Nasal Airway Resistance and the Effects of Bronchodilator Drugs in Expiratory Airflow Disorders

Cohen, Bevin

doi:10.1159/000192591

Cited by 18 publications

(11 citation statements)

References 4 publications

(5 reference statements)

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“…O gura's small subgroup of bronchopulmonary patients had complicating nasal abnor malities [21]. N olte and U lmer described higher mean nasal airflow re sistance figures for patients with 'chronic obstructive bronchitis' than for normal subjects [6], similar to our own demonstration of significant eleva tions in mean lower airways, nasal and total airways resistances for a like group compared with a matched number of normal individuals [5]. In this earlier study, therapy directed only to the nasal airways lowered both the high lower and upper airway resistances [5].…”

Section: Discussionsupporting

confidence: 70%

“…Newer elec tronic methods [5,[15][16][17] now permit critical re-examination of nearly a century of experimental evidence suggesting the importance of events occuring in the nose as determinants of bronchopulmonary function [18]. Nasal obstruction may lead to an attempt at compensation for the altered breathing by the lung, which may prove inadequate in the presence of pulmonary or cardiac disease [2,[19][20][21].…”

Section: Discussionmentioning

confidence: 99%

“…Airway indices were derived as previously detailed [5,9]. Lower airways resist ance (Ra) and the related volume of thoracic gas (Vtg) were measured from con ventional flow-volume and pressure-volume oscilloscope loops inscribed by patients seated in a whole-body, volume displacement plethysmograph [10,11].…”

Section: Methodsmentioning

confidence: 99%

“…Nasal flow resistance (R") was calculated by plethysmographic subtraction, i.e., as the differ ence between the values recorded during nasal (Rn+ R a) and oral (Ra) breathing, and also by electronic posterior rhinometry with the subjects outside the chamber. Final Ra and Vtg data were the means of three determinations of each index, cal culated by the method of Comroe and associates [10]; R" figures were the means of three determinations done by each of the two methods performed in rapid succes sion, using a reference flow rate of 0.5 1/sec [5,12]. The product of Ra and V,K means was utilized as the index of specific airway resistance ([RaXVtg]) [9,13].…”

Section: Methodsmentioning

confidence: 99%

“…Received: July 21, 1969. Local therapy in the nasal passages may improve lower airway dynam ics [1][2][3][4][5], while reducing the elevated nasal flow resistance that com pounds the respiratory burden of many patients with chronic bronchitis and diffuse obstructive pulmonary emphysema [5,6], Because analysis of the behaviour of nasal and lower respiratory tract resistances may be more informative than reliance only upon the latter in judging the efficacy and site of action of drugs for bronchopulmonary disorders [5], we exam ined resistance indices and respiratory partitions before and after lower tract administration of several therapeutic aerosols.…”

mentioning

confidence: 99%

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The Nasal Respiratory Handicap of Expiratory Airflow Disease: The Response to Bronchodilator Aerosols

Bm¹

1970

Respiration

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Fifty normal adults and 50 patients with chronic bronchitis and diffuse obstructive pulmonary emphysema, all free of nasal impediments, had lower airways and nasal resistances determined by plethysmographic subtraction; R_n was also determined by electronic posterior rhinometry. Twenty of the patients pursued a double-blind crossover trial in which isoproterenol, phenylephrine, isoproterenol-phenylephrine, and placebo were given as one dose on four consecutive days from identical hand nebulizers by a randomized arrangement. Measurements of R_a, R_n and Vtg were recorded serially for four hours after each mist inhalation; [R_a×V_tg] and R_n / R_a + R_n were calculated.Mean values for nasal, lower airways and total airways resistances were significantly higher for the patients than for the normal controls. The percent of total resistance due to the nasal compartment was significantly less for the patients, and specific airways resistance higher. Changes in [R_a×R_n] allowed a more precise ranking of aerosol effects in the drug trial than deviations in R_a alone, but neither index was as helpful as total airways resistance ([R_a + R_n]) in estimating overall patient responsiveness.The data imply that examination of changes in nasal and lower respiratory airways resistances, obtained together, are more informative and accurate than reliance upon R_a-related indices in defining the locus and total effects of therapeutic aerosols and in estimating the relative worth of the various inhalants.