Predicting parameters of airway dynamics generated from inspiratory and expiratory plethysmographic airway loops, differentiating subtypes of chronic obstructive diseases

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Abstract: 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.
Data availability statement

Data are available in a public, open access repository. Master files have been stored and secured in the Clinical Trial Unit, Hirslanden Corporate Office, CH-8152 Glattpark, Switzerland

Location: Deutsche Nationalbibliothek Frankfurt am Main

Extent: Online-Ressource

Language: Englisch

Notes: BMJ Open Respiratory Research. - 11, 1 (2024) , e002142, ISSN: 2052-4439

Event: Veröffentlichung

(where): Freiburg

(who): Universität

(when): 2024

Creator: Kraemer, Richard
Smith, Hans‐Jürgen
Reinstaedtler, Juergen
Gallati, Sabina
Matthys, Heinrich

DOI: 10.1136/bmjresp-2023-002142

URN: urn:nbn:de:bsz:25-freidok-2461650

Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.

Last update: 14.08.2025, 10:49 AM CEST

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Associated

Kraemer, Richard
Smith, Hans‐Jürgen
Reinstaedtler, Juergen
Gallati, Sabina
Matthys, Heinrich
Universität

Time of origin

2024

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Predicting parameters of airway dynamics generated from inspiratory and expiratory plethysmographic airway loops, differentiating subtypes of chronic obstructive diseases

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Other Objects (12)

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