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R Peslin

Publications and source records attributed to R Peslin.

At least 55 records · Page 3Linked to original sources
PubMed1994

Two-frequency analysis of respiratory mechanics in artificially ventilated rabbits.

The frequency dependence of respiratory mechanical properties was studied in 10 paralyzed, artificially ventilated rabbits, by superimposing a single sinusoidal signal with a frequency of 10, 20 or 30 Hz upon the ventilator waveform. The tracheal pressure and flow signals were analyzed both with the usual first order model, which provided total respiratory elastance (Ers) and resistance (Rrs), and by Fourier analysis, which provided respiratory impedance (Zrs) at the breathing frequency (0.85 Hz) and at the superimposed oscillation frequency. The real part of Zrs (Re(Zrs)) decreased by 30% from 0.85 to 10 Hz (P < 0.001), but did not vary significantly from 10 to 30 Hz. This finding is satisfactorily explained by tissue viscoelasticity. Following a histamine aerosol, the frequency dependence of Re(Zrs) changed very little in three out of four rabbits, but increased substantially in the fourth. In that instance, assuming that lung hysteresivity was not markedly modified by histamine, the results suggest inhomogeneous airway obstruction and/or airway wall shunting.

Airway Resistance↗
PubMed1994

Tracheal wheezes during methacholine airway challenge (MAC) in workers exposed to occupational hazards.

Methacholine airway challenge (MAC) is a simple and useful means to assess bronchial hyperreactivity in workers exposed to various occupational hazards. Recently, wheeze detection by tracheal auscultation has been proposed as an indicator of bronchial responsiveness during bronchial provocation test in children. Our aim was to examine the relationship between the appearance of wheezes and the concurrent changes in forced expiratory volume in one second (FEV1) observed during MAC test in adults. Three cumulative doses of a methacholine solution (100 micrograms, 500 micrograms and 1500 micrograms) were inhaled by 45 workers with occupational exposure to flour dust. Spirometry was done using an electronic spirometer. Tracheal sounds were recorded with an electronic stethoscope placed over the anterior cervical triangle, 2 cm above the sternal notch. The amplified sounds were stored on magnetic tape, band-pass filtered (50-2000 Hz), and digitized at a sampling rate of 4096 Hz into a GenRad Vibration Control System. Wheezes were detected by fast Fourier transform (FFT) analysis and their presence compared to a 20% fall in FEV1. A positive MAC test by spirometry was found in 12 subjects whereas wheezes were identified in 14 subjects. Among the wheezing subjects, nine had a positive MAC test (range of fall in FEV1 = 20.6 to 42.3%) and five had a negative one (range of fall in FEV1 = 3.6 to 16.9%). Moreover, no wheezes were found in the remaining three subjects with a positive MAC test (range of fall in FEV1 = 20.7 to 27.4%). Taking a 20% fall in FEV1 as reference, wheezes were 75% sensitive and 84.8% specific to detect airflow obstruction. In conclusion, since it carries a significant although small false-negative rate, the acoustic technique based upon wheeze detection cannot, at the present time, fully replace spirometry during airway challenge testing in subjects with suspected asthma.

Adult↗
PubMed1994

Comparative effects of laryngeal mask and tracheal tube on total respiratory resistance in anaesthetised patients.

