Kraemer, Richard; Smith, Hans-Jürgen; Reinstaedtler, Juergen; Gallati, Sabina; Matthys, Heinrich (2024). Predicting parameters of airway dynamics generated from inspiratory and expiratory plethysmographic airway loops, differentiating subtypes of chronic obstructive diseases. BMJ Open Respiratory Research, 11(1) BMJ Publishing Group: Open Access 10.1136/bmjresp-2023-002142
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BACKGROUND
The plethysmographic shift volume-flow loop (sRaw-loop) measured during tidal breathing allows the determination of several lung function parameters such as the effective specific airway resistance (sReff), calculated from the ratio of the integral of the resistive aerodynamic specific work of breathing (sWOB) and the integral of the corresponding flow-volume loop. However, computing the inspiratory and expiratory areas of the sRaw-loop separately permits the determination of further parameters of airway dynamics. Therefore, we aimed to define the discriminating diagnostic power of the inspiratory and expiratory sWOB (sWOBin, sWOBex), as well as of the inspiratory and expiratory sReff (sReff IN and sReff EX), for discriminating different functional phenotypes of chronic obstructive lung diseases.
METHODS
Reference equations were obtained from measurement of different databases, incorporating 194 healthy subjects (35 children and 159 adults), and applied to a collective of 294 patients with chronic lung diseases (16 children with asthma, aged 6-16 years, and 278 adults, aged 17-92 years). For all measurements, the same type of plethysmograph was used (Jaeger Würzburg, Germany).
RESULTS
By multilinear modelling, reference equations of sWOBin, sWOBex, sReff IN and sReff EX were derived. Apart from anthropometric indices, additional parameters such as tidal volume (VT), the respiratory drive (P0.1), measured by means of a mouth occlusion pressure measurement 100 ms after inspiration and the mean inspiratory flow (VT/TI) were found to be informative. The statistical approach to define reference equations for parameters of airway dynamics reveals the interrelationship between covariants of the actual breathing pattern and the control of breathing.
CONCLUSIONS
We discovered that sWOBin, sWOBex, sReff IN and sReff EX are new discriminating target parameters, that differentiate much better between chronic obstructive diseases and their subtypes, especially between chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap (ACO), thus strengthening the concept of precision medicine.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
08 Faculty of Science > School of Biomedical and Precision Engineering (SBPE) 08 Faculty of Science > School of Biomedical and Precision Engineering (SBPE) > Smart Surgical Instruments and Medical Devices |
UniBE Contributor: |
Kraemer, Richard |
Subjects: |
500 Science > 570 Life sciences; biology |
ISSN: |
2052-4439 |
Publisher: |
BMJ Publishing Group: Open Access |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
11 Mar 2024 09:01 |
Last Modified: |
09 Apr 2024 10:37 |
Publisher DOI: |
10.1136/bmjresp-2023-002142 |
PubMed ID: |
38460977 |
Uncontrolled Keywords: |
Asthma COPD Pathology Equipment Evaluations Lung Physiology Respiratory Function Test |
BORIS DOI: |
10.48350/194096 |
URI: |
https://boris.unibe.ch/id/eprint/194096 |
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