Abstract
Testing pulmonary function in preschool children is problematic since individual cooperation is often insufficient to yield adequate results. This is especially the case when repetitive measurements are carried out, e.g., during provocation tests in order to diagnose bronchial hyperresponsiveness. We therefore sought to determine whether the variability of the oscillatory airway resistance, which can be measured with minimal patient cooperation, might serve as an approach to separate asymptomatic children with asthma from age-matched healthy controls. Monofrequent forced oscillation technique was used to measure the oscillatory resistance (Ros) continuously at a repetition rate of 10 Hz. Forty consecutive values of Ros at the end of expiration (Rospe) and at the end of inspiration (Rospi) were used to calculate variability measures [standard deviation (SD), averaged deviation (LD), root mean square successive differences (RMSSD)] known from heart rate variability analysis to describe the airway diameter variability in 36 asthmatics and 21 healthy controls. Airway diameter variability of Rospi and Rospe as expressed by SD from the mean (P=0.01 and 0.05, respectively), from LD (P=0.01 and 0.21, respectively) and from the RMSSD (P=0.006 and 0.03, respectively) was greater in patients with asthma. Mean values of Rospi and Rospe were not different between groups. Airway diameter variability is higher in asymptomatic children with asthma than in healthy controls. Future research should evaluate whether the measurement of the variability of Rospi, which does not require the patient’s cooperation, can give similar information as challenge tests with respect to bronchial hyperresponsiveness.
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Abbreviations
- BHR:
-
Bronchial hyperresponsiveness
- ETCO2:
-
Exhaled endtidal CO2 concentration
- IC:
-
Inhaled corticosteroids
- LD:
-
Averaged deviation of Rospior Rospe from the mean
- LF1:
-
MFO device that measures Ros
- MFO:
-
Monofrequency oscillation method
- P :
-
Oscillating pressure
- PFT:
-
Pulmonary function test
- PNT:
-
Pneumotachograph
- RMSSD:
-
Root mean square successive differences
- Ros:
-
Oscillatory resistance
- Rospe:
-
Ros at the end of expiration
- Rospi:
-
Ros at the end of inspiration
- SD:
-
Standard deviation of Rospior Rospe from the mean
- Vo′:
-
Oscillating gas flow
- Vr′:
-
Respiratory flow
- V t :
-
Tidal volume
- Z :
-
Respiratory impedance
- Z 0 :
-
Reference impedance
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Acknowledgements
We would like to thank Prof. Kiosz/Amrum, Germany and Prof. Wirth/Wuppertal, Germany for their support in this project; Dr. S. Lange/Bochum, Germany for her help with statistical calculations; Prof Schmidt/Munich, Germany for his help in applying the measures of heart rate variability to respiratory signals; Prof. Bogue/New Haven, USA for his help with the preparation of the manuscript and the B.Braun foundation/Melsungen, Germany for financial support (Forschungsbeihilfe 2001).
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Trübel, H., Banikol, W.K.R. Variability analysis of oscillatory airway resistance in children. Eur J Appl Physiol 94, 364–370 (2005). https://doi.org/10.1007/s00421-005-1372-x
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DOI: https://doi.org/10.1007/s00421-005-1372-x