Exploring respiratory mechanics by forced oscillations: principles and pitfalls.
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Humans↗
Biomedical subjects
R Peslin
Publications and source records attributed to R Peslin.
Respiratory impedance to ambient pressure changes at low frequencies.
Respiratory impedance may be studied by measuring airway flow (Vaw) when pressure is varied at the mouth (input impedance) or around the chest (transfer impedance). A third possibility, which had not been investigated so far, is to apply pressure variations simultaneously at the two places, that is to vary ambient pressure (Pam). This provides respiratory impedance to ambient pressure changes (Zapc = Vaw/Pam). In that situation airway impedance (Zaw) and tissue impedance (Zt) are mechanically in parallel, and both are in series with alveolar gas impedance (Zg): Zapc = Zaw + Zg + Zaw.Zg/Zt. We assessed the frequency dependence of Zapc from 0.05 to 2 Hz in nine normal subjects submitted to sinusoidal Pam changes of 2-4 kPa peak to peak. The real part of Zapc (Rapc) was of 6.2 kPa.1(-1).s at 0.05 Hz and decreased to 1.9 kPa.1(-1).s at 2 Hz. Similarly the effective compliance (Capc), computed from the imaginary part of Zapc, decreased from 0.045 1.kPa-1 at 0.05 Hz to 0.027 1.kPa-1 at 2 Hz. Breathing against an added resistance of 0.46 kPa.1(-1).s exaggerated the negative frequency dependence of both Rapc and Capc. When values of airway resistance and inertance derived from transfer impedance data were introduced, Zapc was used to compute effective tissue resistance (Rt) and compliance (Ct). Rt was found to decrease from 0.32 to 0.15 kPa.1(-1).s and Ct from 1.11 to 0.64 1.kPa-1 between 0.25 and 2 Hz. Ct was slightly lower with the added resistance. These results are in good agreement with the data obtained by other approaches.
Adult↗
Stress adaptation and low-frequency impedance of rat lungs.
At transpulmonary pressures (Ptp) of 7-12 cmH2O, pressure-volume hysteresis of isolated cat lungs has been found to be 20-50% larger than predicted from their amount of stress adaptation (J. Hildebrandt, J. Appl. Physiol. 28: 365-372, 1970). This behavior is inconsistent with linear viscoelasticity and has been interpreted in terms of plastoelasticity. We have reinvestigated this phenomenon in isolated lungs from 12 Wistar rats by measuring 1) the changes in Ptp after 0.5-ml step volume changes (initial Ptp of 5 cmH2O) and 2) their response to sinusoidal pressure forcing from 0.01 to 0.67 Hz (2 cmH2O peak to peak, mean Ptp of 6 cmH2O). Stress adaptation curves were found to fit approximately Hildebrandt's logarithmic model [delta Ptp/delta V = A - B.log(t)] from 0.2 to 100 s, where delta V is the step volume change, A and B are coefficients, and t is time. A and B averaged 1.06 +/- 0.11 and 0.173 +/- 0.019 cmH2O/ml, respectively, with minor differences between stress relaxation and stress recovery curves. The response to sinusoidal forcing was characterized by the effective resistance (Re) and elastance (EL). Re decreased from 2.48 +/- 0.41 cmH2O.ml-1.s at 0.01 Hz to 0.18 +/- 0.03 cmH2O.ml-1.s at 0.5 Hz, and EL increased from 0.99 +/- 0.10 to 1.26 +/- 0.20 cmH2O/ml on the same frequency range. These data were analyzed with the frequency-domain version of the same model, complemented by a Newtonian resistance (R) to account for airway resistance: Re = R + B/ (9.2f) and EL = A + 0.25B + B . log 2 pi f, where f is the frequency.(ABSTRACT TRUNCATED AT 250 WORDS)
Adaptation, Physiological↗
Respiratory input and transfer mechanical impedances in patients with chronic obstructive pulmonary disease.