We compared the effects of the laryngeal mask and tracheal tube on total respiratory resistance in 10 anaesthetised, mechanically ventilated patients undergoing otological microsurgery. The subjects were randomly divided into two groups. In the first group, the tracheal tube (Rüsch) was inserted for the first series of measurements. This was then replaced by a laryngeal mask (Intavent) and a second series of measurements was made during the first hour of operation. In the second group, the same protocol was applied with inverse order in the use of the devices. From the measurement of respiratory flow and pressure at the airway opening, total respiratory resistance was calculated by multiple linear regression. The data were corrected to eliminate the previously determined nonlinear resistance of the two devices. Arterial blood pressure, electrocardiogram, oxygen saturation and end-tidal carbon dioxide concentration were continuously monitored. With the laryngeal mask and the tracheal tube, mean (SE) minute ventilation was 9.4(0.9)l.min-1 and 8.1(0.9)l.min-1, respectively for end-tidal carbon dioxide concentrations between 3.6 and 4.1%. Although the glottic resistance was included in the measurement performed with the laryngeal mask but not with the tracheal tube, mean (SE) total respiratory resistance was not significantly different with the two devices (0.61(0.32) and 0.69(0.35) kPa.l-1.s, respectively). Leakage was avoided with the laryngeal mask because the insufflation pressure never exceeded 1.7 kPa except in one patient suffering from severe chronic obstructive pulmonary disease who had a total respiratory resistance of 1.45 kPa.l-1.s. During the first hour of the operation all respiratory variables remained stable irrespective of the device used.

Adult↗
PubMed1994

Small-amplitude pressure oscillations do not modify respiratory mechanics in rabbits.

Changes in respiratory mechanics have occasionally been observed during high-frequency ventilation. In this study we investigated whether small pressure oscillations such as those used for respiratory impedance measurements modified total respiratory resistance (Rrs) and total respiratory elastance (Ers). The latter were measured in six paralyzed artificially ventilated rabbits with and without superimposed pressure oscillations at the airway opening. Rrs and Ers were obtained by least square fitting of low-pass filtered tracheal pressure and flow to the usual first-order model. Pressure oscillations of 2-4 hPa peak-to-peak at 10, 20, and 30 Hz applied for periods of 10 min had virtually no effect on Ers (changes ranging from -2.5 to 2.6%) and Rrs (0-8.2%). Analysis of variance did not show a significant difference on the pooled data. Pressure oscillations were also applied every other minute after a histamine aerosol. Ers and Rrs were similarly unchanged. We conclude that the small pressure oscillations used in respiratory impedance measurements do not modify lung mechanical properties and lung response to bronchomotor agents.

Air Pressure↗
PubMed1994

Human lung impedance from spontaneous breathing frequencies to 32 Hz.

Lung impedance (ZL) was measured from 0.1875 to 32 Hz in spontaneously breathing healthy subjects by spectral analysis of the pressure and flow signals generated simultaneously by the muscular generator of breathing and by a forced oscillation system. This method did not require cooperation from the subject to perform panting or special ventilatory maneuvers and therefore allowed us to analyze the frequency dependence of lung resistance, reactance, and elastance (-2 pi.frequency.reactance) at the physiological conditions of normal breathing. Resistance and elastance parameters were also computed by multiple linear regression of the time-domain pressure and flow data on a simple resistance-elastance model. Resistances and elastances computed at the breathing frequency by spectral analysis and by multiple linear regression were similar (nonsignificant differences < 4 and 10%, respectively). The results obtained when comparing ZL from the breathing component (0.1875-0.75 Hz) of the recorded signals and from the forced oscillation component (2-32 Hz) were fairly consistent. ZL (0.1875-10 Hz) was interpreted in terms of a model consisting of an airway compartment, including a resistance and an inertance, in series with a viscoelastic tissue compartment (J. Hildebrandt. J. Appl. Physiol. 28: 365-372, 1970) characterized by two parameters. The model analysis provided parameter values (resistance 2.49 +/- 0.58 hPa.l-1.s, inertance 1.70 +/- 0.29 Pa.l-1.s2, Hildebrandt parameters 4.87 +/- 2.28 and 0.73 +/- 0.99 hPa/l) consistent with the hypothesis that lung tissue in healthy humans during spontaneous breathing behaves as a viscoelastic structure with a hysteresivity of approximately 0.10.

Adult↗
PubMed1994

Influence of chronic hypoxia on salbutamol tissular concentrations and on respiratory resistance in anesthetized rabbits.

