Effects of respiratory timing and cheek support on resistance measurements, before and after bronchodilation in asthmatic children using the interrupter technique
Effects of respiratory timing and cheek support on resistance measurements, before and after bronchodilation in asthmatic children using the interrupter technique
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DOI：
10.1002/ppul.10384
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发表时间：
2003-12-01
影响因子：
3.1
通讯作者：
Milner, AD
中科院分区：
文献类型：
--
作者：
Hadjikoumi, I;Hassan, A;Milner, AD
中断技术 (R-int) 是一种评估呼吸阻力的无创方法。本研究的目的是评估上气道支持是否影响 R-int 的测量，吸气或呼气 R-int 是否最具重复性，以及哪种评估 R-int 的方法与肺活量测定结果相关性最好，并且对于识别支气管扩张剂反应最敏感。研究中包括 24 名平均年龄为 10.3 岁（范围为 7-16 岁）的哮喘儿童，在脸颊有支撑和无支撑的情况下，在吸气和呼气时获得 R-int 测量值。然后进行肺活量测定。吸入 600 mcg 沙丁胺醇后重复 R-int 和肺活量测定。支持吸气 (0.708 KPa/l/sec) 和呼气 (0.729 KPaA/sec) 的平均 R-int 值显着高于无支持值（吸气，0.622 KPa/l/sec；呼气，0.584 KPa/l/sec），分别为 P < 0.05 和 P < 0.001。是否支持，或者测量是否在吸气或呼气期间进行。脸颊支撑改善了与所有肺功能结果（吸气和呼气测量）的相关性。然而，最佳相关性是针对吸气支持的 R-int 结果发现的。确定支气管扩张剂反应 (BD) 最敏感的方法是吸气支持的 R-int 测量，因为 83.3% 的儿童被确定为对支气管扩张剂治疗有阳性反应，定义为测量变异系数减少两倍。总之，面颊支撑会增加 R-int，但不会影响再现性，尽管它提高了与肺活量指数的相关性。吸气时带有面颊支撑的 R-int 与肺活量指数的相关性最好，并且似乎是对支气管扩张剂反应最敏感的衡量标准。
The interrupter technique (R-int) is a noninvasive method for assessing respiratory resistance. The aims of this study were to assess whether upper airway support affects the measurement of R-int, if inspiratory or expiratory R-int were most reproducible, and which method of assessing R-int correlated best with spirometry results and was the most sensitive for identifying bronchodilator response. Twenty-four asthmatic children with a mean age of 10.3 years (range, 7-16 years) were included in the study R-int measurements were obtained in inspiration and expiration with cheeks supported and unsupported. Spirometry was then performed. R-int and spirometry measurements were repeated after the inhalation of 600 mcg of salbutamol. The mean R-int supported inspiratory (0.708 KPa/l/sec) and expiratory (0.729 KPaA/sec) values were significantly higher than the unsupported values (inspiratory, 0.622 KPa/l/sec; expiratory, 0.584 KPa/l/sec), P < 0.05 and P < 0.001, respectively The reproducibility of R-int was not different whether cheeks were supported or not, or whether the measurements were carried out during inspiration or expiration. Cheek support improved the correlation with all the lung function results, both in inspiratory and expiratory measurements. The best correlations, however, were found for the inspiratory supported R-int results. The most sensitive method to ascertain bronchodilator response (BD) was the inspiratory supported R-int measurement, as 83.3% of children were identified as having a positive response to bronchodilator therapy as defined by a reduction of twice the coefficient of variation of the measurement. In conclusion, cheek support increases R-int but does not impact on reproducibility, though it improves the correlation with spirometric indices. R-int with cheek support on inspiration correlates best with spirometric indices and appears to be the most sensitive measure of response to bronchodilators.