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PubMed1997

Measurement of the specific airway resistance by plethysmography in young children accompanied by an adult.

The purpose of this study was to evaluate a procedure for measurement of specific airway resistance (sRaw) by whole body plethysmography in young awake children accompanied by an adult. sRaw was measured by a single-step procedure, omitting the measurement of the thoracic gas volume. The frequency dependency of sRaw was investigated and the accuracy of simulating body temperature, atmospheric pressure and saturation with water vapour (BTPS) conditions by electronic compensation was assessed. One hundred and thirty one children with asthma were studied. In 57 children (mean (SD) age 5.6 (1.8) yrs) who performed measurements with and without an accompanying adult, the mean value of sRaw was 1.45 (0.36) and 1.44 (0.38) kPa x s, respectively, with a mean difference of 0.008 (0.152) kPa x s, and mean within-subject coefficients of variations (CV) of 8% and 10%, respectively. In 52 children (mean age 3.3 (0.8) yrs), for whom measurements made only in the presence of an accompanying adult, the CV was 8.5%. No measurements could be obtained in 22 children (17%) (mean age 2.8 (0.5) yrs). Measurements exhibited a significant frequency dependency, and electronic BTPS compensation substantially overestimated SRaw. In conclusion, the use of electronic compensation for simulating body temperature, atmospheric pressure and saturation with water vapour introduces a bias that affects the accuracy of the estimate of specific airway resistance. Nevertheless, plethysmographic measurements with and without an accompanying adult yielded comparable and equally repeatable estimates of specific airway resistance. The single-step plethysmographic procedure with an accompanying adult is a clinically useful method for evaluating airway function in children too young to perform plethysmographic measurements alone.

Adult↗
PubMed1997

Chest wall motion in preterm infants using respiratory inductive plethysmography.

Preterm infant tidal breathing may be different from that of healthy full-term infants because of various features of the premature thorax. The purpose of this project was to describe chest wall motion in the preterm infant (gestational age <37 weeks) and compare it with chest wall motion data in a group of healthy, full-term infants. We wanted to use an objective bedside method for assessment with minimal disruption to the infant. The study population consisted of 61 preterm human infants whose mean(+/-sD) postconceptional age at time of study was 35.3+/-2.1 weeks. During the study, the infants were quietly awake in a prone position. Preterm infants had initially been admitted to a level III neonatal intensive care unit for acute management and had been transferred to a step-down area, where they were in stable condition for study. Data were collected with a semiquantitatively calibrated, noninvasive respiratory inductive plethysmograph. Mean(+/-SD) phase angle was significantly greater in preterm infants than in full-term infants (60.6+/-39.8 degrees versus 12.5+/-5.0 degrees, respectively, p < or = 0.0001). The laboured breathing index was significantly greater in preterm infants than in full-term infants (1.35+/-0.35 versus 1.01+/-0.01, respectively, p = 0.001). The ribcage contribution to breathing did not differ significantly between preterm and full-term infants (25.5+/-17.7% versus 36.3+/-14.4%, respectively, p = 0.11). These results indicate a significant increase in the degree of ribcage and abdomen asynchrony in the preterm subjects compared to the full-term infants. Plethysmography provided a time-efficient and objective method of assessing chest wall motion in this fragile population.

Female↗
PubMed2005

Comparison of air displacement plethysmography to hydrostatic weighing for estimating total body density in children.

