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Communications to the Editor |

Assessing Respiratory Resistance Without Spirometry FREE TO VIEW

Dominic MacLeod, MD
Author and Funding Information

London Chest Hospital, London, UK

Correspondence to: Dominic MacLeod, MD, Thoracic Department, London Chest Hospital, Bonner Road, London E2 9JX UK; e-mail: dpjmacleod@aol.com



Chest. 1999;116(1):268. doi:10.1378/chest.116.1.268
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Published online

To the Editor:

The paper by Ducharme and Davis (June 1998)1 highlights the usefulness of forced oscillation methods for assessing respiratory resistance noninvasively in young or acutely unwell subjects who are unable to perform spirometry. The authors stated that there is only one previous report2estimating the intraclass correlation coefficient for repeated measures using the technique. In fact, this is not the case. Using the Siregnost FD5 10-Hz device (Siemens; Erlangen, Germany), I found correlation coefficients of 0.77 in the respiratory resistance averaged during quiet breathing in 26 healthy subjects across three separate visits.3 Gating to end-inspiration, these intraclass correlation results improved slightly to 0.80, then at end-expiration to 0.78. In asthmatics and in patients with COPD studied via a tracheostoma, gating to the respiratory phase also had a marked influence on the responsiveness of the respiratory resistance, with the greatest responses seen at end-expiration at 10 Hz after bronchodilatation.4

Ducharme and Davis highlight the particular usefulness of measurements of resistance, especially when made between 5 to 10 Hz, in terms of their excellent correlation to the FEV1 and other markers of clinical response to bronchodilatation. Another important need for this technique is to standardize the test frequencies and sampling modes used in making these measurements. This should help to further improve the cross-comparisons that can be made among these important studies.

References

Ducharme, FM, Davis, GM (1998) Respiratory resistance in the emergency department: a reproducible and responsive measure of asthma severity.Chest113,1566-1572. [PubMed] [CrossRef]
 
Wouters, EFM Total respiratory impedance measurement by forced oscillations: a noninvasive method to assess bronchial response in occupational medicine.Exp Lung Res1990;16,25-40. [PubMed]
 
MacLeod D. Use of a within-breath forced oscillation technique: development and clinical applications. Doctoral thesis. London, UK: University of London, 1997.
 
MacLeod, D Effect of salbutamol on input impedance measurements in laryngectomized subjects during quiet tidal breathing [abstract]. Thorax. 1996;;51(suppl) ,.:A46
 

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References

Ducharme, FM, Davis, GM (1998) Respiratory resistance in the emergency department: a reproducible and responsive measure of asthma severity.Chest113,1566-1572. [PubMed] [CrossRef]
 
Wouters, EFM Total respiratory impedance measurement by forced oscillations: a noninvasive method to assess bronchial response in occupational medicine.Exp Lung Res1990;16,25-40. [PubMed]
 
MacLeod D. Use of a within-breath forced oscillation technique: development and clinical applications. Doctoral thesis. London, UK: University of London, 1997.
 
MacLeod, D Effect of salbutamol on input impedance measurements in laryngectomized subjects during quiet tidal breathing [abstract]. Thorax. 1996;;51(suppl) ,.:A46
 
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