Total respiratory input (Zin) and transfer (Ztr) mechanical impedances were measured from 4-30 Hz in 9 patients with severe chronic obstructive pulmonary disease (COPD) and in 12 healthy subjects. Zin was obtained by applying a pressure input around the head to minimize transmural pressure across extrathoracic airway walls, and Ztr was obtained with a pressure input at the chest. In agreement with previous studies total respiratory compliance and inertance were decreased in patients, while effective input resistance was increased and exhibited a negative frequency dependence. Effective transfer resistance (Re(Ztr)) was also increased at all frequencies, and, in some patients, the Re(Ztr)-frequency curve was sigmoid in shape, which was never seen in normals. When Ztr was analysed with a six-coefficient monoalveolar model featuring tissue properties, alveolar gas compliance, and airways properties, the model fitted the data less closely in patients than in normals and, in the former, provided unrealistic coefficients. Such was also the case with a bialveolar model. A better fit with more realistic values for the coefficients was obtained in selected patients with a model where central and peripheral (Rp) airway resistance were separated by a shunt representing airway wall compliance (Cb): Cb was found to range from 0.029-0.062 l.kPa-1 and Rp represented 44-81% of total airway resistance.
Adult↗
Measurement of ventilatory mechanical impedance in infants using a head pressure generator.
Two methods of measuring ventilatory mechanical impedance (Z) by forced oscillations between 6 and 20 Hz were compared in 24 infants aged 2 to 49 months: 1) the application of pressure oscillations at the airway opening (Z1); and 2) the application of pressure oscillations around the head (Z2). The latter has been recently proposed to minimize the influence of compliant upper airway walls (Peslin et al., J Appl Physiol. 1985, 59:1790-1795). Ventilatory resistance and compliance (Rsb, Csb) were also obtained with the single breath method. The real part of Z1 (R1) was markedly lower than that of the corresponding Z2 (R2), at any frequency. R1 exhibited a systematic negative frequency dependence, in contrast with R2. At any frequency, the slope of the regression equation on Rsb was closer to unity for R2 than for R1. The imaginary part of Z1 (X1) was negative over the whole frequency interval, and negative values of inertance were derived from X1. X2 was negative at low and positive at high frequencies. Resonant frequency (mean +/- SD = 10.5 +/- 3.5 Hz) was always reached with Z2 and correlated negatively with body weight (r = -0.61). Inertance estimated from X2 was positive and correlated negatively with body height (r = -0.66). The compliance derived from Z1 (C1 = 3.35 +/- 2.32 10(-3) L.cm H2O-1) was not significantly different from that derived from Z2 (C2 = 2.99 +/- 2.02 10(-3) L.cm H2O-1). The marked difference observed between Z1 and Z2 is related to the importance of the upper airway shunt and may be explained by inaccuracies of both methods.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Analysis of the dynamic characteristics of pressure transducers for studying respiratory mechanics at high frequencies.
Differential pressure transducers are commonly used to study respiratory mechanics at physiological frequencies as well as during external forcing at high frequencies. In the latter condition, measuring errors could occur if the input impedance of the pressure transducers is not sufficiently large with respect to that of the respiratory system. In this work we analysed the input impedance Z and the transfer function H of two common pressure transducers (Validyne MP-45 and Celesco LCVR) equipped with membranes of different sensitivities and with connecting tubes of different lengths. Z was measured by the tube method and H was measured by comparison with a flat-response pressure transducer. In agreement with the predictions based on a simple lumped-parameters model, we found that Z reached very low values, especially at the frequencies where H had a resonance peak. For instance, for the widespread Validyne MP-45 transducer (200 Pa) with connecting tubes of 16 cm length and 3.8 mm internal diameter a minimum of Z of 8300 Pa s litre-1 at 96 Hz was measured; at that frequency the amplitude of H attained a value of 3.1. Using the above transducer model we simulated the measurement of a rat input impedance up to 128 Hz using Validyne and Celesco transducers. With the Validyne MP-45 (200 Pa), equipped with the same connecting tubes as above, the computed error reached up to 50 per cent for the real part and 140 per cent for the imaginary part.
Animals↗
Streptococcus pneumoniae and Staphylococcus aureus surface properties in relation to their adherence to human buccal epithelial cells.
