Assessing Change in Airway Calibre—Measurement of Airway Resistance

  • A. E. Tattersfield
  • I. M. Keeping
Chapter

Abstract

The need for tests to assess bronchodilatation or bronchoconstriction is of considerable importance in respiratory pharmacology. It can be approached either by measuring flow during conditions of maximal effort as discussed in the previous paper or by measurements of airway resistance under low flow conditions. Since the physiological basis of these two types of test is somewhat different they do not necessarily give the same information although in most situations there is general concordance. Each test is appropriate to different situations and the purpose of this article is to outline the main physiological factors underlying measurements of airway resistance and discuss the situations where these measurements may be more appropriate than measurements of maximum flow.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. BAIER, H., WANNER, A., ZARZECKI, S. & SACKNER, M.A. (1977). Relationships among glottis opening, respiratory flow and upper airway resistance in humans. J. appl. Physiol. Respirat. Environ. Exercise Physiol., 43, 603–611.Google Scholar
  2. BARTER, C.E. & CAMPBELL, A.H. (1973). Comparison of airways resistance measurements during panting and quiet breathing. Respiration, 30, 1–11.PubMedCrossRefGoogle Scholar
  3. BENSON, M.K. (1975). Bronchial hyperreactivity. Br. J. Dis. Chest, 69, 227–239.PubMedCrossRefGoogle Scholar
  4. BLIDE, R.W., KERR, H.D. & SPICER, W.S. Jr. (1964). Measurement of upper and lower airway resistance and conductance in man. J. appl. Physiol., 19, 1059–1069.PubMedGoogle Scholar
  5. BOUHUYS, A. & van de WOESTIJNE, K.P. (1971). Mechanical consequences of airway smooth muscle relaxation. J. appl. Physiol., 30, 670–676.PubMedGoogle Scholar
  6. BRISCOE, W.A. & DuBOIS, A.B. (1958). The relationship between airway resistance, airway conductance and lung volume in subjects of different age and body size. J. clin. Invest., 37, 1279–1285.PubMedPubMedCentralCrossRefGoogle Scholar
  7. BRODY, A.W., WANDER, H.J., O’HALLORAN, P.S., CONOLLY, J.J. & SCHWERTLEY, F.W. (1963). Correlations, normal standards and interdependence in tests of ventilatory strength and mechanics. Am. Rev. resp. Dis., 89, 214–235.Google Scholar
  8. BUTLER, J., CARO, C.G., ALCALA, R. & DuBOIS, A.B. (1960). Physiological factors affecting airway resistance in normal subjects and in patients with obstructive respiratory disease. J. clin. Invest., 39, 584–591.PubMedPubMedCentralCrossRefGoogle Scholar
  9. COMROE, J.H., BOTELHO, S.Y. & DuBOIS, A.B. (1959). Design of a body Plethysmograph for studying cardiopulmonary physiology. J. appl. Physiol., 14, 439–444.PubMedGoogle Scholar
  10. DAVIES, D.S. (1975). Pharmacokinetics of inhaled substances. Postgrad. med. J., 51, Suppl. 7, 69–75.PubMedGoogle Scholar
  11. DuBOIS, A.B., BOTELHO, S.Y. & COMROE, J.H. Jr., (1956). A new method for measuring airway resistance in man using a body plethysmograph: values in normal subjects and in patients with respiratory disease. J. clin. Invest., 35, 327–335.PubMedPubMedCentralCrossRefGoogle Scholar
  12. DUBOIS, A.B., BRODY, AW., LEWIS, D.H. & BURGESS, B.F. Jr. (1956). Oscillation mechanics of lungs and chest in man. J. appl. Physiol., 8, 587–594.PubMedGoogle Scholar
  13. FERRIS, B.G. Jr., MEAD, J. & OPIE, L.H. (1964). Partitioning of respiratory flow resistance in man. J. appl. Physiol., 19, 653–658.PubMedGoogle Scholar
  14. FISHER, A.B., DuBOIS, A.B. & HYDE, R.W. (1968). Evaluation of the forced oscillation technique for the determination of resistance to breathing. J. clin. Invest., 47, 2045–2057.PubMedPubMedCentralCrossRefGoogle Scholar
