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C Gallina

Publications and source records attributed to C Gallina.

45 records · Page 3Linked to original sources

Evaluation of phase correction and low gas density to improve thoracic gas volume measurement.

We investigated two methods of decreasing the error on plethysmographic determinations of thoracic gas volume (TGV) related to cheeks movements during panting maneuvers: lowering gas density in the airways with an 80% He-20% O2 mixture and computing TGV from the in-phase component of the plethysmographic signal (TGVr). The methods were tested by measuring how TGV estimates varied when panting frequency was raised from 0.8 to 2.5 Hz during the same occlusion. The measurements were performed in 6 normal subjects and 12 patients with chronic bronchitis with and without cheeks support and when the airway was connected to an external device simulating an increased cheeks compliance. A small negative frequency dependence of TGV (delta TGV/delta f = -1.2 +/- 0.8%/Hz with cheeks support), most probably unrelated to upper airway walls, was found in normal subjects. Delta TGV/delta f was positive and algebraically larger in patients than in normals, reaching 2.2 +/- 3.4%/Hz without cheeks support and 11.8 +/- 8.0%/Hz with the additional cheeks. The latter value was only 20% smaller when computed on the basis of TGVr, demonstrating the limited usefulness of the phase-based correction. In contrast, breathing He-O2 decreased delta TGV/delta f to approximately 50% of its air value (P less than 0.01) and appears as an effective way to diminish the error in obstructive patients.

Adult↗

Total respiratory input and transfer impedances in humans.

Total respiratory input (Zrs,in) and transfer (Zrs,tr) impedances were obtained from 4 to 30 Hz in 10 healthy males by simultaneously measuring mouth and chest flow while applying pseudo-random pressure variations at the mouth. Compared with Zrs,in, the real part of Zrs,tr was larger up to 10 Hz but exhibited a much stronger negative frequency dependence. The imaginary part was larger at all frequencies, with a resonant frequency (fn) at 6.0 +/- 0.8 Hz compared with 8.2 +/- 2.9 Hz for Zrs,in. The two impedances were analyzed with a model featuring airway resistance and inertance, alveolar gas compressibility, and tissue resistance, inertance, and compliance. A good fit was generally obtained but, in most cases, with a different partitioning of resistance between airway and tissue for Zrs,in and Zrs,tr. The data were also used to compute separately airway and tissue (Zt) impedances. In most subjects Zt could not be properly fitted with a simple resistance-inertance-compliance unit and was consistent with a slow (fn = 7.4 +/- 2.3 Hz) overdamped compartment in parallel with a fast (fn = 37.1 +/- 5.6 Hz) underdamped one.

Airway Resistance↗

Respiratory impedance measured with head generator to minimize upper airway shunt.

A new method for measuring total respiratory input impedance (Zrs), which ensures minimal motion of extrathoracic airway walls, was tested over frequencies of 4-30 Hz in 14 normal subjects and 10 patients with airway obstruction. It consists of applying pressure variations around the head, rather than at the mouth, so that transmural pressure across upper airway walls is equal to the small pressure drop across the pneumotachograph. Compared with reference Zrs values obtained by directly measuring airway wall motion with a head plethysmograph and correcting the data for it, the investigated method provided similar values for respiratory resistance at all frequencies (30 Hz, 3.67 +/- 2.24 cmH2O X 1(-1) X s compared with 3.55 +/- 2.00) but slightly overestimated respiratory reactance at the largest frequencies (30 Hz, 2.82 +/- 1.28 cmH2O X 1(-1) X s compared with 2.52 +/- 1.22, P less than 0.01). In contrast, when the data were not corrected for airway wall motion, resistance was largely underestimated, especially in patients (-48% at 30 Hz, P less than 0.001), and the reactance-frequency curve was shifted to the right. The investigated method is almost as accurate as the reference method, provides equally reproducible data, and is much simpler.

Airway Resistance↗

Upper airway artifact in respiratory impedance measurements.

When studying respiratory impedance by forced oscillations, part of the flow measured at the mouth is lost in upper airway wall motion and does not enter the trachea. The corresponding error was studied in 10 normal subjects and 8 patients with chronic obstructive pulmonary disease (COPD) by measuring respiratory impedance with the cheeks unsupported, with the cheeks supported, and when upper airway wall motion was simultaneously measured with a head plethysmograph, and corrected for. In normal subjects, wall motion had little influence on respiratory resistance but, whether the cheeks were supported or not, increased the resonant frequency (p less than 0.05) and respiratory compliance (p less than 0.001) and decreased respiratory inertance (p less than 0.001). In patients with COPD, average resistance from 4 to 30 Hz was significantly lower when the cheeks were not supported (3.32 +/- 0.57 cm/H2O X L-1 X s; m +/- SD) than when they were (4.59 +/- 0.73, p less than 0.01) and when the data were corrected (5.41 +/- 1.14, p less than 0.001). Moreover, resistance increased with increasing frequency when wall motion was corrected for and decreased when it was not. Upper airway wall motion also tended to increase resonant frequency and decrease inertance in patients. The data show that supporting the cheeks does not prevent large errors on respiratory impedance and derived parameters, especially in obstructive patients; accurate measurements require that airway wall motion be evaluated and corrected for.

