Document Detail

Detecting upper airway obstruction in patients with tracheal stenosis.
MedLine Citation:
PMID:  20466805     Owner:  NLM     Status:  MEDLINE    
We propose a forced oscillation test modality for detecting upper airway obstruction (UAO) as an alternative to spirometric UAO indices in patients with tracheal stenosis. From oscillometry performed at different breathing flow rates, airway resistance at 5 Hz was determined at 0.5 l/s (R), and flow dependence of resistance was computed as the regression slope of resistance vs. flow up to 1 l/s (Delta R/Delta V). It was first verified by measurement in 10 normal subjects and 10 patients with chronic obstructive pulmonary disease that Delta R/Delta V was unaffected by the presence of peripheral airway obstruction and that external orifices (with lumen area down to 28 mm(2)) induced marked increases in R and Delta R/Delta V. Ten patients eligible for tracheal dilatation underwent spirometry and impulse oscillometry before and after intervention. Considering the lumen area of tracheal stenosis in the patients (42 +/- 28 mm(2), represented as the mean +/- SD), the R and Delta R/Delta V increases were of similar magnitude to those predicted by the external orifices. In addition, R (r = -0.68; P = 0.001) and Delta R/Delta V (r = -0.65; P = 0.001) showed better correlations with minimal tracheal lumen than any spirometric UAO index. Delta R/Delta V, but not R, showed a consistent return to normal after intervention in the stenosis patients. We conclude that the forced oscillation test at different breathing flow rates up to 1 l/s provides a measure of UAO, namely flow dependence of resistance Delta R/Delta V, which can signal a critical level of tracheal stenosis and is not confounded by the presence of concomitant peripheral airway obstruction.
Sylvia Verbanck; Tom de Keukeleire; Daniël Schuermans; Marc Meysman; Walter Vincken; Bruce Thompson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-13
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  109     ISSN:  1522-1601     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-30     Completed Date:  2010-10-14     Revised Date:  2013-09-26    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol (1985)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  47-52     Citation Subset:  IM    
Respiratory Division, University Hospital, Vrije Universiteit Brussel, Brussels, Belgium.
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MeSH Terms
Aged, 80 and over
Airway Obstruction / diagnosis*,  physiopathology*,  surgery
Airway Resistance*
Forced Expiratory Volume
Middle Aged
Pulmonary Disease, Chronic Obstructive / physiopathology*,  surgery
Tracheal Stenosis / physiopathology*,  surgery
Young Adult

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