BACKGROUND: The purpose of this study was to examine the accuracy of total body density and percent body fat (% fat) using air displacement plethysmography (ADP) and hydrostatic weighing (HW) in children. METHODS: Sixty-six male and female subjects (40 males: 12.4 +/- 1.3 yrs, 47.4 +/- 14.8 kg, 155.4 +/- 11.9 cm, 19.3 +/- 4.1 kg/m2; 26 females: 12.0 +/- 1.9 yrs, 41.4 +/- 7.7 kg, 152.1 +/- 8.9 cm, 17.7 +/- 1.7 kg/m2) were tested using ADP and HW with ADP always preceding HW. Accuracy, precision, and bias were examined in ADP with HW serving as the criterion method. Lohman's equations that are child specific for age and gender were used to convert body density to % fat. Regression analysis determined the accuracy of ADP and potential bias between ADP and HW using Bland-Altman analysis. RESULTS: For the entire group (Y = 0.835x + 0.171, R2 = 0.84, SEE = 0.007 g/cm3) and for the males (Y = 0.837x + 0.174, R2 = 0.90, SEE = 0.006 g/cm3) the regression between total body density by HW and by ADP significantly deviated from the line of identity. However in females, the regression between total body density by HW and ADP did not significantly deviate from the line of identity (Y = 0.750x + 0.258, R2 = 0.55, SEE = 0.008 g/cm3). The regression between % fat by HW and ADP for the group (Y = 0.84x + 3.81, R2 = 0.83, SEE = 3.35 % fat) and for the males (Y = 0.84x + 3.25, R2 = 0.90, SEE = 3.00 % fat) significantly deviated from the line of identity. However, in females the regression between % fat by HW and ADP did not significantly deviate from the line of identity (Y = 0.81x + 5.17, R2 = 0.56, SEE = 3.80 % fat). Bland-Altman analysis revealed no bias between HW total body density and ADP total body density for the entire group (R = 0.-22; P = 0.08) or for females (R = 0.02; P = 0.92), however bias existed in males (R = -0.37; P < or = 0.05). Bland-Altman analysis revealed no bias between HW and ADP % fat for the entire group (R = 0.21; P = 0.10) or in females (R = 0.10; P = 0.57), however bias was indicated for males by a significant correlation (R = 0.36; P < or = 0.05), with ADP underestimating % fat at lower fat values and overestimating at the higher % fat values. CONCLUSION: A significant difference in total body density and % fat was observed between ADP and HW in children 10-15 years old with a potential gender difference being detected. Upon further investigation it was revealed that the study was inadequately powered, thus we recommend that larger studies that are appropriately powered be conducted to better understand this potential gender difference.

Adipose Tissue↗
PubMed2006

Validity of new child-specific thoracic gas volume prediction equations for air-displacement plethysmography.

BACKGROUND: To determine the validity of the recently developed child-specific thoracic gas volume (TGV) prediction equations for use in air-displacement plethysmography (ADP) in diverse pediatric populations. METHODS: Three distinct populations were studied: European American and African American children living in Birmingham, Alabama and European children living in Lisbon, Portugal. Each child completed a standard ADP testing protocol, including a measured TGV according to the manufactures software criteria. Measured TGV was compared to the predicted TGV from current adult-based ADP proprietary equations and to the recently developed child-specific TGV equations of Fields et al. Similarly, percent body fat, derived using the TGV prediction equations, was compared to percent body fat derived using measured TGV. RESULTS: Predicted TGV from adult-based equations was significantly different from measured TGV in girls from each of the three ethnic groups (P < 0.05), however child-specific TGV estimates did not significantly differ from measured TGV in any of the ethnic or gender groups. Percent body fat estimates using adult-derived and child-specific TGV estimates did not differ significantly from percent body fat measures using measured TGV in any of the groups. CONCLUSION: The child-specific TGV equations developed by Fields et al. provided a modest improvement over the adult-based TGV equations in an ethnically diverse group of children.

Black or African American↗
PubMed2001

Inductance plethysmography: an alternative signal to servocontrol the airway pressure during proportional assist ventilation in small animals.

During proportional assist ventilation (PAV), the ventilator pressure is servocontrolled throughout each spontaneous inspiration such that it instantaneously increases in proportion to the airflow (resistive unloading mode), or inspired volume (elastic unloading mode), or both (combined unloading mode). The PAV pressure changes are generated in a closed-loop feedback circuitry commonly using a pneumotachographic signal. In neonates, however, a pneumotachograph increases dead space ventilation, and its signal may include a substantial endotracheal tube leak component. We hypothesized that respiratory inductive plethysmography (RIP) can replace pneumotachography to drive the ventilator during PAV without untoward effects on ventilation or respiratory gas exchange. Ten piglets and five rabbits were supported for 10-min (normal lungs) or 20-min (meconium injured lungs) periods by each of the three PAV modes. In each mode, three test periods were applied in random order with the ventilator driven by the pneumotachograph signal, or the RIP abdominal band signal, or the RIP sum signal of rib cage and abdomen. Interchanging the three input signals did not affect the regularity of spontaneous breathing, and gas exchange was achieved with similar peak and mean airway pressures (ANOVA). However, the RIP sum signal worked adequately only when the relative gains of rib cage and abdominal band signal were calibrated. We conclude that an RIP abdominal band signal can be used to generate PAV, avoiding increased dead space and endotracheal tube leak problems.

