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Effect of nasal airway nonlinearities on oscillometric resistance measurements in infants

Abstract : Oscillometric measurements of respiratory system resistance (R-rs) in infants are usually made via the nasal pathways, which not only significantly contribute to overall R-rs but also introduce marked flow (V')-dependent changes. We employed intrabreath oscillometry in casts of the upper airways constructed from head CT images of 46 infants. We examined oscillometric nasal resistance (R-n) in upper airway casts with no respiratory flow (R-0) and the effect of varying V' on R-n by simulating tidal breathing. A characteristic nonlinear relationship was found between R-n and V', exhibiting segmental linearity and a prominent breakpoint (V'(bp)) after log-log transformation. V'(bp) was linearly related to the preceding value of end-expiratory volume acceleration (V `'(eE); on average r(2) = 0.96, P < 0.001). R-n depended on V', and R at end-expiration (R-eE) showed a strong dependence on V `'(eE) in every cast (r(2) = 0.994, P < 001) with considerable interindividual variability. The intercept of the linear regression of R-eE versus V `'(eE) was found to be a close estimate of R-0. These findings were utilized in reanalyzed R-rs data acquired in vivo in a small group of infants (n = 15). Using a graphical method to estimate R-0 from R-eE, we found a relative contribution of V'-dependent nonlinearity to total resistance of up to 33%. In conclusion, we propose a method for correcting the acceleration-dependent nonlinearity error in R-eE. This correction can be adapted to estimate R-0 from a single intrabreath oscillometric measurement, which would reduce the masking effects of the upper airways on the changes in the intrathoracic resistance. NEW & NOTEWORTHY Oscillometric measurements of respiratory system resistance (R-rs) in infants are usually made via the nasal pathways, which not only significantly contribute to overall R-rs but also introduce marked flow acceleration-dependent distortions. Here, we propose a method for correcting flow acceleration-dependent nonlinearity error based on in vitro measurements in 3D-printed upper airway casts of infants as well as in vivo measurements. This correction can be adapted to estimate R-rs from a single intrabreath oscillometric measurement.
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Soumis le : vendredi 4 février 2022 - 16:20:17
Dernière modification le : vendredi 8 juillet 2022 - 10:08:15

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Bence L. Radics, Gergely Makan, Thibault Coppens, Nicolas André, Cyril Page, et al.. Effect of nasal airway nonlinearities on oscillometric resistance measurements in infants. Journal of Applied Physiology, American Physiological Society, 2020, 129 (3), pp.591-598. ⟨10.1152/japplphysiol.00128.2020⟩. ⟨hal-03558215⟩

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