Dependence of human respiratory thermal washout on extrathoracic airway conditions

Thermal washout curves have been proposed as noninvasive tools for analysing lower airway dimensions and pulmonary blood flow, but how upper airway heat transfer affects these washout curves is unclear. The present study was designed to compare extrathoracic and tracheobronchial contributions to thermal washout curves. Respiratory frequency, air ambient temperature, and body core temperature (tc) were varied in six male subjects before and after immersion in cold (1.1 degrees C) water for up to 2 h under three conditions: 1) control: ambient temperature (tamb) = 25 degrees C, rectal temperature change (delta tre) = 0 degrees C; 2) pre-immersion: tamb = 4 degrees C, delta tre = 0 degrees C; and 3) post-immersion: tamb = 25 degrees C, delta tre = -0.7 degrees C. Both peak expiratory nasal (tpn) and oral (tpo) airstream temperatures were measured. Each subject was tested twice. Expiratory tpo was generally higher than tpn in all conditions. Increasing breathing rates lowered tpn and tpo in the control and cold air environments. Orifice temperatures, which are presumed to reflect upper airway blood temperatures, correlated with both tpn and tpo. Lowering tc had no effect on washout curves during quiet breathing and affected only tpn during rapid breathing. The results suggest that while tracheobronchial conditions may contribute to thermal washout curves, extrathoracic conditions predominate. Strong correlations between orifice temperatures, peak expiratory nasal temperatures and peak expiratory oral temperature demonstrate the dominant role of upper airway heat exchange in determining thermal washout curves.