Airway Resistance↗

Comparative value of respiratory input and transfer impedances in field studies.

Total respiratory impedance was obtained from 4 to 30 Hz in 39 healthy males and in 140 iron miners by studying the relationship between transrespiratory pressure and mouth flow when forced oscillations were applied to the respiratory system in two different ways: by varying pressure at the mouth (input impedance, Zin); by varying pressure around the chest (transfer impedance, Ztr). Zin was characterized by the slope (S) and intercept (R0) of the resistance-frequency curve, by the resonant frequency (fn), and by total respiratory inertance (I) and compliance (C) obtained from the reactance. Transfer resistance and reactance curves were respectively analysed with a two-parameter (m1, m3) and a three-parameter (m0, m2, m4) equation. Significant correlations were found between impedance indices, particularly between m1 and both R0 (r = 0.931; p less than 0.001) and m2 (r = 0.739; p less than 0.001), and also between impedance indices and maximal expiratory flows. Nonsmoking miners (n = 40), compared to control nonsmokers (n = 16), had slightly lower maximal flows at high lung volumes (p less than 0.05) and higher values of m1 (p less than 0.001), R0, S, m3 (p less than 0.01) and m2 (p less than 0.05). In contrast, miners who smoked (n = 46) mainly differed from miners who did not smoke by lower flows at middle and low lung volumes (p less than 0.01) and larger m0 (p less than 0.01), m2 and m4 (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Respiratory input and transfer impedances in children 9-13 years old.

Reference values for respiratory impedances in children are scarce and limited to the situation where pressure is varied at the mouth. Total respiratory impedance was therefore measured from 4 to 30 Hz in 69 healthy children (9-13 yr) with both a pressure input at the mouth (input impedance, Zin) and a pressure input at the chest (transfer impedance, Ztr). Zin was characterized by the average resistance (R), the low-frequency limit of resistance (R0), the slope of the resistance-frequency curve (S), respiratory elastance (E) and respiratory inertance (I). Similar coefficients (R0', S', E', I'), some of which however have slightly different physiological meanings, were derived from Ztr. R, R0 and R0' were found to be significantly correlated to body height (p less than 0.001) and, independently, to age (p less than 0.05): R (kPa X l-1 X s) = 1.76-5.29 10(-3) height (cm) -4.13 10(-2) age (yr). Elastances were better correlated to height than to age: E (kPa X l-1) = 20.95-0.101 height (cm) and inertances better correlated to age than to height: I (Pa X l-1 X s2) = 4.39-0.128 age (yr). S and S' were not correlated to biometric variables. No difference was found between children living in polluted (n = 36) and nonpolluted (n = 33) areas, except for S which was significantly lower in the first group (p less than 0.01).

Adolescent↗

Methodological factors in the variability of lung volume and specific airway resistance measured by body plethysmography.

Thoracic gas volume (TGV) and specific airway resistance (sRaw) are commonly measured using pressure type and flow type body plethysmographs. Within-subject variability of the data, defined as the coefficient of variation of eight to ten measurements during the same session, was assessed with the two kinds of instruments and compared in fifteen normal subjects. The reproducibility of data obtained several days apart was also compared. All measurements were made in a 480-l body chamber, which could be used in both the pressure and the flow mode. The signals were processed digitally using three different algorithms: 1) simple linear regression (LR); 2) linear regression with drift correction achieved by adding to, or subtracting from the plethysmographic signal a term proportional to time (LRC); 3) Fourier analysis (FFT). Within-subject variability of TGV was much larger with flow than with pressure plethysmography when the signals were processed by LR (14.5 +/- 7.5 vs 6.3 +/- 3.0%; p less than 0.001), but almost the same using LRC (6.7 +/- 3.2 vs 5.4 +/- 2.7%) and FFT (6.1 +/- 2.4 vs 5.0 +/- 2.4%). For sRaw, variabilities were larger and less influenced by methodological factors. Adequate digital processing may therefore largely remedy the inherently greater variability of TGV measurements with flow plethysmographs.

Adult↗