Frey U, Silverman M, Kraemer R, Jackson A C
Dept of Child Health, University of Leicester School of Medicine, UK.
Eur Respir J. 1998 Jul;12(1):148-58. doi: 10.1183/09031936.98.12010148.
High-frequency input impedance (Z(f)) measurements, including antiresonances, provide useful noninvasive information on airway geometry and especially airway wall mechanics in the canine and human adult respiratory system. A knowledge of airway wall mechanics would be particularly important in understanding flow limitation phenomena in infants. High-frequency Z(f) has not been measured in infants above 256 Hz, because the high impedance of the infantile respiratory system would be expected to result in low amplitudes of oscillatory flow at higher frequencies. The aim of this study was to develop a technique to measure high-frequency Z(f) in infants and to elucidate the nature of the antiresonance phenomena in the Z(f) spectrum in infants. Z(f) was measured from 32-900 Hz during rapid airflow interruption by the high-speed interrupter technique (HIT) in 18 infants (aged 24-149 weeks) with wheezing disorders. The HIT enables the excitement of higher flow amplitudes at high frequencies using a pseudostep forcing function. In all infants Z(f) showed a mean (SD) first antiresonance (far,1) of 172 (35) Hz (real part of Z(f) at far,1 (Z(f)re(far,1)): 4.9 (1.1) kPa x L(-1) x s) and in five infants a second antiresonance (far,2) of 564 (51) Hz (Z(f)re(far,2): 2.0 (0.7) kPa x L(-1) x s). The antiresonances were found to be related to wave propagation in the airways (acoustic antiresonances), because they increased by a factor of approximately 2 when He-O2 was inhaled. This implies that far,1 and its harmonics are a function of airway wall compliance. In conclusion, the first and second antiresonances may be helpful in understanding flow limitation in wheezing disorders in infants, because flow limitation is related not only to airway diameter but also to airway wall compliance.
高频输入阻抗(Z(f))测量,包括反共振,能提供关于犬类和人类成人呼吸系统气道几何形状,特别是气道壁力学的有用非侵入性信息。了解气道壁力学对于理解婴儿的气流受限现象尤为重要。尚未对频率高于256Hz的婴儿进行高频Z(f)测量,因为婴儿呼吸系统的高阻抗预计会导致在较高频率下振荡气流的低振幅。本研究的目的是开发一种测量婴儿高频Z(f)的技术,并阐明婴儿Z(f)频谱中反共振现象的本质。通过高速中断技术(HIT)在18名患有喘息疾病的婴儿(年龄24 - 149周)中,在快速气流中断期间从32 - 900Hz测量Z(f)。HIT使用伪阶跃强迫函数能够在高频下激发更高的气流振幅。在所有婴儿中,Z(f)显示平均(标准差)第一反共振(far,1)为172(35)Hz(Z(f)在far,1处的实部(Z(f)re(far,1)):4.9(1.1)kPa×L(-1)×s),在五名婴儿中第二反共振(far,2)为564(51)Hz(Z(f)re(far,2):2.0(0.7)kPa×L(-1)×s)。发现这些反共振与气道中的波传播(声学反共振)有关,因为吸入氦 - 氧混合气时它们增加了约2倍。这意味着far,1及其谐波是气道壁顺应性的函数。总之,第一和第二反共振可能有助于理解婴儿喘息疾病中的气流受限,因为气流受限不仅与气道直径有关,还与气道壁顺应性有关。