Airway Resistance↗
PubMed2001

Estimation of body fatness by air displacement plethysmography in African American and white children.

The purpose of this study was to determine the ability of air displacement plethysmography (ADP) to estimate body fatness in prepubertal and early pubertal African American and white children. One hundred nineteen nonoverweight and overweight boys (N = 56) and girls (N = 63), age (mean +/- SD) 9.8 +/- 1.7 y, body mass index 25.9 +/- 7.6 kg/m2 (range, 14.2-47.0 kg/m2), and mean percent body fat (%BF) by dual-energy x-ray absorptiometry (DXA) 39.2 +/- 11.7% (range, 12.2-57.5%), were studied. %BF by ADP was compared with DXA %BF estimates and with body fat by several field methods: skinfold thicknesses using the Slaughter et al. equations (Hum Biol 60: 709-723, 1988), bioelectrical impedance analysis (BIA) using the Houtkooper et al. equation (J Appl Physiol 72: 366-373, 1992), and a predictive equation using skinfold thicknesses, BIA, and weight (Goran et al.: Am J Clin Nutr 63: 299-305, 1996). All methods used to estimate %BF were significantly correlated with DXA (all p < 0.0001), with r2 ranging from 0.85 (skinfold measurements) to 0.95 (ADP). ADP using the Siri equation underestimated %BF by -1.9% (p < 0.001); the Bland-Altman limits of agreement (defined as +/-2 SD) were +/-7.4%. %BF by ADP-Siri underestimated %BF by DXA by 3.0% for girls (p < 0.001) and by 0.6% for boys (NS). Agreement between body fat estimation by ADP and DXA did not vary with age, race, or pubertal stage. Application of the age-adjusted Lohman model to ADP significantly increased the magnitude of the underestimation to -6.9% (p < 0.0001). Prediction of %BF by the Slaughter skinfold thickness equation showed no significant mean bias for the overall data, but significantly underestimated %BF in girls (-3.7%) while overestimating %BF in boys (+2.4%) with wide limits of agreement (+/-17.7%, p < 0.01 versus ADP). %BF by the Houtkooper BIA equation or Goran model underestimated %BF to a significantly greater degree than ADP (Houtkooper, -8.1%; Goran, -10.1%; both p < 0.0001 versus DXA or ADP). Determination of %BF from ADP using the Siri model slightly underestimates %BF as determined by DXA in girls, but appears to be superior to existing field methods both in accuracy and limits of agreement. Because of the ease with which it can be performed, ADP may prove useful for investigations of adiposity in children.

Adipose Tissue↗
PubMed2004

Use of air displacement plethysmography in the determination of percentage of fat mass in african american children.

The purpose of this study was to determine the ability of air displacement plethysmography (ADP) to estimate percentage of fat mass (%FM) in African American children. %FM was determined in 21 boys and 13 girls (11.0 +/- 1.4 y, 18.6 +/- 4.2 kg/m(2) [mean +/- SD]) by ADP (using six published densitometric equations) and dual-energy x-ray absorptiometry (DXA). Measures were done within 2 h of one another, in random order. Regardless of equation, %FM(ADP) was significantly correlated with %FM(DXA) (R(2) = 0.67-0.71, all p < 0.001). %FM(ADP) using the equation of Siri (%FM(ADP-Siri) 20.3 +/- 9.0) agreed most closely with %FM(DXA) (20.0 +/- 10.2, difference p = 0.729). Together, surface area artifact and bone mineral content per unit of bone-free fat-free mass accounted for 29% of the variance in the residual between methods. The correlation between %FM(ADP-Siri) and %FM(DXA) was not significant for those <35 kg (n = 10; R(2) = 0.084, p = 0.417). There was a trend toward %FM(ADP-Siri) underestimating %FM(DXA) in girls (-1.46 +/- 3.0%FM; p = 0.103) but not in boys (1.43 +/- 6.4%FM; p = 0.315). Predicted lung volume was 40.1% higher than measured lung volume (p < 0.001). %FM(ADP-Siri) determined using predicted lung volume was 23.5 +/- 8.9, higher than that using measured lung volume (p < 0.001) and higher than %FM(DXA) (p = 0.001). We conclude that in 9- to 14-y-old African American children and provided lung volume is measured, %FM using ADP with Siri's equation approximates that obtained by DXA. Body composition results determined by ADP in children <35 kg should be interpreted with caution.

