Measurement of the specific airway resistance by plethysmography in young children accompanied by an adult

Klug, B; Bisgaard, Hans

doi:10.1183/09031936.97.10071599

Cited by 78 publications

(80 citation statements)

References 20 publications

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“…41 Since sR aw is primarily used in children, normative data are mainly limited to pediatrics. 20,23,24,40 As most of the children involved in these studies would likely not have been able to perform reliable spirometry, using sR aw as a measure of airways disease is a valuable tool in pediatric lung disease.…”

Section: Clinical Utility Of Sr Aw and Sg Awmentioning

confidence: 99%

“…Instead, flow is related to the small shifts in lung volume that occur during tidal breathing to derive sR aw . 1,2,20,23,24 Mathematically, the relationship between pressure and flow during panting and its relationship to TGV (ie, R aw ) is equivalent to dividing sR aw by TGV, so R aw ϭ sR aw /TGV, or sR aw ϭ R aw ϫ TGV. 2,20 This latter expression reveals that sR aw reflects not only R aw but also lung volume, and is not a resistance per se, but rather a form of work (pressure ϫ volume).…”

Section: Measurement Of Airway Resistance By Body Plethysmographymentioning

confidence: 99%

“…39 Details regarding techniques of measurement, quality control, and interpretation are available in recent, excellent reviews. 20,23,24,40 sR aw has been measured in children as young as 2 years old, and has been used in assessment of bronchodilators and response to methacholine, histamine, and cold air. 24 Other studies have included measuring the effects of short-and long- acting bronchodilators, inhaled corticosteroids, and leukotriene receptor antagonists in asthmatic children.…”

Section: Clinical Utility Of Sr Aw and Sg Awmentioning

confidence: 99%

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What Does Airway Resistance Tell Us About Lung Function?

2012

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SummarySpirometry is considered the primary method to detect the air flow limitation associated with obstructive lung disease. However, air flow limitation is the end-result of many factors that contribute to obstructive lung disease. One of these factors is increased airway resistance. Airway resistance is traditionally measured by relating air flow and driving pressure using body plethysmography, thus deriving airway resistance (R aw ), specific airway resistance (sR aw ), and specific airway conductance (sG aw ). Other methods to measure airway resistance include the forced oscillation technique (FOT), which allows calculation of respiratory system resistance (R RS ) and reactance (X RS ), and the interrupter technique, which allows calculation of interrupter resistance (R int ). An advantage of these other methods is that they may be easier to perform than spirometry, making them particularly suited to patients who cannot perform spirometry, such as young children, patients with neuromuscular disorders, or patients on mechanical ventilation. Since spirometry also requires a deep inhalation, which can alter airway resistance, these alternative methods may provide more sensitive measures of airway resistance. Furthermore, the FOT provides unique information about lung mechanics that is not available from analysis using spirometry, body plethysmography, or the interrupter technique. However, it is unclear whether any of these measures of airway resistance contribute clinically important information to the traditional measures derived from spirometry (FEV 1 , FVC, and FEV 1 /FVC). The purpose of this paper is to review the physiology and methodology of these measures of airway resistance, and then focus on their clinical utility in relation to each other and to spirometry.

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Section: Clinical Utility Of Sr Aw and Sg Awmentioning

confidence: 99%

Section: Measurement Of Airway Resistance By Body Plethysmographymentioning

confidence: 99%

Section: Clinical Utility Of Sr Aw and Sg Awmentioning

confidence: 99%

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What Does Airway Resistance Tell Us About Lung Function?

