Model analysis of multiple breath nitrogen washout data: robustness to variations in breathing pattern

We recently developed a model-based method for analyzing multiple breath nitrogen washout data that does not require identification of Phase-III. In the present study, we assessed the effect of irregular breathing patterns on the intra-subject variabilities of the model parameters. Nitrogen fraction at the mouth was measured in 18 healthy and 20 asthmatic subjects during triplicate performances of multiple breath nitrogen washout, during controlled (target tidal volume 1 L at 8-12 breaths per minute) and free (unrestricted) breathing. The parameters S_cond, S_acin and functional residual capacity (FRC) were obtained by conventional analysis of the slope of Phase-III. Fitting the model to the washout data provided functional residual capacity (FRC_M), dead space volume (V_D), the coefficient of variation of regional specific ventilation ([Formula: see text]), and the model equivalent of S_acin (S_acin-M). Intra-participant coefficients of variation for the model parameters for both health and asthma were FRC_M < 5.2%, V_D < 5.4%, [Formula: see text] < 9.0%, and S_acin-M < 45.6% for controlled breathing, and FRC_M < 4.6%, V_D < 5.3%, [Formula: see text] < 13.2%, and S_acin-M < 103.2% for free breathing. The coefficients of variation limits for conventional parameters were FRC < 6.1%, with S_cond < 73.6% and S_acin < 49.2% for controlled breathing and S_cond < 35.0% and S_acin < 74.4% for free breathing. The model-fitting approach to multiple breath nitrogen washout analysis provides a measure of regional ventilation heterogeneity in [Formula: see text] that is less affected by irregularities in the breathing pattern than its corresponding Phase-III slope analysis parameter S_cond.