Salbutamol is a potent beta 2-adrenoceptor agonist given to patients with bronchial asthma who are frequently hypoxemic. The aims of this study were to document the influence of chronic hypoxia on salbutamol tissue concentrations and on salbutamol effect on total respiratory resistance. To this purpose, salbutamol (60 micrograms/kg) was administered intravenously to four groups of six rabbits exposed to four experimental conditions: (1) control rabbits breathing air, (2) histamine-induced bronchoconstriction in rabbits breathing air, (3) animals with chronic hypoxia, (4) histamine-induced bronchoconstriction in animals with chronic hypoxia. The area under salbutamol plasma concentration time curve (0 to 45 min) was not affected by these experimental conditions. Compared with control rabbits breathing air, following histamine-induced bronchoconstriction, salbutamol concentrations rose by 40 to 50% in lung and heart (p < 0.05). Hypoxia did not affect salbutamol distribution in these organs; however, in hypoxic animals, histamine-induced bronchoconstriction increased salbutamol concentrations only in the heart (p < 0.05), without affecting those in the lung. Compared with rabbits breathing air and with histamine-induced bronchoconstriction, the effect of salbutamol was reduced in rabbits under chronic hypoxia and histamine-induced bronchoconstriction (p < 0.05). We conclude that chronic hypoxia reduces salbutamol effect on pulmonary resistance, possibly by decreasing salbutamol lung concentrations.

Airway Resistance↗
PubMed1994

Expiratory capnography in asthma: evaluation of various shape indices.

The shape of the capnogram is modified by airway obstruction, and the evaluation of this deformation, using measurable indices, could allow an indirect measurement of bronchial patency. A previous study undertaken in asthmatic subjects showed a good correlation between a capnographic index (end-tidal slope) and a spirometric parameter (forced expiratory volume in one second as a percentage of predicted (FEV1 %pred)) and suggested the study of other indices. The correlations between capnographic and spirometric indices were measured in 10 healthy subjects and 30 asthmatic patients. The usefulness of eight descriptive indices, analysing the successive phases of the capnogram, was assessed by measuring their reproducibility and their sensitivity to airway obstruction. The intraindividual and interindividual variabilities (Vi and VI) and the noise/signal ratio (Vi/VI) were measured by comparing the results of two successive capnographic measurements in 14 asthmatic subjects. The results show an increasing noise/signal ratio along the expiration (between 23 and 62%). Significant correlations between spirometry and capnography were found with all indices, but the strongest were observed with indices analysing the intermediate phase of the capnogram, that is the angle between the ascending phase (E2) and the alveolar plateau (E3). The correlations show that the analysis of the capnogram's shape is a quantitative method for evaluating the severity of bronchospasm. This ability, added to specific advantages (noninvasiveness, effort-independency, measurements during tidal breathing) opens new fields of application to capnography, such as measurement of bronchospasm in children and computerized monitoring of asthma.

Adult↗
PubMed1994

Input respiratory impedance to estimate airway hyperreactivity in children: standard method versus head generator.

We previously found that a significant underestimation of respiratory mechanical impedance (Zrs) at high frequency may result from the upper airway artefact in children, when pressure is directly varied at the mouth. To determine the importance of this artefact in estimating lung response to bronchomotor agents with the forced oscillation technique, input respiratory mechanical impedance was measured using 6-32 Hz pseudorandom pressure oscillations applied directly to the mouth (standard generator (SG)) and around the subject's head (head generator (HG)) in 35 children aged 2.5-13 yrs. Changes in resistance were generally larger with HG than SG. The mean +/- SEM changes in resistance of the respiratory system (Rrs) at 20 Hz induced by acetylcholine or allergen challenge were 15 +/- 4% for SG and 67 +/- 12% for HG, and changes induced by bronchodilators were -25 +/- 2% for SG, and -46 +/- 4% for HG (p < 0.01). Challenge induced negative frequency dependence of Rrs with SG and positive frequency dependence with HG. There was significant increase in inertance after salbutamol with SG, but no significant change occurred with HG. With both methods, respiratory compliance decreased significantly after challenge. Computer simulations showed that the difference in change in Rrs induced by airway challenge with HG and SG could be explained by the effect of the upper airway wall impedance (Zuaw). Zuaw could also account for the change in inertance and compliance observed with SG, but not for the change in compliance with HG. The latter could be reproduced by simulating unequal distribution of mechanical time constants within the lung, increased peripheral lung resistance with compliant central airways.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Resistance↗
PubMed1994

Fourier analysis versus multiple linear regression to analyse pressure-flow data during artificial ventilation.

