How should airways resistance be measured in young children: mask or mouthpiece?

Child, F; Clayton, Steven; Davies, Sheryl M; Fryer, Anthony A.; Jones, P. W.; Lenney, Warren

doi:10.1183/09031936.01.00089501

Cited by 26 publications

(15 citation statements)

References 26 publications

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“…The use of face masks in children v3 yrs may enhance the feasibility of the test, but Rint measurements obtained using face masks can differ from those obtained with mouthpieces [21] due to differences in the compliance and resistance of the mask and the degree of airways obstruction. Rint measurements using face masks may require specific reference equations.…”

Section: Discussionmentioning

confidence: 99%

Measurements of interrupter resistance: reference values for children 3–13 yrs of age

Merkus¹,

Arets²,

Joosten³

et al. 2002

Eur Respir J

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The interrupter technique is a convenient and sensitive technique for studying airway function in subjects who cannot actively participate in (forced) ventilatory function tests.Reference values for preschool children exist but are lacking for children w7 yrs. Reference values were obtained for expiratory interrupter resistance (Rint,e) in 208 healthy Dutch Caucasian children 3-13 yrs of age.A curvilinear relationship between Rint,e and height was observed, similar to published airways resistance data measured by plethysmography. No significant differences in cross-sectional trend or level of Rint,e were observed according to sex. It was found that Z-scores could be used to express individual Rint,e values and to describe intra-and interindividual differences based on the reference equation: 10 logRint,e=0.645-0.006686 standing height (cm) kPa?L -1 ?s -1 and residual SD (0.093 kPa?L -1 ?s -1 ).Expiratory interrupter resistance provides a tool for clinical and epidemiological assessment of airway function in a large age range. Eur Respir J 2002; 20: 907-911.

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Section: Discussionmentioning

confidence: 99%

Measurements of interrupter resistance: reference values for children 3–13 yrs of age

Merkus¹,

Arets²,

Joosten³

et al. 2002

Eur Respir J

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“…4,5,32 Al igual que otros trabajos previos, 4,6,[17][18][19]21,28 no hay diferencias significativas entre las medidas, lo que indica que la fiabilidad de la técnica es adecuada, similar a la de otras técnicas de medición de resistencias. 26 En un estudio previo 33 se encontraron diferencias pequeñas entre las mediciones con boquilla y mascarilla, por lo que se prefirió el uso de mascarilla. Esta medida no mejoró la reproducibilidad e insumió más tiempo en cada medida.…”

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Evaluación de la medición de las resistencias pulmonares por técnica de interrupción

Reyna¹

2013

Arch Argent Pediat

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RESUMENIntroducción. Las pruebas de función pulmonar permiten objetivar el grado de obstrucción bronquial en sujetos colaboradores. La medición de las resistencias pulmonares por métodos pasivos es muy útil en sujetos no colaboradores. El objetivo de este estudio fue evaluar la aplicabilidad de la medición de resistencias por interrupción (Rint) en la edad pediátrica, valorando su reproducibilidad, fiabilidad y exactitud en relación con otras técnicas de medición de resistencias. Material y métodos. Estudio transversal en niños de entre 2 y 18 años, sanos y con patología obstructiva. Se midió la Rint con un aparato portátil y se comparó con las resistencias medidas por oscilometría y pletismografía. Se valoró la reproducibilidad de las mediciones y la influencia de diferentes variables (uso de mascarilla o boquilla, sujeción de mejillas o uso de pinza nasal). Resultados. De 460 niños (47,6% menores de 7 años) se obtuvieron medidas válidas en el 82,6%. La reproducibilidad fue muy buena (CCI= 0,9412; p < 0,00001), sin encontrar diferencias entre las medidas obtenidas separadas en el tiempo (0,75 ± 0,3 contra 0,74 ± 0,28; p= 0,435). Ninguno de los factores antes mencionados afectó la reproducibilidad de las medidas. Los valores de resistencia obtenidos por pletismografía y oscilometría fueron superiores a los obtenidos por Rint, con una correlación positiva entre ambos. La correlación con la pletismografía disminuía cuanto mayor era el grado de obstrucción. Conclusiones. La medición de Rint es factible y reproducible, y se correlaciona bien con las resistencias medidas por oscilometría o pletismografía, por lo que sería de utilidad en los pacientes poco colaboradores. En los pacientes obstruidos, podría infraestimar la resistencia, dificultando su uso para el seguimiento de una patología obstructiva moderada-grave o en las pruebas de provocación bronquial. Palabras clave: resistencia de la vía aérea, Rint, función pulmonar, estudio de evaluación, edad pediátrica.http://dx

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“…4,5,32 As with other previous studies, 4,6,[17][18][19]21,28 no significant differences were observed among measurements, indicating that the technique is adequately reliable, as the other techniques to measure resistances. 26 One previous study 33 found small differences in measurements obtained with a mouthpiece and a mask; for this reason, the mask was chosen, but did not improve reproducibility and it took longer to obtain each measurement. In our study, no significant differences were observed between both types of measurements, so it appears that there are no sufficient data to favor one method over the other.…”

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confidence: 99%

Assessing the measurement of airway resistance by the interrupter technique

Reyna¹

2013

Arch Argent Pediat

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Introduction. Pulmonary function tests allow an objective assessment of the degree of bronchial obstruction in collaborative subjects. The measurement of airway resistance using passive methods is very helpful in non-collaborative subjects. The objective of this study was to assess the applicability of measuring airway resistance by the interrupter technique (Rint) in pediatric subjects, determining its reproducibility, reliability and accuracy versus other techniques to measure airway resistance. Material and Methods. Cross-sectional study in healthy children and in children with an obstructive airway disease, all aged 2-18 years old. The Rint was measured using a portable device and results were compared to airway resistance measured by oscillometry and plethysmography. The reproducibility of measurements and the influence of the different outcome measures (use of mask or mouthpiece, cheek support, or nose clip) were assessed. Results. Valid measurements were obtained in 82.6% of 460 children (47.6% younger than 7 years old). Reproducibility was very good (ICC= 0.9412; p <0.00001), and no differences were found among the measurements obtained at separate time intervals (0.75 ± 0.3 versus 0.74 ± 0.28; p= 0.435). None of the factors indicated before had an effect on the reproducibility of measurements. Resistance values obtained by plethysmography and oscillometry were higher than those obtained using the Rint, with a positive correlation between them. The higher the degree of airway obstruction, the worse the correlation with plethysmography. Conclusions. The Rint measurement is a plausible and reproducible technique, and has an adequate correlation with the resistance measurements obtained using oscillometry or plethysmography, thus making it useful for noncollaborative patients. In patients with airway obstruction, this technique could underestimate resistance, so it would be a hurdle to use it to follow-up subjects with a moderate to severe obstructive disease or in bronchial challenge tests.

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How should airways resistance be measured in young children: mask or mouthpiece?

Cited by 26 publications

References 26 publications

Measurements of interrupter resistance: reference values for children 3–13 yrs of age

Measurements of interrupter resistance: reference values for children 3–13 yrs of age

Evaluación de la medición de las resistencias pulmonares por técnica de interrupción

Assessing the measurement of airway resistance by the interrupter technique

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