Absorptiometry, Photon↗
PubMed2004

Effect of race and musculoskeletal development on the accuracy of air plethysmography.

PURPOSE: The purpose of this study was to determine the effect of race and musculoskeletal development on the accuracy of estimates of body fatness (%fat) via air displacement plethysmography (AP). METHODS: Estimates of %fat were made via AP, hydrostatic weighing (HW), dual-energy x-ray absorptiometry (DXA), and the criterion, a four-component model (4C) in 64 black (B) and white (W) men, who were either resistance trained (RT) or served as controls (C). RESULTS: Based on a three-way ANOVA, there were no statistically significant three-way or race x musculoskeletal development interactions. There was no main effect of race on the validity of estimating %fat by AP; the mean bias between %FatAP and %Fat4C was similar for B (3.6% body fat) and W (3.7%). In addition, the density of the fat-free mass (Dffm) for B (1.098 +/- 0.002 g x mL) was not different than 1.10 g x mL. There was a significant effect of musculoskeletal development on the validity of the estimation of %fat from AP; the mean difference in %fat between %FatAP and %Fat4C was less in RT (1.5% body fat) than in C (5.3%), but a large SEE of 5.5% was observed for RT. A significant (P < 0.05) correlation was found between the mean bias between methods and body volume (-0.44) and mesomorphy (-0.55). CONCLUSIONS: Race does not affect the accuracy of estimating %fat by AP. Race-specific equations estimating %fat via densitometry (e.g., AP, HW) such as the Schutte are not justified, because Dffm is not greater than 1.10 g x mL. Estimation of %fat via AP is more accurate in larger individuals with high musculoskeletal development as a group, but individual results are highly variable.

Absorptiometry, Photon↗
PubMed2006

Reliability of air displacement plethysmography in a large, heterogeneous sample.

INTRODUCTION: Several studies have assessed the validity of air displacement plethysmography (ADP), but few have assessed the reliability of ADP using a large, heterogeneous sample. PURPOSE: This study was conducted to determine the reliability of ADP using the Bod Pod in a large, heterogeneous sample. METHODS: A total of 980 healthy men and women (30 +/- 15 yr, mean +/- SD) completed two body composition assessments separated by 15-30 min. All testing was done in accordance with the manufacturer's instructions. RESULTS: A significant correlation (r = 0.992, P = 0.001) was found between body density (BD) 1 (1.046 +/- 0.001 kg.L(-1); mean +/- SEM) and BD 2 (1.046 +/- 0.001 kg.L(-1). A paired t-test revealed no significant difference between BD 1 and 2 (P = 0.935). The coefficient of variation (CV) for BD was 0.15%. A significant intraclass correlation coefficient (ICC) was found for BD (ICC = 0.996, P = 0.001), and the standard error of measurement (SEM) was 0.001 kg.L(-1). Body mass (BM) 1 and 2 were correlated significantly (r = 0.999, P = 0.001); however, a significant (P = 0.001) decrease was seen from BM 1 (75.510 +/- 0.461 kg) to BM 2 (75.497 +/- 0.461 kg). Body volume (BV) tended to decrease (P = 0.08) from BV 1 (69.900 +/- 0.449 L) to BV 2 (69.884 +/- 0.449 L). CONCLUSION: ADP using the Bod Pod appears to assess BD reliably; however, the observed CV suggests that multiple trials are necessary to detect small treatment effects.

Absorptiometry, Photon↗
PubMed1989

Quantitative estimation of compliance of human systemic veins by occlusion plethysmography with radionuclide--methodology and the effect of nitroglycerin.

