Fretheim-Kelly Zoe, Engan Mette, Clemm Hege, Andersen Tiina, Heimdal John-Helge, Strand Eric, Halvorsen Thomas, Røksund Ola, Vollsæter Maria
Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway.
Dept of Paediatrics and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway.
ERJ Open Res. 2022 Mar 14;8(1). doi: 10.1183/23120541.00581-2021. eCollection 2022 Jan.
Exercise-induced laryngeal obstruction is an important cause of exertional dyspnoea. The diagnosis rests on visual judgement of relative changes of the laryngeal inlet during continuous laryngoscopy exercise (CLE) tests, but we lack objective measures that reflect functional consequences. We aimed to investigate repeatability and normal values of translaryngeal airway resistance measured at maximal intensity exercise.
31 healthy nonsmokers without exercise-related breathing problems were recruited. Participants performed two CLE tests with verified positioning of two pressure sensors, one at the tip of the epiglottis (supraglottic) and one by the fifth tracheal ring (subglottic). Airway pressure and flow data were continuously collected breath-by-breath and used to calculate translaryngeal resistance at peak exercise. Laryngeal obstruction was assessed according to a standardised CLE score system.
Data from 26 participants (16 females) with two successful tests and equal CLE scores on both test sessions were included in the translaryngeal resistance repeatability analyses. The coefficient of repeatability (CR) was 0.62 cmHO·L·s, corresponding to a CR% of 21%. Mean±sd translaryngeal airway resistance (cmHO·L·s) in participants with no laryngeal obstruction (n=15) was 2.88±0.50 in females and 2.18±0.50 in males. Higher CLE scores correlated with higher translaryngeal resistance in females (r=0.81, p<0.001).
This study establishes translaryngeal airway resistance obtained during exercise as a reliable parameter in respiratory medicine, opening the door for more informed treatment decisions and future research on the role of the larynx in health and disease.
运动性喉梗阻是运动性呼吸困难的一个重要原因。诊断依赖于在连续喉镜检查运动（CLE）测试期间对喉入口相对变化的视觉判断，但我们缺乏反映功能后果的客观指标。我们旨在研究在最大强度运动时测量的经喉气道阻力的可重复性和正常值。
招募了31名无运动相关呼吸问题的健康非吸烟者。参与者进行了两次CLE测试，两个压力传感器位置经核实，一个位于会厌尖端（声门上），另一个位于气管第五环处（声门下）。逐次呼吸连续收集气道压力和流量数据，并用于计算运动峰值时的经喉阻力。根据标准化的CLE评分系统评估喉梗阻情况。
经喉阻力可重复性分析纳入了26名参与者（16名女性）的数据，这26名参与者两次测试均成功且两次测试的CLE评分相同。重复性系数（CR）为0.62 cmH₂O·L⁻¹·s⁻¹，对应CR%为21%。无喉梗阻的参与者（n = 15）中，女性经喉气道阻力的平均值±标准差（cmH₂O·L⁻¹·s⁻¹）为2.88±0.50，男性为2.18±0.50。女性中较高的CLE评分与较高的经喉阻力相关（r = 0.81，p < 0.001）。
本研究确定了运动期间获得的经喉气道阻力是呼吸医学中的一个可靠参数，为更明智的治疗决策以及未来关于喉部在健康和疾病中的作用的研究打开了大门。