Adherence to host cells by pathogenic bacteria is achieved through both specific and non-specific mechanisms. The former involve bacterial adhesin and corresponding cell receptors (Gibbons and Van Houte, 1980), while the second include electric charges and hydrophobicity of bacterial cell walls. In a previous study (Beck et al., 1988), we showed that these two cell surface characteristics vary during growth of Staphylococcus aureus in a manner which should promote adherence to host cells. The aims of the current study were to assess: (1) whether the same growth-related variations in surface properties were present in another bacterial species, Streptococcus pneumoniae; (2) whether the adherence of the two types of bacteria to epithelial cells was in fact different at different growth times; and (3) whether such differences were consistent with the observed surface properties.
Bacterial Adhesion↗
Computer simulation of respiratory impedance and flow transfer functions during high frequency oscillations.
The usefulness of measuring respiratory flow in the airway and at the chest wall and of measuring respiratory input impedance (Z) to monitor high frequency ventilation was investigated by computer simulation using a monoalveolar 10-coefficient model. The latter included a central airway with its resistance (Rc) and inertance (lc), a resistive peripheral airway (Rp), a lumped bronchial compliance (Cb), alveolar gas compliance (Cgas), lung tissue with its resistance (RL) and compliance (CL), and chest wall resistance (RW), inertance (lw) and compliance (Cw). Gas flow in the peripheral airway (Vp), shunt flow through Cb (Vb), gas compression flow (Vgas) and rate of volume change of the lung (VL) and of the chest (VW) were computed and expressed as a function of gas flow in the central airway (Vc). For normal values of the coefficients, Vp/Vc was found to decrease moderately with increasing frequency and was still 0.75 at 20 Hz. Peripheral airway obstruction (Rp x 5) considerably decreased Vp/Vc, particularly at high frequency. It did not change the relationship between the two measurable flows, Vc and Vw, but increased the effective resistance at low frequency and shifted the reactance curve to the right. A reduced lung or chest wall compliance produced little change in Vp/Vc and Z except at very low frequencies; however, it decreased the phase lag between Vw and Vc. Finally, an increased airway wall compliance decreased Vp/Vc, but had little effect on Z and Vw/Vc. It is concluded that measuring respiratory impedance may help in detecting some, but not all of the conditions in which peripheral flow convection is decreased during high frequency oscillations.
Airway Obstruction↗
A correction procedure for the asymmetry of differential pressure transducers in respiratory impedance measurements.
The usual setup for measuring respiratory input impedance requires a differential pressure transducer attached to a pneumotachograph. As, up to now, no data correction procedure has been devised to account for transducer asymmetry, a highly symmetrical transducer is required to obtain reliable impedance data. In this communication, a general model for the measuring system is presented. Its main feature is that differential pressure transducers are modeled as two input-one output systems. From the theoretical model, we defined a dynamic calibration and data correction procedure. This was tested using highly asymmetrical transducers (common-mode rejection ratio between 45 and 27 dB) to measure the impedance of two respiratory analogs. The latter were linear resistance (R), inertance (I), compliance (C) series models simulating a normal subject (R = 3.47 hPa.s.l-1, I = 1.45 Pa.s2.l-1, C = 18.6 ml.hPa-1) and an obstructive patient (R = 11.15 hPa.s.l-1, I = 1.28 Pa.s2.l-1, C = 18.5 ml.hPa-1). Results obtained applying the devised procedure (errors in R, I, and C always less than 4 percent) show that respiratory input impedance can be adequately measured if data are corrected for transducer asymmetry.
Airway Resistance↗
Lung impedance in healthy humans measured by forced oscillations from 0.01 to 0.1 Hz.
