Assessment of airway function in young children with asthma: Comparison of spirometry, interrupter technique, and tidal flow by inductance plethsmography

Black, Julie Christine; Baxter-Jones, Adam D.G.; Gordon, Joanna Clodagh; Findlay, Alex.; Helms, Peter Joseph Benedict

doi:10.1002/ppul.20046

Cited by 33 publications

(27 citation statements)

References 29 publications

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“…15 Other studies suggesting closer relationships between the R int and FEV 1 have concentrated on population rather than individual data sets. 4,16 Unless otherwise stated, all data are presented as mean (standard deviation). FEV 1 , forced expiratory volume in 1 sec; R int , interrupter resistance; SI, sensitivity index; GM, geometric mean.…”

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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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%

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

Davies

Doull

Child

2006

Pediatric Pulmonology

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“…69 In the latter group, a correlation coefficient of 0.73 was found for baseline values of spirometry and R int . 71 R int has been used in conjunction with other measures to evaluate bronchodilator response in asthmatic children. As to discriminating capacity, R aw , R5, R int , and X5 were found to be useful, with positive predictive values of 84%, 74%, 82%, and 76%, respectively.…”

Section: Measurement Of Airway Resistance By the Interrupter Techniquementioning

confidence: 99%

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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“…In studies involving asthma patients, the Rint technique was shown to be accurate in measuring such a response. (15)(16)(17)(18)(19) The objectives of the present study were to measure airway resistance with the Rint technique in children and adolescents with CF and to determine whether the values obtained correlated with spirometric parameters, as well as to evaluate the accuracy of the Rint technique in determining the airway response to a bronchodilator. Instrumentation Inc., Louisville, CO, USA).…”

Section: Introductionmentioning

confidence: 99%

Utilização da técnica de resistência do interruptor na avaliação da resistência das vias aéreas em pacientes com fibrose cística

et al. 2012

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Objective: To measure airway resistance with the interrupter resistance (Rint) technique in patients with cystic fibrosis (CF) and to determine whether Rint values correlate with spirometric parameters, as well as to evaluate the accuracy of the Rint technique in determining the airway response to a bronchodilator. Methods: This was a cross-sectional study involving 38 children and adolescents with CF followed at the Cystic Fibrosis Outpatient Clinic of the São Lucas Hospital, located in the city of Porto Alegre, Brazil. After Rint had been measured, the subjects underwent spirometry. To evaluate bronchodilator response, we repeated the measurements after the use of inhaled albuterol. Results: There was a strong correlation between inverse Rint and FEV 1 (r = 0.8; p < 0.001), and there was a moderate correlation between inverse Rint and FEF 25-75% (r = 0.74; p < 0.001), as well as between inverse Rint and body mass index (r = 0.62; p < 0.001). We used a ROC curve to compare the bronchodilator response, as determined by Rint, with spirometric values. For a Rint cut-off point of −28%, the area under the curve was 0.75, with a sensitivity of 66% and a specificity of 82%. Conclusions: Our findings suggest that Rint correlates well with spirometric parameters, although the Rint technique was not sufficiently accurate to replace spirometry in the evaluation of bronchodilator responses. Keywords:Respiratory function tests; Cystic fibrosis; Spirometry; Airway resistance. ResumoObjetivo: Medir a resistência de vias aéreas utilizando a técnica de resistência do interruptor (Rint) em pacientes com fibrose cística (FC) e correlacioná-la com parâmetros espirométricos, assim como avaliar a acurácia de Rint para determinar a resposta das vias aéreas a um broncodilatador. Métodos: Estudo transversal com 38 crianças e adolescentes com FC acompanhados no Ambulatório de FC do Hospital São Lucas, em Porto Alegre (RS). Após a determinação de Rint, os pacientes foram submetidos à espirometria. Para a avaliação da resposta ao broncodilatador, as medições foram repetidas após o uso de salbutamol inalatório. Resultados: Houve uma forte correlação entre o inverso de Rint e VEF 1 (r = 0,8; p < 0,001) e moderadas correlações entre o inverso de Rint e FEF 25-75% (r = 0,74; p < 0,001) e entre o inverso de Rint e índice de massa corpórea (r = 0,62; p < 0,001). A curva ROC foi utilizada na comparação da resposta ao broncodilatador determinada por Rint com aquela determinada por valores espirométricos. Para um ponto de corte de −28% para Rint, a área sob a curva foi de 0,75, com uma sensibilidade de 66% e uma especificidade de 82%. Conclusões: Nossos achados indicam que Rint apresenta uma boa correlação com parâmetros espirométricos, embora a técnica Rint não tenha sido suficientemente acurada para substituir a espirometria na avaliação da resposta ao broncodilatador.Descritores: Testes de função respiratória; Fibrose cística; Espirometria; Resistência das vias respiratórias.

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Assessment of airway function in young children with asthma: Comparison of spirometry, interrupter technique, and tidal flow by inductance plethsmography

Cited by 33 publications

References 29 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

What Does Airway Resistance Tell Us About Lung Function?

Utilização da técnica de resistência do interruptor na avaliação da resistência das vias aéreas em pacientes com fibrose cística

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