BioMedical Engineering OnLine | |
Forced oscillations and respiratory system modeling in adults with cystic fibrosis | |
Adma N Lima1  Alvaro C D Faria2  Agnaldo J Lopes1  José M Jansen1  Pedro L Melo3  | |
[1] Pulmonary Function Laboratory - Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil | |
[2] Biomedical Instrumentation Laboratory - Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil | |
[3] BioVasc Research Laboratory - Institute of Biology, State University of Rio de Janeiro, Rio de Janeiro, Brazil | |
关键词: Forced oscillation technique; Respiratory biomechanics; Adults; Cystic fibrosis; Diagnosis; Biomedical instrumentation; Respiratory system modeling; | |
Others : 1127596 DOI : 10.1186/s12938-015-0007-7 |
|
received in 2014-11-03, accepted in 2015-01-28, 发布年份 2015 | |
【 摘 要 】
Background
The Forced Oscillation Technique (FOT) has the potential to increase our knowledge about the biomechanical changes that occur in Cystic Fibrosis (CF). Thus, the aims of this study were to investigate changes in the resistive and reactive properties of the respiratory systems of adults with CF.
Methods
The study was conducted in a group of 27 adults with CF over 18 years old and a control group of 23 healthy individuals, both of which were assessed by the FOT, plethysmography and spirometry. An equivalent electrical circuit model was also used to quantify biomechanical changes and to gain physiological insight.
Results and discussion
The CF adults presented an increased total respiratory resistance (p < 0.0001), increased resistance curve slope (p < 0.0006) and reduced dynamic compliance (p < 0.0001). In close agreement with the physiology of CF, the model analysis showed increased peripheral resistance (p < 0.0005) and reduced compliance (p < 0.0004) and inertance (p < 0.005). Significant reasonable to good correlations were observed between the resistive parameters and spirometric and plethysmographic indexes. Similar associations were observed for the reactive parameters. Peripheral resistance, obtained by the model analysis, presented reasonable (R = 0.35) to good (R = 0.64) relationships with plethysmographic parameters.
Conclusions
The FOT adequately assessed the biomechanical changes associated with CF. The model used provides sensitive indicators of lung function and has the capacity to differentiate between obstructed and non-obstructed airway conditions. The FOT shows great potential for the clinical assessment of respiratory mechanics in adults with CF.
【 授权许可】
2015 Lima et al.; licensee BioMed Central.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150221015914231.pdf | 590KB | download | |
Figure 4. | 49KB | Image | download |
Figure 3. | 63KB | Image | download |
Figure 2. | 78KB | Image | download |
Figure 1. | 26KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
Figure 4.
【 参考文献 】
- [1]Foundation CF: Cystic Fibrosis Foundation Patient Registry. Annual data report to the center directors Cystic fibrosis foundation patient registry 2013.
- [2]Coe CI, Watson A, Joyce H, Pride NB: Effects of smoking on changes in respiratory resistance with increasing age. Clin Sci 1989, 76:487-94.
- [3]Oostveen E, MacLeod D, Lorino H, Farre R, Hantos Z, Desager K, et al.: The forced oscillation technique in clinical practice: methodology, recommendations and future developments. Eur Respir J 2003, 22:1026-41.
- [4]Bates JH, Irvin CG, Farre R, Hantos Z: Oscillation mechanics of the respiratory system. Compr Physiol 2011, 1:1233-72.
- [5]Kaczka DW, Dellaca RL: Oscillation mechanics of the respiratory system: applications to lung disease. Crit Rev Biomed Eng 2011, 39:337-59.
- [6]Ionescu CM, Desager K, Vandersteen G, De Keyser R: Respiratory mechanics in children with cystic fibrosis. Biomed Signal Proces 2014, 11:74-9.
- [7]Gangell CL, Horak F, Patterson HJ, Sly PD, Stick SM, Hall GL: Respiratory impedance in children with cystic fibrosis using forced oscillations in clinic. Eur Respir J 2007, 30:892-7.
- [8]Lebecque P, Stanescu D: Respiratory resistance by the forced oscillation technique in asthmatic children and cystic fibrosis patients. Eur Respir J 1997, 10:891-5.
- [9]Hellinckx J, Demedts M: No paradoxical bronchodilator response with forced oscillation technique in children with cystic fibrosis. Chest 1998, 113:55-9.
- [10]Pandit C, Valentin R, De Lima J, Robinson P, Fitzgerald D, van Asperen P, et al.: Effect of general anesthesia on pulmonary function and clinical status on children with cystic fibrosis. Pediatr Anesth 2014, 24:164-9.
- [11]Brennan S, Hall GL, Horak F, Moeller A, Pitrez PMC, Franzmann A, et al.: Correlation of forced oscillation technique in preschool children with cystic fibrosis with pulmonary inflammation. Thorax 2005, 60:159-63.