  15. FRANK, N.R., MEAD, J. & FERRIS, B.G. Jr. (1957). The mechanical behaviour of the lungs in healthy elderly persons. J. clin. Invest., 36, 1680–1687.PubMedPubMedCentralCrossRefGoogle Scholar
  16. FRANK, N.R., MEAD, J. & WHITTENBERGER, J.L. (1971). Comparative sensitivity of four methods for measuring changes in respiratory flow resistance in man. J. appl. Physiol., 31, 934–938.PubMedGoogle Scholar
  17. FREEDMAN, S. (1979). Lung volumes. Br. J. clin. Pharmac., 8, 99–107.CrossRefGoogle Scholar
  18. FREEDMAN, S., TATTERSFIELD, A.E. & PRIDE, N.B. (1975). Changes in lung mechanics during asthma induced by exercise. J. appl. Physiol., 38, 974–982.PubMedGoogle Scholar
  19. GAYRARD, P., OREHEK, J., GRIMAUD, C. & CHARPIN, J. (1975). Bronchoconstrictor effects of a deep inspiration in patients with asthma. Am. Rev. resp. Dis., 111, 433–439.PubMedGoogle Scholar
  20. GOLD, W.M., KAUFMAN, H.S. & NADEL, J.A. (1967). Elastic recoil of the lungs in chronic asthmatic patients before and after therapy. J. appl. Physiol., 23, 433–438.PubMedGoogle Scholar
  21. GOLDMAN, M., KNUDSON, R.J., MEAD, J., PETERSON, N., SCHWABER, J.R. & WOHL, M.E. (1970). A simplified measurement of respiratory resistance by forced oscillation. J. appl. Physiol., 28, 113–116.PubMedGoogle Scholar
  22. GRAHAM, W.G.B., HEIME, E. & CONSTANTINE, H.P. (1967). Measurement of airway variation and bronchial reactivity in normal and asthmatic subjects. Am. Rev. resp. Dis., 96, 266–274.PubMedGoogle Scholar
  23. GRIBBIN, H.R., BALDWIN, C.J. & TATTERSFIELD, A.E. (1979). Quantitative assessment of bronchial β-adrenoceptor blockade in man. Br. J. clin. Pharmac., 7, 551–556.CrossRefGoogle Scholar
  24. GRIMBY, G., TAKISHIMA, T., GRAHAM, W., MACKLEM, P. & MEAD, J. (1968). Frequency dependence of flow resistance in patients with obstructive lung disease. J. clin. Invest., 47, 1455–1465.PubMedPubMedCentralCrossRefGoogle Scholar
  25. GUYATT, A.R. & ALPERS, J.H. (1968). Factors affecting airways conductance; a study of 752 working men. J. appl. Physiol., 24, 310–316.PubMedGoogle Scholar
  26. GUYATT, A.R., ALPERS, J.H., HILL, I.D. & BRAMLEY, A.C. (1967). Variability of Plethysmograph measurements of airway resistance in man. J. appl. Physiol., 22, 383–389.PubMedGoogle Scholar
  27. HARVEY, J.E. & TATTERSFIELD, A.E. (1978). Beta adrenergic responsiveness in asthma. Clin. Sci., 54, 24–25P.CrossRefGoogle Scholar
  28. HOGG, J.C., MACKLEM, P.T. & THURLBECK, W.M. (1968). Site and nature of airway obstruction in chronic obstructive lung disease. New Engl. J. Med., 278, 1355–1360.PubMedCrossRefGoogle Scholar
  29. HOLGATE, S.T., BALDWIN, C.J. & TATTERSFIELD, A.E. (1977). β-Adrenergic agonist resistance in normal human airways. Lancet, i, 375–377.CrossRefGoogle Scholar
  30. HRUBY, J. & BUTLER, J. (1975). Variability of routine pulmonary function tests. Thorax, 30, 548–553.PubMedPubMedCentralCrossRefGoogle Scholar
  31. HYATT, R.E. & WILCOX, R.E. (1961). Extrathoracic airway resistance in man. J. appl. Physiol., 16, 326–330.PubMedGoogle Scholar
  32. HYATT, R.E., ZIMMERMAN, I.R., PETERS, G.M. & SULLIVAN, W.J. (1970). Direct write out of total respiratory resistance. J. appl. Physiol., 28, 675–678.PubMedGoogle Scholar
  33. INGRAM, RH. Jr., WELLMAN, J.J., McFADDEN, E.R. & MEAD, J. (1977). Relative contributions of large and small airways to flow limitation in normal subjects before and after atropine and isoproterenol. J. clin. Invest., 59, 696–703.PubMedPubMedCentralCrossRefGoogle Scholar
  34. JAEGER, M.J. & OTIS, A.B. (1964). Measurement of airway resistance with a volume displacement body Plethysmograph. J. appl. Physiol., 19, 813–820.PubMedGoogle Scholar
