Evaluation of nasal prongs for estimating nasal flow

Nasal prongs (NP) connected to a pressure transducer have been suggested as a useful alternative for measuring nasal flow in sleep apnea/hypopnea patients. However, flow measured with NP is expected to be nonlinear. The aim of the present study was to analyze and correct the nonlinearity of nasal flow measurements with NP (VNP). Nasal flow was simultaneously measured with a pneumotachograph (PNT; V) and (NP; VNP) in six healthy subjects during 60 s of breathing at different tidal volumes. Nonlinearity of VNP was assessed by fitting separately, for inspiration and expiration, a Rorher-model equation (VNP x K1 x V + K2 x V2). In addition, we fitted the data to a simpler nonlinear quadratic model (P = K x V2). The main findings were: (1) an excellent fit of the Rorher equation to measured data in all cases; (2) although differences in the Rorher equation coefficients between inspiration and expiration were observed, they were not statistically significant; (3) a substantial intersubject variability was found; and finally, (4) the square root of VNP acceptably fitted the nasal flow data measured by PNT (V) in most cases. We conclude that in order to quantitatively assess nasal flow with NP, data should be corrected for their nonlinear pressure-flow relationships and, that the square root of the flow signal measured with NP is the simplest method of correcting for the observed nonlinearity.