- [12]Faria AC, Lopes AJ, Jansen JM, Melo PL: Evaluating the forced oscillation technique in the detection of early smoking-induced respiratory changes. Biomed Eng Online 2009, 8:22. BioMed Central Full Text
- [13]Faria AC, Lopes AJ, Jansen JM, Melo PL: Assessment of respiratory mechanics in patients with sarcoidosis using forced oscillation: correlations with spirometric and volumetric measurements and diagnostic accuracy. Respiration 2009, 78:93-104.
- [14]Miranda IA, Dias Faria AC, Lopes AJ, Jansen JM, Lopes de Melo P: On the respiratory mechanics measured by forced oscillation technique in patients with systemic sclerosis. PLoS One 2013, 8:e61657.
- [15]Meraz EG, Nazeran H, Ramos CD, Nava P, Diong B, Goldman MD, et al.: Analysis of impulse oscillometric measures of lung function and respiratory system model parameters in small airway-impaired and healthy children over a 2-year period. Biomed Eng Online 2011, 10:21. BioMed Central Full Text
- [16]Diong B, Nazeran H, Nava P, Goldman M: Modeling human respiratory impedance. Comparing the best method with the least estimation errors. IEEE Eng Med Biol Mag 2007, 26:48-55.
- [17]Horsley A, Siddiqui S: Putting lung function and physiology into perspective: cystic fibrosis in adults. Respirology 2014, 20(1):33-45.
- [18]Rosenstein BJ, Cutting GR: The diagnosis of cystic fibrosis: a consensus statement. Cystic fibrosis foundation consensus panel. J Pediatr 1998, 132:589-95.
- [19]Farrell PM, Rosenstein BJ, White TB, Accurso FJ, Castellani C, Cutting GR, et al.: Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic fibrosis foundation consensus report. J Pediatr 2008, 153:S4-14.
- [20]Knudson RJ, Lebowitz MD, Holberg CJ, Burrows B: Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis 1983, 127:725-34.
- [21]Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al.: Standardisation of spirometry. Eur Respir J 2005, 26:319-38.
- [22]Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al.: Interpretative strategies for lung function tests. Eur Respir J 2005, 26:948-68.
- [23]Hyatt RE, Scandon PD, Nakamura M: Interpretation of pulmonary function tests. Lippincott-Raven, Phyladelphia; 1997.
- [24]Goldman HI, Becklake MR: Respiratory function tests - normal values at median altitudes and the prediction of normal results. Am Rev Tuberc Pulm 1959, 79:457-67.
- [25]de Melo PL, Werneck MM, Giannella-Neto A: New impedance spectrometer for scientific and clinical studies of the respiratory system. Rev Sci Instrum 2000, 71:2867-72.
- [26]Farre R, Navajas D, Peslin R, Rotger M, Duvivier C: A correction procedure for the asymmetry of differential pressure transducers in respiratory impedance measurements. Ieee T Bio-Med Eng 1989, 36:1137-40.
- [27]Cauberghs M, Vandewoestijne KP: Calibration procedure of the forced oscillation technique. Eur Respir Rev 1991, 1(3):158-62.
- [28]Lorino AM, Zerah F, Mariette C, Harf A, Lorino H: Respiratory resistive impedance in obstructive patients: linear regression analysis vs viscoelastic modelling. Eur Respir J 1997, 10:150-5.
- [29]Peslin R, Marchal F, Duvivier C, Ying Y, Gallina C: Evaluation of a modified head generator for respiratory impedance measurements. Eur Respir Rev 1991, 1(3):140-5.
- [30]Pride NB: Forced oscillation techniques for measuring mechanical properties of the respiratory system. Thorax 1992, 47:317-20.
- [31]Ying Y, Peslin R, Duvivier C, Gallina C, Felicio da Silva J: Respiratory input and transfer mechanical impedances in patients with chronic obstructive pulmonary disease. Eur Respir J 1990, 3:1186-92.
- [32]Nagels J, Landser FJ, van der Linden L, Clement J, Van de Woestijne KP: Mechanical properties of lungs and chest wall during spontaneous breathing. J Appl Physiol 1980, 49:408-16.
- [33]MacLeod D, Birch M: Respiratory input impedance measurement: forced oscillation methods. Med Biol Eng Comput 2001, 39:505-16.
- [34]Lorino AM, Atlan G, Lorino H, Zanditenas D, Harf A: Influence of posture on mechanical parameters derived from respiratory impedance. Eur Respir J 1992, 5:1118-22.
- [35]Oostveen E, Peslin R, Gallina C, Zwart A: Flow and volume dependence of respiratory mechanical-properties studied by forced oscillation. J Appl Physiol 1989, 67:2212-8.
- [36]Dawson B, Trapp RG: Basic & Clinical Biostatistics. 3rd edition. McGraw-Hill, London, England; 2001.