  35. JIEMSRIPONG, K., HYATT, R.E. & OFFORD, K.P. (1976). Total respiratory resistance by forced oscilation in normal subjects. Mayo Clin. Proc., 51, 553–556.PubMedGoogle Scholar
  36. LANDAU, L.I. & PHELAN, P.D. (1973). Evaluation of two techniques for measurement of respiratory resistance by forced oscillation. Thorax, 28, 136–141.PubMedPubMedCentralCrossRefGoogle Scholar
  37. LEAVER, D.G. TATTERSFIELD, A.E. & PRIDE, N.B. (1973). Contributions of loss of lung recoil and of enhanced airways collapsibility to the airflow obstruction of chronic bronchitis and emphysema. J. clin. Invest., 52, 2117–2118.PubMedPubMedCentralCrossRefGoogle Scholar
  38. LINDERHOLM, H. (1963). Lung mechanics in sitting and horizontal postures studied by body Plethysmographic methods. Am. J. Physiol., 204, 85–91.Google Scholar
  39. LORD, P.W. & BROOKS, A.G.F. (1977). A comparison of manual and automated methods of measuring airway resistance and thoracic gas volume. Thorax, 32, 60–66.PubMedPubMedCentralCrossRefGoogle Scholar
  40. LORD, P.W., BROOKS, A.G.F. & EDWARDS, J.M. (1977). Variation between observers in the estimation of airway resistance and thoracic gas volume. Thorax, 32, 67–70.PubMedPubMedCentralCrossRefGoogle Scholar
  41. LORD, P.W. & EDWARDS, J.M. (1978). Variation in airways resistance when defined over different ranges of airflow. Thorax, 33, 401–405.PubMedPubMedCentralCrossRefGoogle Scholar
  42. MACKAY, A.D., MUSTCHIN, C.P. & STERLING, G.M. (1978). Responses of asthmatic and normal bronchi to maximum respiratory manoeuvres. Bull. Eur. Physiopath. respiratoire, 14, 199P.Google Scholar
  43. MANSELL, A., LEVISON, H., KRUGER, K. & TRIPP, T.L. (1972). Measurement of respiratory resistance in children by forced oscillations. Am. Rev. resp. Dis., 106, 710–714.PubMedCrossRefGoogle Scholar
  44. MARSHALL, R. & DuBOIS, A.B. (1956). The measurement of the viscous resistance of the lung tissues in normal man. Clin. Sci., 15, 161–170.PubMedGoogle Scholar
  45. McDERMOTT, M. & COLLINS, M.M. (1965). Acute effects of smoking on lung airways resistance in normal and bronchitic subjects. Thorax, 20, 562–569.PubMedPubMedCentralCrossRefGoogle Scholar
  46. McFADDEN, E.R. Jr., NEWTON-HOWES, J. & PRIDE, N.B. (1970). Acute effects of inhaled isoproterenol on the mechanical characteristics of the lungs in normal man. J. clin. Invest., 49, 779–790.PubMedPubMedCentralCrossRefGoogle Scholar
  47. MEAD, J. (1969). Contribution of compliance of airways to frequency dependent behaviour of lungs. J. appl. Physiol., 26, 670–673.PubMedGoogle Scholar
  48. MEAD, J. & MILIC-EMILI, J. (1964). Theory and methodology. In Respiratory mechanics with glossary of symbols. Handbook of Physiology, Sect. 3, Vol. 1. Chapter 11, 363–376. Washington DC: American Physical Society.Google Scholar
  49. MEAD, J., TAKISHIMA, T. & LEITH, D. (1970). Stress distribution in lungs: a model of pulmonary elasticity. J. appl. Physiol., 28, 596–608.PubMedGoogle Scholar
  50. MEAD, J. & WHITTENBERGER, J.L. (1953). Physical properties of human lungs measured during spontaneous respiration. J. appl. Physiol., 5, 779–796.Google Scholar
  51. MEAD, J. & WHITTENBERGER, J.L. (1954). Evaluation of airway interruption technique as a method for measuring pulmonary airflow resistance. J. appl. Physiol., 6, 408–416.PubMedGoogle Scholar
  52. NADEL, J.A. & COMROE, J.H. Jr. (1961). Acute effects of inhalation of cigarette smoke on airway conductance. J. appl. Physiol., 16, 713–716.PubMedGoogle Scholar
  53. NADEL, J.A. & TIERNEY, D.F. (1961). Effect of a previous deep inspiration on airway resistance in man. J. appl. Physiol., 16, 717–719.PubMedGoogle Scholar