Volume-pressure relationship and compliance of human systemic veins were estimated quantitatively and noninvasively using radionuclide. The effect of nitroglycerin (NTG) on these parameters was examined. Plethysmography with radionuclide (RN) was performed using the occlusion method on the forearm in 56 patients with various cardiac diseases after RN angiocardiography with 99mTc-RBC. The RN counts-venous pressure curve was constructed from (1) the changes in radioactivity from region of interest on the forearm that were considered to reflect the changes in the blood volume of the forearm, and (2) the changes in the pressure of the forearm vein (fv) due to venous occlusion. The specific compliance of the forearm veins (Csp.fv; (1/V).(delta V/delta P] was obtained graphically from this curve at each patient's venous pressure (Pv). Csp.fv was 0.044 +/- 0.012 mmHg-1 in class I (mean +/- SD; n = 13), 0.033 +/- 0.007 mmHg-1 in class II (n = 30), and 0.019 +/- 0.007 mmHg-1 in class III (n = 13), of the previous NYHA classification of work tolerance. There were significant differences in Csp.fv among the three classes. The systemic venous blood volume (Vsv) was determined by subtracting the central blood volume, measured by RN-angiocardiography, from total blood volume, measured by the indicator dilution method utilizing 131I-human serum albumin. Systemic venous compliance (Csv) was calculated from Csv = Csp.fv.Vsv. The Csv was 127.2 +/- 24.8 ml.mmHg-1 (mean +/- SD) in class I, 101.1 +/- 24.1 ml.mmHg-1 in class II and 62.2 +/- 28.1 ml.mmHg-1 in class III. There were significant differences in Csv among the three classes. The class I Csv value was calculated to be 127.2 +/- 24.8 ml.mmHg-1 and the Csv/body weight was calculated to be 2.3 +/- 0.7 ml.mmHg-1.kg-1 of body weight, which was very close to the values for Csv reported previously by other investigators in animal experiments. The administration of NTG caused the RN counts - venous pressure curve to become steeper and shift upward. It increased Csv significantly in all cases.

Adult↗
PubMed1991

Pressure-volume relationships of finger arteries in healthy subjects and patients with coronary atherosclerosis measured non-invasively by photoelectric plethysmography.

Knowledge of the mechanical properties of the small arteries is important for understanding physiological and pathophysiological conditions in the human peripheral circulation. We have recently developed a new method for the noninvasive measurement of arterial elastic properties in human fingers using photoelectric plethysmography. In this study, the pressure-volume relationship, an index for expressing arterial elasticity, was measured by this method in the finger arteries of 91 healthy subjects and 102 patients with coronary artery disease. Aging effects on the elastic properties of finger arteries were examined in healthy subjects classified into three groups: under 30, 31-49, and over 50 years of age. The pressure-volume curve shifted downward with increase in age, indicating that the elasticity of finger arteries decreased with age. Patients with 75% or greater coronary stenosis, as compared with age-matched healthy subjects, showed distinctly lower elasticity of finger arteries. As the number of diseased coronary arteries increased, the elasticity of finger arteries tended to decrease steadily. The elasticity of finger arteries decreased in coronary disease patients with hypertension much more than in those without hypertension. These results suggest that age-related changes in arterial elasticity can occur in peripheral small arteries, and that peripheral arteries in patients with coronary atherosclerosis are less elastic than those in healthy subjects.

Adult↗
PubMed1992

Postthoracotomy respiratory muscle mechanics during incentive spirometry using respiratory inductance plethysmography.

We undertook this study to characterize the postthoracotomy compartmental displacement and respiratory mechanical changes occurring during and after the performance of the incentive spirometry maneuver. We also evaluated the effect of recumbency angle on compartmental recruitment. Sixteen patients were randomized to perform incentive spirometry either at 30 degrees or 60 degrees recumbency angle. They were studied using respiratory inductance plethysmography to measure tidal volume, respiratory frequency, inspiratory time, rib cage motion/tidal volume ratio, inspiratory duty cycle, and inspiratory flow. Patients were studied before surgery and on postoperative days 1 and 3. Statistical analysis was accomplished using multiple measures ANOVA with post-hoc Student's t-tests when appropriate. Preoperative incentive spirometry augmented VT by increasing both VT/TI and TI. Postoperatively, the incentive recruitment of VT was reduced, a result of a decrease in TI and TI/TTOT; VT/TI was unchanged. There was postoperative decrease of AB and AB/VT during incentive spirometry, greatest in the 60 degrees group. Our results characterize the nature of the respiratory recruitment afforded by incentive spirometry, before and after thoracotomy. We also found evidence of postthoracotomy diaphragmatic derecruitment during incentive spirometry exacerbated by a high recumbency angle.

