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1 Respiratory Division, Academic Hospital, Vrije Universiteit Brussel, Brussels 1090; and 2 Laboratoire de Physique Biomédicale, Université Libre de Bruxelles, 1070 Brussels, Belgium
In a companion study (Verbanck S, Schuermans D,
Vincken W, and Paiva M, J Appl Physiol 90:
1754-1762, 2001), we investigated whether saline aerosol
bolus tests could also be used to detect proximal, as opposed to
peripheral, airway alterations. We studied 10 never-smokers before and
after histamine challenge, obtaining, for various volumetric lung
depths (VLD), saline bolus-derived indexes computed by discarding
aerosol concentrations below either 50% of the exhaled bolus maximum
(half-width, H) or below cutoffs ranging from 5 to 25% (standard
deviation,
5%-
25%) and skew
(sk5-sk25%). Multiple-breath
N2 washout-derived indexes of conductive
(Scond) and acinar
(Sacin) ventilation inhomogeneity were also
determined. After histamine, Scond
significantly increased (P = 0.008) whereas
Sacin remained unaffected, indicating purely conductive airway alteration. Consistent with this observation, sk5% (or sk25%) was increased to the same
extent at all VLD, and
5% was increased preferentially
at low VLD. By contrast, H and
25% displayed
preferential increases at high VLD, a pattern similar to that induced
by peripheral alterations. The present work shows that proximal airway
alteration can be reliably identified by saline bolus tests only if
these include measurements at low and high VLD and if bolus dispersion
is quantified as a standard deviation with a low cutoff.
N2 washout; provocation
This article has been cited by other articles:
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S. T. Jayaraju, M. Paiva, M. Brouns, C. Lacor, and S. Verbanck Contribution of upper airway geometry to convective mixing J Appl Physiol, December 1, 2008; 105(6): 1733 - 1740. [Abstract] [Full Text] [PDF] |
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S. Verbanck, D. Schuermans, W. Vincken, and M. Paiva Saline aerosol bolus dispersion. I. The effect of acinar airway alteration J Appl Physiol, May 1, 2001; 90(5): 1754 - 1762. [Abstract] [Full Text] [PDF] |
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