  54. von NEERGAARD, K. & WIRZ, K. (1927). Über eine Methode zu Messung der Lungenelastizität am leberien Menschen insbesondere beim Emphysem. Ztschr. f. klin. Med., 105, 35–51.Google Scholar
  55. OREHEK, J., GAYRARD, P., GRIMAUD, C. & CHARPIN, J. (1975). Effect of maximal respiratory manoeuvres on bronchial sensitivity of asthmatic patients as compared to normal people. Br. med. J., 1, 123–125.PubMedPubMedCentralCrossRefGoogle Scholar
  56. OTIS, A.B., McKERROW, C.B., BARTLETT, R.A., MEAD, J., McILROY, B., SELVERSTONE, N.J. & RADFORD, E.P. Jr. (1956). Mechanical factors in distribution of pulmonary ventilation. J. appl. Physiol., 8, 427–443.PubMedGoogle Scholar
  57. PELZER, A.M. & THOMSON, M.L. (1966). Effect of age, sex, stature and smoking habits on human airway conductance. J. appl. Physiol., 21, 469–476.PubMedGoogle Scholar
  58. PELZER, A.M. & THOMSON, M.L. (1969). Body Plethysmographic measurements of airway conductance in obstructive pulmonary disease. Am. Rev. resp. Med., 99, 194–204.Google Scholar
  59. PESET, R., QUANJER, P.H. & TAMMELING, G.J. (1969). Bronchodilation estimated by body plethysmography (comparison between the panting and spontaneous breathing methods). Prog. Resp. Res., 4, 215–227.CrossRefGoogle Scholar
  60. PRIDE, N.B. (1971). The assessment of airflow obstruction. Role of measurements of airway resistance and of tests of forced expiration. Br. J. Dis. Chest, 65, 135–169.PubMedCrossRefGoogle Scholar
  61. PRIDE, N.B. (1979). Assessment of changes in airways calibre. 1. Tests of forced expiration. Br. J. clin. Pharmac., 8, 193–203.CrossRefGoogle Scholar
  62. SIMONSSON, B.G., JACOBS, F.M. & NADEL, J.A. (1967). Role of autonomic nervous system and the cough reflex in the increased responsiveness of airways in patients with obstructive airway disease. J. clin. Invest., 46, 1812–1818.PubMedPubMedCentralCrossRefGoogle Scholar
  63. SKINNER, C. & PALMER, K.N.V. (1974). Changes in specific airways conductance and forced expiratory volume in one second after a bronchodilator in normal subjects and patients with airways obstruction. Thorax, 29, 574–577.PubMedPubMedCentralCrossRefGoogle Scholar
  64. SOBOL, B.J. (1968). Tests of ventilatory function not requiring maximal subject effort. Am. Rev. resp. Dis., 97, 868–879.Google Scholar
  65. SPANN, R.W. & HYATT, R.E. (1971). Factors affecting upper airway resistance in conscious man. J. appl. Physiol., 31, 708–712.PubMedGoogle Scholar
  66. STANESCU, D.C., PATTIJN, J., CLEMENT, J. & van de WOESTIJNE, K.P. (1972). Glottis opening and airway resistance. J. appl. Physiol., 32, 460–466.PubMedGoogle Scholar
  67. WATANABE, S., RENZETTI, A.D., BEGIN, R. & BIGLER, A.H. (1974). Airway responsiveness to a bronchodilator aerosol. Normal human subjects. Am. Rev. resp. Dis., 109, 530–537.PubMedGoogle Scholar
  68. WOOLCOCK, A.J. & READ, J. (1968). The static elastic properties of the lung in asthma. Am. Rev. resp. Dis., 98, 788–794.PubMedGoogle Scholar
  69. ZAPLETAL, A., SAMANEK, M., TUMA, S., RUTH, C. & PAUL, T. (1972). Assessment of airway function in children. Bull. Physiol. Path. resp., 8, 535–544.Google Scholar
  70. ZEDDA, S. & SARTORELLI, E. (1971). Variability of Plethysmographic measurements of airway resistance during the day in normal subjects and in patients with bronchial asthma and chronic bronchitis. Respiration, 28, 158–166.PubMedCrossRefGoogle Scholar

Copyright information

© Macmillan Publishers Limited 1981

Authors and Affiliations

  • A. E. Tattersfield
    • 1
  • I. M. Keeping
    • 1
  1. 1.Faculty of MedicineSouthampton General HospitalSouthamptonUK

Personalised recommendations