- [37]Andrade EF, Fonseca DLO, Abreue Silva FA, Menna-Barreto SS: Spirometry evolution assessment of cystic fibrosis. J Pneumol 2001, 27:130-1.
- [38]Chmiel JF, Konstan MW: Inflammation and anti-inflammatory therapies for cystic fibrosis. Clin Chest Med 2007, 28:331.
- [39]Regamey N, Ochs M, Hilliard TN, Muhlfeld C, Cornish N, Fleming L, et al.: Increased airway smooth muscle mass in children with asthma, cystic fibrosis, and non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med 2008, 177:837-43.
- [40]Yankaskas JR, Marshall BC, Sufian B, Simon RH, Rodman D: Cystic fibrosis adult care - consensus conference report. Chest 2004, 125:1S-39.
- [41]Cavalcanti JV, Lopes AJ, Jansen JM, Melo PL: Detection of changes in respiratory mechanics due to increasing degrees of airway obstruction in asthma by the forced oscillation technique. Respir Med 2006, 100:2207-19.
- [42]Di Mango AM, Lopes AJ, Jansen JM, Melo PL: Changes in respiratory mechanics with increasing degrees of airway obstruction in COPD: detection by forced oscillation technique. Respir Med 2006, 100:399-410.
- [43]Bhalla M, Turcios N, Aponte V, Jenkins M, Leitman BS, Mccauley DI, et al.: Cystic-fibrosis - scoring system with thin-section Ct. Radiology 1991, 179:783-8.
- [44]Clement J, Landser FJ, Vandewoestijne KP: Total resistance and reactance in patients with respiratory complaints with and without airways obstruction. Chest 1983, 83:215-20.
- [45]Hellinckx J, De Boeck K, Demedts M: No paradoxical bronchodilator response with forced oscillation technique in children with cystic fibrosis. Chest 1998, 113:55-9.
- [46]Ionescu CM: The human respiratory system: an analysis of the interplay between anatomy, structure, breathing and fractal dynamics. Springer, London; 2013.
- [47]Hantos Z, Daroczy B, Suki B, Nagy S, Fredberg JJ: Input impedance and peripheral inhomogeneity of dog lungs. J Appl Physiol 1992, 72:168-78.
- [48]Bates JHT: Lung mechanics: an inverse modeling approach. Cambridge University Press, Cambridge; 2009.
- [49]Michaelson ED, Grassman ED, Peters WR: Pulmonary mechanics by spectral analysis of forced random noise. J Clin Invest 1975, 56:1210-30.
- [50]Hayes DA, Pimmel RL, Fullton JM, Bromberg PA: Detection of respiratory mechanical dysfunction by forced random noise impedance parameters. Am Rev Respir Dis 1979, 120:1095-100.
- [51]Ionescu C, de Keyser R: Parametric models for characterizing respiratory input impedance. J Med Eng Technol 2008, 32:315-24.
- [52]Iwatsubo Y, Lorino H, Hubert C, Duvivier C, Peslin R, Pham QT, et al.: Measurement of respiratory impedance by forced oscillation - comparison of the standard and head generator methods. Eur Respir J 1994, 7:901-6.
- [53]Dellaca RL, Duffy N, Pompilio PP, Aliverti A, Koulouris NG, Pedotti A, et al.: Expiratory flow limitation detected by forced oscillation and negative expiratory pressure. Eur Respir J 2007, 29:363-74.
- [54]Kelly VJ, Sands SA, Harris RS, Venegas JG, Brown NJ, Stuart-Andrews CR, et al.: Respiratory system reactance is an independent determinant of asthma control. J Appl Physiol 2013, 115:1360-9.
- [55]Fuchs SI, Gappa M, Eder J, Unsinn KM, Steinkamp G, Ellemunter H: Tracking lung clearance index and chest CT in mild cystic fibrosis lung disease over a period of three years. Respir Med 2014, 108:865-74.
- [56]Gustafsson PM, Robinson PD, Gilljam M, Lindblad A, Houltz BK: Slow and fast lung compartments in cystic fibrosis measured by nitrogen multiple-breath washout. J Appl Physiol 2014, 117:720-9.
- [57]Vanderhelst E, De Meirleir L, Schuermans D, Malfroot A, Vincken W, Verbanck S: Evidence of an acinar response following treatment for exacerbation in adult patients with cystic fibrosis. Respiration 2014, 87:492-8.
- [58]Lutchen KR, Jackson AC: Statistical measures of parameter estimates from models fit to respiratory impedance data: emphasis on joint variabilities. IEEE Trans Biomed Eng 1986, 33:1000-9.
- [59]Lutchen KR, Jackson AC: Reliability of parameter estimates from models applied to respiratory impedance data. J Appl Physiol 1987, 62:403-13.
- [60]Bates JHT: Lung mechanics: an inverse modeling approach. Cambridge University Press, New York, United States of America; 2009.