Airway Resistance Measurements in Children with Cystic Fibrosis

Morrison, Lisa; Ball, R.; Conway, S.; Brownlee, K.G.

doi:10.1016/s0031-9406(05)60095-8

Cited by 3 publications

(5 citation statements)

References 24 publications

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“…To our knowledge, only two previous studies have attempted to explore the relationship between spirometry and R int in children with cystic fibrosis. 8,17 Neither of these studies directly compared R int with spirometry to assess bronchodilator responsiveness. In a 4-year longitudinal study of pre-school children, Nielsen et al collected seven sets of plethysmographic data including R int from 30 children aged 2.7-7.7 years.…”

Section: Discussionmentioning

confidence: 99%

“…Morrison et al 17 used spirometry and the interrupter technique to assess changes in airways resistance following a course of intravenous antibiotics in 67 children with cystic fibrosis (mean age 13 years). As in our study, they showed a significant negative correlation between R int and FEV 1 values as a whole but a poor correlation when data from individual children before and after treatment were compared.…”

Section: Discussionmentioning

confidence: 99%

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The interrupter technique to assess airway responsiveness in children with cystic fibrosis

Davies

Doull

Child

2006

Pediatric Pulmonology

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Summary. The aim of this study was to assess the validity of the interrupter technique (R int ) in measuring airway responsiveness in children with cystic fibrosis. Fifty children (aged 6-16 years) with cystic fibrosis performed six R int measurements followed by three acceptable forced expiratory maneuvers. Each child then inhaled 5 mg of nebulized salbutamol by facemask. After 20 min the R int and forced expiratory measurements were repeated. In the population as a whole a moderate but significant correlation between inverse R int and FEV 1 values was observed, both before and after inhaled bronchodilator (r ¼ 0.71 and 0.72, respectively, P < 0.001). However, when changes in R int and FEV 1 readings following inhaled bronchodilator were examined, no relationship was seen. Indeed, the two methods identified completely different subsets of children as being bronchodilator responsive. These results indicate that although a relationship exists between R int and FEV 1 in the whole population, this is not the case in individual children. R int and FEV 1 reflect different aspects of lung function. It is not appropriate to use R int as a simple alternative for FEV 1 in children with cystic fibrosis when assessing airway responsiveness.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The interrupter technique to assess airway responsiveness in children with cystic fibrosis

Davies

Doull

Child

2006

Pediatric Pulmonology

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“…In the study presented here, a CF-induced Raw TB of about 2.0 cm H 2 O s L −1 for patients with a functional residual capacity of 3300 mL [16] and a Raw TB of 0.5-1.0 cm H 2 O s L −1 for children [21] were used to determine the degree of airway diameter reduction. Scaling procedure was conducted according to the iterative algorithm introduced by Martonen et al [9].…”

Section: Simulation Of Particle Deposition In Cf Lungsmentioning

confidence: 99%

“…As outlined in several medical contributions [5,21,24], breathing behaviour in COPD patients shows some specificities with respect to the breathing of healthy subjects. Respective irregularities mainly include the development of asymmetric breathing cycles with constant inhalation times, but significantly increased durations for exhalation.…”

Section: Simulation Of Particle Deposition In Cf Lungsmentioning

confidence: 99%

Stochastic Modeling of Particle Deposition in Lungs of Cystic Fibrosis Patients

Sturm

2011

ISRN Pulmonology

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A stochastic model describing particle deposition in cystic fibrosis (CF) patients has been developed. The model should help to optimize drug administration in the treatment of CF by exploring those physiologic and physical parameters that are responsible for the delivering of pharmaceutical aerosols to appropriate sites (receptor cells). Concerning the modeling of deposition, changes of the lungs due to CF were expressed by either constant or random scaling of the airway calibers. Additionally, continuous enlargement of the alveoli and the definition of asymmetric breathing cycles (different lengths for inhalation and exhalation time) were carried out. Application of these model considerations to three different age groups (infants, children, and adults) showed that permanent reduction of the airway calibers generally increases deposition in the tracheobronchial tree by more than 100% with respect to healthy controls. The fraction of particles deposited in the alveoli and alveolar ducts may be decreased at the same time. These tendencies are even more pronounced by the simulation of emphysema and by extending exhalation time with respect to inhalation time. Relative particle fractions deposited in the tracheobronchial compartment significantly increase from infant to adult.

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“…Rint and spirometry reflect different aspects of the lung function and are not exactly interchangeable: Rint is more affected by large airway function and it measures the total resistance system and some added chest wall resistance. Moreover, it is a quick, noninvasive measure of respiratory resistance during tidal breathing that may be more easily performed in the preschooler than spirometry [ 21 , 22 ]. This technique appeared as a reliable tool in the diagnostic work-up of pulmonary function in young CF patients [ 10 , 12 – 14 ], even if its use that has been standardized by the ERS/ATS task force reported little evidence supporting the clinical utility in the preschool population with CF [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of inhaled hypertonic (7%) saline on lung function test in preschool children with cystic fibrosis: results of a crossover, randomized clinical trial

et al. 2017

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BackgroundThis crossover, randomized, double-blind study (conducted over a 32-week period) was performed to determine, in clinically stable Cystic fibrosis (CF) preschool children: the effects of 7% inhaled hypertonic saline on spirometry and interrupter resistance technique (Rint), and the possible side effects.MethodsTwelve CF children (6M, mean age ± SD: 5.7 ± 0.8 yrs) were enrolled and randomly assigned to receive hypertonic saline (HS-4 ml 7% sodium chloride), or normal saline (NS-0.9% sodium chloride) twice a day. After a 16 weeks period, therapy was exchanged to allow all the patients enrolled in the study to carry out both treatments. Monitoring visits, spirometry (COSMED Quark PFT4 ergo) and Rint were scheduled at 0,4,16,20,32 weeks. At T0, spirometric measurements and Rint were performed immediately before and 30 min after the inhalation therapy. Salbutamol (400 mcg) was administered before the drug at each visit.ResultsAfter a 16-weeks treatment with HS an improvement of FVC (p = 0.02) and a favorable trend of FEV1 were registered. A worsening of FEV1 (p < 0.0001) and of FEF25-75 (p = 0.019) were found in NS group. No differences were found in expiratory and inspiratory Rint in both groups. No serious adverse events occurred.ConclusionsSeven percent hypertonic saline therapy proved to be a useful and safe treatment in young CF children with clinically stable conditions.Trial registration ISRCTN12345678.

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Airway Resistance Measurements in Children with Cystic Fibrosis

Cited by 3 publications

References 24 publications

The interrupter technique to assess airway responsiveness in children with cystic fibrosis

The interrupter technique to assess airway responsiveness in children with cystic fibrosis

Stochastic Modeling of Particle Deposition in Lungs of Cystic Fibrosis Patients

Effects of inhaled hypertonic (7%) saline on lung function test in preschool children with cystic fibrosis: results of a crossover, randomized clinical trial

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