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A Reversible, Non-invasive Method for Airway Resistance Measurements and Bronchoalveolar Lavage Fluid Sampling in Mice

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Airway resistance by the interrupter technique: which algorithm for measuring pressure?

C S Pao¹, M J R Healy, S A McKenzie

¹Department of Respiratory Paediatrics, Royal London Hospital, Barts and London NHS Trust, London, UK.

Pediatric Pulmonology

|December 18, 2003

Summary

Different algorithms for measuring airway resistance (Rint) significantly impact results. While bronchodilator response is similar on average, individual measurements vary, necessitating consistent algorithm use.

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Area of Science:

Pediatric Pulmonology
Respiratory Physiology
Medical Device Technology

Background:

Airway resistance (Rint) measurement is crucial for diagnosing respiratory conditions in children.
Commercial devices use various algorithms to estimate pressure changes during Rint measurement.
Understanding algorithmic differences is key to accurate and reproducible Rint assessment.

Purpose of the Study:

To investigate and quantify the differences in Rint measurements obtained using distinct algorithms.
To evaluate the impact of these algorithms on bronchodilator response (BDR) measurements.
To provide recommendations for standardized Rint measurement protocols.

Main Methods:

Compared Rint and BDR in 39 wheezing children (2-5 years old) using four different algorithms for pressure change estimation.
Algorithms included back-extrapolation (70/30 msec, 15 msec), two-thirds interruption, and near end-interruption.
Flow was measured immediately prior to airway interruption.

Main Results:

Significant differences in Rint values were observed across the four algorithms, ranging from 1.21 to 1.71 kPa·l⁻¹·sec.
On average, BDR measurements showed no significant difference between algorithms (29.9% to 32.9%).
Individual BDR measurements could vary by up to 40% depending on the algorithm used.

Conclusions:

The choice of algorithm significantly influences Rint measurements in children.
While average BDR is algorithm-independent, individual variability necessitates careful consideration of the algorithm.
Laboratories should clearly state their chosen algorithm for consistent longitudinal and group data analysis.