Interrupter technique for evaluation of exercise-induced bronchospasm in children

Kannisto, Senja; Vanninen, Esko; Remes, Kyllikki; Korppi, Matti

doi:10.1002/(sici)1099-0496(199903)27:3<203::aid-ppul9>3.0.co;2-g

Cited by 18 publications

(14 citation statements)

References 22 publications

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“…Rint correlates well with other measurements of lung function in normal children [8,11,19], in children with asthma [6,8,15,17] and in children with cystic fibrosis [8]. The correlation between Rint and specific airways resistance measured using a plethysmograph is also good [5], but Rint measurements are potentially affected by the resistance of the lungs and chest wall as much as that of the airways themselves [25].…”

Section: Discussionmentioning

confidence: 73%

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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Section: Discussionmentioning

confidence: 73%

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 characteristics of the subjects and the enrolment criteria, as well as exercise challenge results, have been published in more detail recently (Kannisto et al, 1999). The age of the children ranged from 4á9 to 15 years (mean 10á5).…”

Section: Subjectsmentioning

confidence: 99%

“…The repeatability of the R int measurements was assessed by the within-subject coef®cient of variation (CV) at baseline, after exercise (Kannisto et al, 1999) and after bronchodilator inhalation. The repeatability of the R int measurements was assessed by the within-subject coef®cient of variation (CV) at baseline, after exercise (Kannisto et al, 1999) and after bronchodilator inhalation.…”

Section: Figurementioning

confidence: 99%

Evaluation of the interrupter technique in measuring post‐exercise bronchodilator responses in children

Kannisto

Vanninen

Korppi

2000

Clinical Physiology

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A significant response in a bronchodilation test is one of the main diagnostic criteria of asthma. However, it is not known what the significant bronchodilator response (BDR) is by the interrupter technique (IR), measuring respiratory resistance (Rint) during tidal breathing. Fifty children with symptoms suggestive for asthma underwent an 8 min free running test outdoors. Flow-volume spirometry (FVS) and IR measurements were performed before and 10 min after running. Thereafter, all children received a salbutamol inhalation, and pulmonary function measurements were repeated 15 min later. The study population was classified into three groups according to the post-exercise pulmonary function: FEV1 > 100% of predicted (group I, n=15), FEV1 86-99% of predicted (group II, n=20) and FEV1 < 85% of predicted (group III, n=15). There were no differences in BDRs between groups I and II; the mean increases in FEV1 were 4-6% and in MMEF 20-23%, and the mean decreases in Rint were 23-26%. The mean changes in group III were significantly higher: 15% (P=0.004) in FEV1, 55% (P=0.021) in MMEF and 38% (P=0. 014) in Rint. BDR was positive (FEV1 rise >10%) in 15 children; five were in group II and 10 in group III. For MMEF and Rint, the best combination of sensitivity and specificity was achieved by a limit of 35%. By this limit, MMEF identified 14 and Rint 17 positive cases. The IR technique agreed with both FEV1 and MMEF in 73% of the cases. The IR technique provides an alternative to conventional ventilatory function measurements in bronchodilation tests in children. We suggest a decrease of 35% or more in Rint as diagnostic in post-exercise bronchodilation tests.

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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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Interrupter technique for evaluation of exercise-induced bronchospasm in children

Cited by 18 publications

References 22 publications

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

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

Evaluation of the interrupter technique in measuring post‐exercise bronchodilator responses in children

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

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