2012

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“…Based on SHROUT9s [22] reliability standards, the ICCs obtained suggest that both methods were only moderately reliable [22]. However, compared with specific airways resistance (sRaw), respiratory resistance and respiratory impedance measurements [5,6,27] in children of similar ages, the present study9s CoVs were good. No evidence was found that children produced more reliable results with practice and it was confirmed that recording more than six Rint values makes little difference to the mean result [12].…”

Section: Discussionmentioning

confidence: 89%

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

Child¹,

Clayton²,

Davies³

et al. 2001

Eur Respir J

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The reproducibility and acceptability of airways resistance measurements using the interrupter technique (MicroRint) obtained using a mouthpiece were compared with those using a face mask.Fifty children aged 4 -7 yrs performed four sets of six Rint measurements; two using a mouthpiece and two using a face mask with integral mouthpiece.Complete data were obtained from 45 (90%) children using the mouthpiece and 43 (86%) children using the mask. The two methods were equally repeatable with comparable intraclass correlation coefficients (ICC) and coefficients of variation. Mean Rint values obtained using the mouthpiece were significantly lower than those using the face mask ((mean¡SD) mouthpiece~0.81¡0.18 kPa?L -1 ?s, mask~0.88¡0.24 kPa?L -1 ?s p~0.0002). Although the mean paired differences between the two methods were small (0.07 kPa?L -1 ?s), the ICC and limits of agreement confirmed that the two methods could not be used interchangeably. Sixty-seven per cent of children preferred the face mask but this was more time-consuming (p~0.03). Children did not produce more repeatable results using their preferred method, nor did they improve with practice.Repeatable airway resistance measurements using the interrupter technique can be obtained from young children using either a mouthpiece or a face mask, but there are significant clinical and statistical differences between the results obtained.

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“…The potential advantage over forced expirations is that the measurements take place during normal tidal breathing, without interfering the breathing pattern, bronchial tone or resting lung volumes levels. 24 Although some comparative studies have been published in awake preschool children, 25,26 so far, there have been no attempts to compare whole body plethysmography and RTC technique in assessing airway responsiveness in sedated infants.…”

Section: Lung Function Testsmentioning

confidence: 99%

Methacholine‐induced lung function changes measured with infant body plethysmography

Malmberg

Kotaniemi‐Syrjänen

Malmström

et al. 2010

Pediatric Pulmonology

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Several techniques have been applied to measure airway responsiveness (AR) in infants, but there are limited data on lung function changes measured by body plethysmography during induced bronchoconstriction. The aim of this study was to compare changes in maximum forced expiratory flow measured at functional residual capacity (V'maxFRC) by rapid thoracoabdominal compression (RTC) technique with plethysmographic measurements of specific airway conductance (sGaw), and to investigate whether changes in functional residual capacity (FRC) occur during methacholine‐induced bronchoconstriction in infants. We examined 94 infants with recurrent airway symptoms using methacholine airway challenge test including RTC and plethysmographic measurements. A significant association between changes in V'maxFRC and sGaw (r = 0.30; P = 0.004) was observed, but after adjustments with baseline variability the changes in V'maxFRC were greater and showed a closer association with changes in oxygen saturation. At the point of maximal airway obstruction, there was a poor agreement between V'maxFRC and sGaw to indicate a significant methacholine‐induced bronchoconstriction. Airway challenge was also associated with a significant increase in FRC (P < 0.001), with decreasing V'maxFRC. We conclude that in infants undergoing airway challenge with methacholine, plethysmographic measurements of sGaw correlate with the changes in VmaxFRC, but the agreement is poor and the methods cannot be used interchangeably. VmaxFRC is also more sensitive to detect airway obstruction than sGaw. However, methacholine‐induced bronchoconstriction was associated with significant increases in FRC, which may affect the validity of VmaxFRC measurements during the test. Pediatr Pulmonol. 2011; 46:362–368. © 2010 Wiley‐Liss, Inc.

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Measurement of the specific airway resistance by plethysmography in young children accompanied by an adult

Cited by 78 publications

References 20 publications

What Does Airway Resistance Tell Us About Lung Function?

What Does Airway Resistance Tell Us About Lung Function?

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

Methacholine‐induced lung function changes measured with infant body plethysmography

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