Respiratory resistance (Rrs) and elastance (Ers) are commonly measured in artificially-ventilated patients or animals by multiple linear regression of airway opening pressure (Pao) versus flow (V') and volume (V), according to the first order model: Pao = P0 + Ers.V + Rrs.V', where P0 is the static recoil pressure at end-expiration. An alternative way to obtain Rrs and Ers is to derive them from the Fourier coefficients of Pao and V' at the breathing frequency. A potential advantage of the second approach over the first is that it should be insensitive to a zero offset on V' and to the corresponding volume drift. The two methods were assessed comparatively in six tracheotomized, paralysed and artificially ventilated rabbits with and without adding to V' an offset equal to 5% of the mean unsigned flow. The 5% flow offset did not modify the results of Fourier analysis, but increased Rrs and Ers from linear regression by 15.8 +/- 4.6% and 4.55 +/- 0.64%, respectively. Without additional offset, differences between the two methods averaged 30.2 +/- 14.0% for Rrs and 9.3 +/- 6.2% for Ers. The differences almost completely disappeared (2.47 and 0.61%, respectively) when the flow signal was zero-corrected using the assumption that inspired and expired volumes were the same. After induced bronchoconstriction, however, Ers was still slightly larger by linear regression than by Fourier analysis, which may result from nonlinearities and/or frequency dependence of the parameters. We conclude that the regression method requires zero flow correction and that Fourier analysis is an attractive alternative.

Algorithms↗
PubMed1994

Measurement of respiratory impedance by forced oscillation: comparison of the standard and head generator methods.

Physiological and clinical studies have shown that the standard method of measuring respiratory impedance by forced oscillation leads to less efficient control of the upper airway shunt effect than the head generator method. To test the effects of these two techniques in epidemiological studies, we compared, in a sample of 73 French agricultural workers, the values obtained with each method for five forced oscillation parameters: resistance, frequency dependence of resistance, inertance, compliance and resonant frequency. For these comparisons, subjects were classified according to four respiratory status factors: smoking status, cough, expectoration and airway obstruction assessed from the maximum expiratory flow volume curve. Logistic regression models using the set of four forced oscillation parameters (excluding resonant frequency, which is derived from compliance and inertance) were then used to analyse the ability of each method to classify the subjects in each group. Significant differences between the two methods were observed for the mean values obtained for all five parameters. However, when each parameter was considered separately, the correlations between the values for each method were significant. Each method possessed the necessary ability to separate subjects into our group classification, but the significant relationships were not always found for the same parameters. Finally, logistic regression models showed that the two methods led to almost the same classification of the subjects. According to our results, the standard method of applying forced oscillation at the mouth seems an acceptable device for measuring respiratory impedance for epidemiological purposes.

Airway Obstruction↗
PubMed1993

Low-frequency vs. high-frequency respiratory mechanics after methacholine challenge in artificially ventilated rabbits.