Female↗
PubMed1992

Body plethysmography in the evaluation of intrathoracic airway abnormalities.

A patient with a previously unsuspected intrathoracic tracheal malignancy presented with symptoms suggestive of asthma and an unusual pattern seen by conventional PFTs. Reduced expiratory flows with a large difference between FVC and SVC, normal inspiratory flows and high MVV/FEV1 were found. Body plethysmography using normal and panting efforts with increasing tidal volume and flow helped define the lesion as a variable intrathoracic obstruction and document its regression after palliative therapy.

Adult↗
PubMed1994

Effect of positive pressure ventilation on impedance plethysmography.

It has been stated that positive pressure ventilation (PPV) may cause false positive impedance plethysmography (IPG) results because PPV can decrease venous outflow. We studied 36 patients who were being weaned from mechanical ventilation to determine the effect of PPV on IPG. Patients had IPGs performed during spontaneous ventilation and while receiving mechanical ventilation in the assist/control (A/C) mode without positive end expiratory pressure (PEEP) and with 10 cm H2O PEEP. No patient developed a positive IPG with institution of PPV (mean airway pressure = 6.8 cm H2O), or with PEEP (mean airway pressure = 14.9 cm H2O). The IPG values for venous capacitance and venous outflow did not change during either mode of mechanical ventilation. There also was no tendency for positive pressure ventilation to move IPG results in the direction of a positive test. In summary, PPV does not cause IPG results to be false positive, nor does it move IPG results toward the discriminant line that separates normal from abnormal results.

Aged↗
PubMed1998

Evaluation of respiratory inductive plethysmography in controlled ventilation: measurement of tidal volume and PEEP-induced changes of end-expiratory lung volume.

STUDY OBJECTIVE: To determine the accuracy of respiratory inductive plethysmography (RIP) with a respiratory monitor (Respitrace Plus; NIMS Inc., Miami) operating in the DC-mode for the measurement of tidal volumes (VT) and positive end-expiratory pressure (PEEP)-induced changes of end-expiratory lung volume (deltaEELV) in patients with normal pulmonary function, acute lung injury (ALI), and COPD during volume-controlled ventilation. DESIGN: Prospective comparison of RIP with pneumotachography (PT) for assessment of VT and with multibreath nitrogen washout procedure (N2WO) for determination of deltaEELV as reference methods. SETTING: Mixed ICU at a university hospital. PATIENTS: Thirty-one sedated and paralyzed patients: 12 patients with normal pulmonary function mechanically ventilated after major surgery, 10 patients with respiratory failure due to ALI, and 9 patients with a known history of COPD ventilated after surgery or because of respiratory failure due to bronchopulmonary infection. INTERVENTIONS: Stepwise increase of PEEP from 0 to 5 to 10 cm H2O and reduction to 0 cm H2O again. On each PEEP level, N2WO was performed. MEASUREMENTS AND MAIN RESULTS: The baseline drift of RIP averaged 25.4+/-29.1 mL/min but changed over a wide range even in single patient measurements. Determination of VT for single minutes revealed that 66.5% and 90.0% of all values were accurate within a range of +/-10% and +/-20%, respectively. The deviation for VT measurements between RIP and PT in patients with COPD was significantly (p<0.05) higher compared to patients with ALI or normal pulmonary function. The difference of deltaEELV between RIP and N2WO was 11.6+/-174.1 mL with correlation coefficients of 0.77 (postoperative and COPD patients) and 0.86 (ALI patients). However, just 25.8% and 46.2% were precise within +/-10% and +/-20%, respectively. deltaEELV determination in COPD patients differed more between RIP and N2WO than in the other groups, but this was not significant. CONCLUSION: In a mixed group of patients undergoing controlled ventilation, RIP using the Respitrace Plus monitor was not consistently precise enough for quantitative evaluation of VT and EELV when compared to our reference methods. This was most evident in patients with COPD. For long-term volume measurements, a better control of the baseline drift of RIP should be achieved.

Aged↗
PubMed1999

Accuracy of respiratory inductive plethysmography for the diagnosis of upper airway resistance syndrome.