Lung impedance was measured from 0.01 to 0.1 Hz in six healthy adults by superimposing small-amplitude forced oscillations on spontaneous breathing. Measurements were made with an almost constant-volume input (160-180 ml) or with an almost constant-flow input (20-30 ml.s-1). No significant difference was found between the two conditions. Lung resistance (RL) sharply decreased from 0.97 kPa.l-1.s at 0.01 Hz to 0.27 kPa.l-1.s at 0.03 Hz and then mildly to 0.23 kPa.l-1.s at 0.1 Hz. Lung effective compliance (CL) decreased slightly and regularly from 0.01 Hz (2.38 l.kPa-1) to 0.1 Hz (1.93 l.kPa-1). The data were analyzed using a linear viscoelastic model adapted from Hildebrandt (J. Appl. Physiol. 28:365-372, 1970) and complemented by a Newtonian resistance (R): RL = R + B/(9.2f); CL = 1/(A + 0.25B + B.log2 pi f), where f is the frequency and B/A is an index of lung tissue viscoelasticity. A good fit was generally obtained, with an average difference of 10% between the observed and predicted values. The ratio B/A was not affected by the breathing and was 10.6 and 13.6% in the constant-volume and constant-flow conditions, respectively, which agrees with Hildebrandt's observations in isolated cat lungs. R was systematically larger than the plethysmographic airway resistance, suggesting that lung tissue resistance might also include a Newtonian component.
Adult↗
Human respiratory impedance from 8 to 256 Hz corrected for upper airway shunt.
Respiratory input impedance (Zrs) was measured from 8 to 256 Hz in 10 healthy subjects by a method that eliminated the shunt impedance of extrathoracic airway walls. It consisted of combining the data obtained with a pressure input at the mouth (standard method, Zst) and with a pressure input around the head (Zhg) Zrs = Zst.(Zp + Zhg)/(Zp + Zst) where Zp is the impedance of the mouthpiece and pneumotachograph. Large quantitative differences were observed between Zrs and Zst, demonstrating that the standard method is unreliable at such frequencies. The real part of Zrs increased from 2.6 +/- 0.8 cmH2O.l-1.s at 8 Hz to a maximum of 38 +/- 19 cmH2O.l-1.s at 158 +/- 49 Hz. The imaginary part exhibited a maximum of 19 +/- 8 cmH2O.l-1.s at 126 +/- 38 Hz, a resonance at 157 +/- 43 Hz, and a minimum of lambda 19 +/- 16 cmH2O.l-1.s at 185 +/- 45 Hz. The data were analyzed with five models featuring alveolar gas compressibility; tissue resistance, inertance, and compliance; and different representations of the airways with lumped and distributed parameters. All except the simplest (lumped frequency-dependent resistance) fitted the data equally well, but none provided reliable estimates of gas compliance. Three models gave a consistent description of the airway in terms of equivalent rigid tubes (cross-sectional area 3.5-3.7 cm2, length 47-51 cm). We conclude that high-frequency input impedance could prove useful in exploring the airways but not the peripheral lung.
Adult↗
Flow and volume dependence of respiratory mechanical properties studied by forced oscillation.
The influence of inspiratory and expiratory flow magnitude, lung volume, and lung volume history on respiratory system properties was studied by measuring transfer impedances (4-30 Hz) in seven normal subjects during various constant flow maneuvers. The measured impedances were analyzed with a six-coefficient model including airway resistance (Raw) and inertance (Iaw), tissue resistance (Rti), inertance (Iti), and compliance (Cti), and alveolar gas compressibility. Increasing respiratory flow from 0.1 to 0.4 1/s was found to increase inspiratory and expiratory Raw by 63% and 32%, respectively, and to decrease Iaw, but did not change tissue properties. Raw, Iti, and Cti were larger and Rti was lower during expiration than during inspiration. Decreasing lung volume from 70 to 30% of vital capacity increased Raw by 80%. Cti was larger at functional residual capacity than at the volume extremes. Preceding the measurement by a full expiration rather than by a full inspiration increased Iaw by 15%. The data suggest that the determinants of Raw and Iaw are not identical, that airway hysteresis is larger than lung hysteresis, and that respiratory muscle activity influences tissue properties.
Adult↗
[Repercussions of propofol and combinations with alfentanyl on the bronchial reactivity in asthmatics].
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Alfentanil↗
[The mechanics of forced oscillation--principles and use].
The technique of forced oscillation is a basic method of investigation of electrical and mechanical systems. Various modifications may be used in the field of respiratory physiology and pathology. When applying the oscillations at the mouth, we will measure respiratory input impedance; when applying the oscillations at total body surface, we will measure respiratory transfer impedance. Combining both methods one can calculate airway impedance and tissue impedance separately. Despite of the large number of studies which have already been carried out, I am convinced that the potential of the method is not yet exhausted.