Respiratory system resistance (Rrs) and elastance (Ers) were estimated by two methods, before and after methacholine in six anesthetized, paralyzed, and artificially ventilated rabbits. Rrs and Ers were obtained (1) by multiple linear regression analysis of the relationship between tracheal pressure and tidal volume and flow [Rrs(mlr)], Ers(mlr), and (2) by analysis of the Fourier transforms of tracheal pressure and flow resulting from 4 to 30 Hz pseudorandom pressure oscillations delivered by an Infant Star respirator [Rrs(os), Ers(os)]. Rrs(os) was significantly lower than Rrs(mlr). For instance, Rrs(os) at 20 Hz [Rrs(os)20] was (mean +/- SD) 17.3 +/- 3.5 vs 21.4 +/- 3.6 cm H2O x L-1 x s (P < 0.01) for Rrs(mlr). Ers(os) was significantly higher than the respective value obtained by multiple linear regression (718.2 +/- 81.0 vs 403.7 +/- 43.0 cm H2O L-1; P < 0.01). After methacholine, the changes of respiratory mechanics were similar with both methods. Rrs(mlr) and Rrs(os)20 increased respectively by 131 +/- 45 and 134 +/- 76%, and Ers(mlr) and Ers(os) increased respectively by 63 +/- 7 and 54 +/- 13%. A significant correlation was observed between Rrs(mlr) and Rrs(os)20 (r = 0.97) and between Ers(mlr) and Ers(os) (r = 0.96). We conclude that positive response to methacholine may be detected by forced oscillation as well as by multiple linear regression. However, the identified physiological components of the lung response (alteration in lung viscoelastic properties, increased lung inhomogeneity or increased intrathoracic airway shunt) are likely to be different with each method.

Airway Resistance↗
PubMed1993

Validity of the esophageal balloon technique at high frequencies.

The reliability of the esophageal balloon technique in measuring high-frequency changes in pleural pressure (Ppl) was investigated in six normal subjects by studying the amplitude ratio (A) and phase angle (phi) of esophageal (Pes) and mouth (Pm) pressures during airway occlusion and while pseudorandom pressure variations (2-32 Hz) were applied to the chest. The measurements were made with a common esophageal balloon-catheter system connected to a high-impedance piezoresistive transducer. When the cheeks were firmly supported, A averaged 1.08 +/- 0.063 at 2 Hz and 1.06 +/- 0.11 at 32 Hz. Pes increasingly led Pm with increasing frequency, and phi averaged 20.8 +/- 4.0 degrees at 32 Hz. Washing the airways with 80% He-20% O2 reduced phi by 50%. When the cheeks were not supported, A exhibited a strong positive frequency dependence, averaging 1.71 +/- 0.34 at 32 Hz, whereas phi increased much faster below 20 Hz and tended to decrease afterward. Because the esophageal transfer function Pes/Ppl = (Pes/Pm)/(Ppl/Pm), we could estimate Pes/Ppl by computing for individual subjects the pressure difference between the pleura and the mouth based on the lung and upper airway wall properties that were measured separately. The results suggest that the ratio of Pes and Ppl remains close to unity from 2 to 32 Hz, but Pes lags slightly behind Ppl (phi equals about -7 degrees at 32 Hz).

Adult↗
PubMed1993

Respiratory input impedance up to 256 Hz in healthy humans breathing foreign gases.

Currently available data concerning respiratory input impedance (Zrs) at frequencies up to 300 Hz indicate that Zrs is determined mainly by the airways and, in particular, the gas compressibility in the airways and the airway wall compliance. Hence, measurements of Zrs when breathing gases with different physical properties would be useful in investigating airway mechanics and the role of acoustic propagation. Zrs measured with a standard generator (Zst) and corrected for the upper airway shunt (Zrs*) were measured in nine healthy subjects breathing air or a gas mixture consisting of 20% O2 and 80% He or SF6. The frequency band was extended up to 256 Hz for air and He-O2 and up to 128 Hz for SF6-O2. Zrs exhibited a similar pattern for the three gases, with a shift toward low frequencies as the gas density increased. Moreover, the resonance peaks tended to be narrower and higher as the gas density increased. The second frequency of resonance for He-O2, air, and SF6-O2 were 220, 180, and 50 Hz, respectively, for Zrs* and were systematically higher for Zst. Zrs* and Zst data were interpreted in terms of a tricompartmental model that partitioned the airways into two segments: a central one featuring the acoustic propagation in the airways and a peripheral one that included bronchial wall elasticity (Farré et al. J. Appl. Physiol. 67: 1973-1981, 1989). The model was able to interpret the gas dependence of Zrs* but not that of Zst. The influence of the gas physical properties on both Zrs* and Zst confirms that total Zrs at high frequencies is basically that of the airways and that the second resonance is related mainly to the gas compressibility in the airways.

