aged 5 to 18 years, who were categorized into non-obstructed (NObs) (n = 27) and obstructed (Obs) (n = 16) groups. Spirometry and the three different resistance measurements were performed on all children. Rint1 and Raw were assessed after a bronchodilator (BD) test in 16 and nine children, respectively, in the Obs group.


RESULTS
Raw (0.48 ± 0.20 kPa.s/L) was lower than Rint1 (1.04 ± 0.34 kPa.s/L) and Rint2 (0.63 ± 0.18 kPa.s/L) (P < 0.001). Raw, but neither Rint1 nor Rint2, was significantly higher in the Obs group than in the NObs group (0.57 ± 0.23 vs 0.42 ± 0.16 kPa.s/L, P < 0.05). The differences Rint1-Raw and Rint2-Raw were correlated with FEV(1) /VC (P < 0.01 and P < 0.001), and Rint1-Raw was correlated with height (P < 0.001). After BD significant changes in Rint1 and Raw were observed in 5/9 and 7/9 children, respectively.


CONCLUSIONS
Rint2, as well as Rint1, may be underestimated in the most Obs children and may therefore fail to detect severe obstruction. Rint1 is likely to include a non-negligible contribution from the tissue component, especially in the youngest children. Although not different between Obs and NObs children at baseline, Rint1 did detect bronchodilation in some Obs children.
Oswald-Mammosser
Monique
M
Service de Physiologie et d'Explorations Fonctionnelles, Pôle de Pathologie Thoracique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. monique.oswald@chru-strasbourg.fr
Charloux
Anne
A
Enache
Irina
I
Lonsdorfer-Wolf
Evelyne
E
D000293:Adolescent; D000402:Airway Obstruction / Q000175:diagnosis; D000403:Airway Resistance / Q000502:physiology*; D001249:Asthma / Q000503:physiopathology*; D001993:Bronchodilator Agents; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D010991:Plethysmography / Q000379:methods; D012129:Respiratory Function Tests / Q000379:methods*; D013147:Spirometry / Q000379:methods
D001993:Bronchodilator Agents