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Variability analysis of oscillatory airway resistance in children

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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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Authors and Affiliations

  1. Zentrum für Kinderheilkunde und Jugendmedizin, HELIOS Klinikum Wuppertal, University of Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Germany

    Hubert Trübel

  2. Bereich Klinische Physiologie, University of Witten/Herdecke, Alfred Herrhausen Str. 50, 58455, Witten, Germany

    Hubert Trübel & Wolfgang K. R. Banikol

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  1. Hubert Trübel
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  2. Wolfgang K. R. Banikol
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Correspondence to Hubert Trübel.

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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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