Adult↗
PubMed1993

Acute pulmonary response to intravenous histamine at fixed lung volume in dogs.

We measured tracheal pressure (Ptr), tracheal flow, and two alveolar pressures in five open-chest anesthetized and paralyzed dogs. The lungs were maintained at a fixed volume for 50 s while small amplitude oscillations in flow at 6 Hz were applied at the tracheal opening. The measurements of alveolar pressure showed that the resulting oscillations in Ptr were virtually entirely determined by airway resistance (Raw) and consequently gave accurate estimates of the same. A 20-mg bolus of histamine was given intravenously at the start of this period when Ptr was 0.5 kPa. After approximately 10 s the mean Ptr increased sharply by approximately 40% and plateaued after approximately 25 s. Raw, in contrast, continued to increase throughout the oscillation period. Furthermore, the increases in mean Ptr were virtually identical in all dogs, whereas the increases in Raw were highly variable among the dogs. Our results suggest that the increases in mean Ptr caused by histamine were due to contraction of distal elements in the lung, whereas the changes in Raw were due mainly to constriction of more central airways.

Air Pressure↗
PubMed1993

Airway and tissue impedances of canine lungs after step volume changes.

We investigated the changes in pulmonary mechanics in five anesthetized paralyzed tracheostomized open-chest dogs after step changes in lung volume. We applied small-amplitude (10-ml) volume oscillations at 6 Hz at the tracheal opening for 50-s periods, during which we applied a step volume change of 250, 500, or 750 ml to the lungs. Alveolar capsule measurements of alveolar pressure allowed us to calculate cycle-by-cycle values for airway resistance (Raw) and reactance (Xaw) and lung tissue resistance (Rti) and reactance (Xti). Before the step changes in lung volume, when transpulmonary pressure (Ptp) had a mean value of 0.65 kPa, Raw was markedly greater than Rti. The situation was reversed after the step changes, however, when Raw decreased and Rti increased. Both Raw and Xaw showed negative dependences on Ptp and hence on airway caliber, as expected, and also decreased transiently after the step volume changes, almost certainly due to a vagally mediated bronchodilation reflex. Both Rti and Xti showed clear linear dependences on Ptp and were themselves tightly coupled. Furthermore, our estimate of bulk modulus for lung tissue at 6 Hz is comparable to its previously reported values at much lower oscillation frequencies.

Airway Resistance↗
PubMed1993

Optimal frequency range to analyze respiratory transfer impedance with six-element model.

The aim of this investigation was to assess the optimal frequency range for analyzing respiratory transfer impedance (Ztr) in terms of tissue and airway mechanical properties using the six-element model of DuBois et al. (J. Appl. Physiol. 8:587-594, 1956). Ztr was measured in nine healthy subjects from 2 to 64 Hz by studying the relationship between airway flow and pseudorandom pressure oscillations applied around the chest. The measurements were performed with and without two mechanical loads placed at the mouth: an added inertance of 1.4 Pa.s2.l-1 and an added resistance of 1.65 hPa.s.l-1. The data were corrected for the shunt effect of upper airway walls. The changes in Ztr induced by the loads were very consistent up to 56 Hz with the T-network topology assumed in DuBois's model; the agreement deteriorated at higher frequencies, presumably due to the difficulty of obtaining a homogeneous pressure field around the chest. The fit of the model to the data also worsened sharply at above 56 Hz. In the 2- to 56-Hz frequency range, similar values of the tissue and airway coefficients were obtained with and without the loads. In that frequency range the confidence intervals of the coefficients were better than 10%. We conclude that DuBois's model is valid from 2 to 56 Hz in healthy subjects and allows accurate partitioning of airways and tissue properties. In addition, we present evidence that the upper airway shunt negligibly influences Ztr data and the derived coefficients provided airway flow is measured with a low-impedance pneumotachograph.

Adult↗