OBJECTIVE: To determine the sensitivity and specificity of quantitative respiratory inductive plethysmography (RIP) compared with the "gold standard," nocturnal esophageal pressure (Pes) measurement, in the diagnosis of upper airway resistance syndrome (UARS) in adults. METHODS: Fourteen consecutive patients without obstructive sleep apnea and suspected of having UARS underwent simultaneous measurement of Pes with a catheter and standard nocturnal polysomnography along with RIP. UARS events (RERAs, respiratory effort-related arousals) were identified by observing crescendo changes in Pes with a Pes nadir < or = -12 cm H2O, followed by an arousal or microarousal. UARS was defined as > or = 10 RERAs per hour. For each patient, the ratio of peak inspiratory flow to mean inspiratory flow (PIFMF) measured by RIP was performed during quiet wakefulness and with 40 randomly selected breaths in the supine position for two conditions: stage 2 sleep, immediately prior to arousals in any sleep stage. The mean PIFMF (wake-sleep) was calculated for each condition. RESULTS: The sensitivities and specificities, respectively, of RIP to distinguish UARS patients from non-UARS patients are from stage 2 sleep (67%, 80%), immediately prior to arousals (100%, 100%). For breaths occurring immediately prior to arousals, the mean PIFMF (wake-sleep) is > or = 0.13 for UARS patients and < 0.13 for non-UARS patients. CONCLUSION: The PIFMF measured by RIP allows for the most accurate identification of UARS patients when breaths are selected for analysis immediately prior to arousals.

Adolescent↗
PubMed2003

Respiratory inductance plethysmography in healthy 3- to 5-year-old children.

STUDY OBJECTIVES: Because of the challenges of using standard measurements such as spirometry to measure respiratory function in 3- to 5-year-old children, there may be a role for respiratory inductive plethysmography (RIP), which is noninvasive and requires minimal subject cooperation. In this study, we described normative values of thoracoabdominal motion and timing mechanics in 3- to 5-year-old children, and hypothesized positional dependence of these measurements in this age group. DESIGN: We measured relative thoracoabdominal motion during tidal breathing using the phase angle (Phi), the labored breathing index, and the phase relation during the total breath and timing mechanics with the ratio of time to peak tidal expiratory flow to expiratory time (TPTEF/TE). SETTING: Preschools within the greater Philadelphia area and the Pulmonary Office of The Children's Hospital of Philadelphia. PATIENTS OR PARTICIPANTS: Fifty healthy children between 3 years and 5 years of age. INTERVENTIONS: RIP. MEASUREMENTS AND RESULTS: All measures varied with position. Thoracoabdominal motion was nearly synchronous in the sitting position and most asynchronous in the supine position (Phi, 15.7 +/- 4.0 degrees vs 56.1 +/- 4.3 degrees, respectively; p < 0.001). This also led to an increase in the TPTEF/TE from the sitting to the supine positions (30.3 +/- 1.4% vs 37.0 +/- 1.6%, respectively; p < 0.001). Measurements of thoracoabdominal motion and timing mechanics did not change with age, weight, height, or gender. CONCLUSIONS: We conclude that the positional dependence of these measurements is due to the alteration in respiratory mechanics between the sitting, standing, and supine positions. We further conclude that if RIP is to be a useful longitudinal measure of respiratory function in this age range, comparison measurements should be made in the same position.

Abdominal Wall↗
PubMed1979

Measurement of regional lung function by tetrapolar electrical impedance plethysmography.

This study demonstrates the clinical feasibility of atraumatically measuring dynamic regional lung function with tetrapolar electrical impedance plethysmography (EIP) in the pediatric age group. A tetrapolar electrode system was used because of its ability to detect local baseline and pulsatile impedance changes, minimal electrode-tissue impedance interference, and uniform current distribution. Studies performed on 4 children 4 to 15 years old with various pulmonary diseases are presented. The information obtained on their regional ventilation and pulsatile perfusion by EIP was found to agree closely with pulmonary ventilation and perfusion scans. In one case, EIP detected pulsatile perfusion abnormalities which were not apparent in the non-pulsatile perfusion scan but were demonstrated by cineangiography. It is concluded that tetrapolar EIP can provide safe, reliable regional information about ventilation and perfusion in diseased lungs, and because of its atraumatic approach, is technically most suitable for use in children.

Adolescent↗