Airway Resistance↗
Mechanics of the ventilatory system in sedated infants: forced oscillations versus single-breath method.
The real--Re(Z)--and imaginary--Im(Z)--parts of the ventilatory system impedance were measured between 6 and 30 Hz in 18 normal infants and in 19 with airway obstruction. The intercept (R0) and slope (S) of the Re(Z)-frequency function, as well as inertance (I) and compliance (C) estimated from Im(Z), were compared with ventilatory system resistance (Rrs) and compliance (Crs) (single-breath method). R0 correlated significantly with Rrs (r = 0.86), although the slope of the regression equation was significantly lower than 1 (P less than 0.01). Negative frequency dependence of Re(Z) was observed in all subjects and a significant correlation was found between S and Rrs (r = -0.80). "Inertance" was negative in 20 subjects and correlated negatively with Rrs (r = -0.61). C correlated with Crs (r = 0.64) and with 1/Rrs (r = 0.85). The ratio of C to Crs (mean +/- SD = 0.168 +/- 0.082) also correlated with 1/Rrs (r = 0.51). The main characteristics of the total impedance/frequency function could be simulated with a model featuring the upper airway wall (Zuaw) in parallel with the ventilatory system (Zrs). It is suggested that the differential change in Zuaw and Zrs with growth accounts for the marked frequency dependence of Re(Z) as well as the inaccurate estimation of both I and C in this population.
Airway Resistance↗
A new estimator to minimize the error due to breathing in the measurement of respiratory impedance.
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Humans↗
Density dependence of respiratory input and transfer impedances in humans.
Total respiratory input (Zin) and transfer (Ztr) impedances were obtained from 4 to 30 Hz in 10 healthy subjects breathing air and He-O2. Zin was measured by applying pressure oscillations around the head to minimize the upper airway shunt and Ztr by applying pressure oscillations around the chest. Ztr was analyzed with a six-coefficient model featuring airways resistance (Raw) and inertance (Iaw), alveolar gas compressibility, and tissue resistance, inertance, and compliance. Breathing He-O2 significantly decreased Raw (1.35 +/- 0.32 vs. 1.74 +/- 0.49 cmH2O.l-1.s in air, P less than 0.01) and Iaw (0.59 +/- 0.33 vs. 1.90 +/- 0.44 x 10(-2) cmH2O.l-1.s2), but, as expected, it did not change the tissue coefficients significantly. Airways impedance was also separately computed by combining Zin and Ztr data. This approach demonstrated similar variations in Raw and Iaw with the lighter gas mixture. With both analyses, however, the changes in Iaw were more than what was expected from the change in density. This indicates that factors other than gas inertance are included in Iaw and reveals the short-comings of the six-coefficient model to interpret impedance data.
Airway Resistance↗
Measurement of alveolar gas volume by ambient pressure changes in isolated lungs.
Alveolar gas volume (AGV) may be measured in humans (Peslin et al., J. Appl. Physiol. 62: 359-363, 1987) by applying very slow sinusoidal variations of ambient pressure (delta Pam) around the body and studying the relationship between delta Pam and the resulting gas displacement at the mouth (delta Vaw): AGVapc = (PB.delta Vaw)/(delta Pam.cos phi), where AGVapc is AGV measured by ambient pressure changes, PB is barometric minus alveolar water vapor pressure, and phi is the phase angle between Pam and Vaw. The applicability of this method to excised lungs at various transpulmonary pressures was assessed in six rabbit lungs and three dog lobes by reference to AGV measurements by He dilution (AGVdil) and by a volumetric method (AGVvol). Except in one instance, AGVapc did not change significantly when the frequency of delta Pam was varied from 0.02 to 0.2 Hz. AGVapc was highly correlated (P less than 0.001) to both AGVdil and AGVvol. It did not differ significantly from AGVdil (81.4 +/- 50.6 vs. 80.2 +/- 44.2 ml) and was only marginally higher than AGVvol (64.6 +/- 26.9 vs. 62.4 +/- 24.4 ml, P less than 0.05). We conclude that the method usually provides accurate results in excised lung preparations. Its main advantages are that it does not require manipulating the lung or changing its volume and that the measurement takes less than 1 min.
Animals↗