Cheek support affects lung mechanics measurements of tidal-based spontaneous breathing.

Biomedical modeling and simulation Lung mechanics Model-based methods Signal analysis Spirometry Tidal breathing

Journal

Computer methods and programs in biomedicine
ISSN: 1872-7565
Titre abrégé: Comput Methods Programs Biomed
Pays: Ireland
ID NLM: 8506513

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 04 02 2020
revised: 14 04 2020
accepted: 28 04 2020
pubmed: 14 5 2020
medline: 15 5 2021
entrez: 14 5 2020
Statut: ppublish

Résumé

Patients are required to support their cheeks during breath-occluding lung function tests. This prevents cheek expansion which would alter pressure measured at the mouth, and, consequently, lung mechanics measurements. To date, the effect of cheek support on airway resistance measurements has been assessed. However other lung mechanics have not been studied as thoroughly, and no algorithm to account for the effect of missing cheek support on lung mechanics measurements has been developed. Lung mechanics were assessed with a breath occlusion test during light panting in healthy subjects with and without cheek support in a body plethysmograph. Average model-based airway resistance, lung elastance, and a parameter representing the viscoelastic were measured. Results were compared to quantify the effect of cheek support on these three parameters. In the nine healthy subjects (5 Female, 4 Male) recruited for this study, all mechanics tended to be underestimated when cheeks were unsupported. Changes in elastance, resistance, and viscoelastic parameter ranged between 1.6-66.8 %, -4.5-21.8 %, and -4.7-68.2 %, respectively, when cheek support was added. The underestimation was due to reduced mouth pressure during cheek expansion when the breath was occluded. The variance of lung mechanics parameters did not change with cheek support in all subjects. The error in lung mechanics measurement caused by unsupported cheeks was subject dependent. Hence, no rule-of-thumb could be identified to reconstruct missing cheek support. For correct lung mechanics measurements during breath-occluding lung tests, patients must have adequate cheek support. ROCC: Occlusion resistance; COPD: Chronic Obstructive Pulmonary Disorder; SB: spontaneous breathing.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Patients are required to support their cheeks during breath-occluding lung function tests. This prevents cheek expansion which would alter pressure measured at the mouth, and, consequently, lung mechanics measurements. To date, the effect of cheek support on airway resistance measurements has been assessed. However other lung mechanics have not been studied as thoroughly, and no algorithm to account for the effect of missing cheek support on lung mechanics measurements has been developed.
METHODS METHODS
Lung mechanics were assessed with a breath occlusion test during light panting in healthy subjects with and without cheek support in a body plethysmograph. Average model-based airway resistance, lung elastance, and a parameter representing the viscoelastic were measured. Results were compared to quantify the effect of cheek support on these three parameters.
RESULTS RESULTS
In the nine healthy subjects (5 Female, 4 Male) recruited for this study, all mechanics tended to be underestimated when cheeks were unsupported. Changes in elastance, resistance, and viscoelastic parameter ranged between 1.6-66.8 %, -4.5-21.8 %, and -4.7-68.2 %, respectively, when cheek support was added. The underestimation was due to reduced mouth pressure during cheek expansion when the breath was occluded. The variance of lung mechanics parameters did not change with cheek support in all subjects.
CONCLUSIONS CONCLUSIONS
The error in lung mechanics measurement caused by unsupported cheeks was subject dependent. Hence, no rule-of-thumb could be identified to reconstruct missing cheek support. For correct lung mechanics measurements during breath-occluding lung tests, patients must have adequate cheek support.
ABBREVIATIONS BACKGROUND
ROCC: Occlusion resistance; COPD: Chronic Obstructive Pulmonary Disorder; SB: spontaneous breathing.

Identifiants

pubmed: 32402845
pii: S0169-2607(20)30268-6
doi: 10.1016/j.cmpb.2020.105526
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105526

Informations de copyright

Copyright © 2020. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no competing interests.

Auteurs

S L Howe (SL)

University of Canterbury, 8041, Christchurch, New Zealand. Electronic address: sarah.howe@pg.canterbury.ac.nz.

M März (M)

Institute of Technical Medicine (ITeM), Furtwangen University, Villingen-Schwenningen, Germany.

J Pinter (J)

Institute of Technical Medicine (ITeM), Furtwangen University, Villingen-Schwenningen, Germany.

S Krüger-Ziolek (S)

Institute of Technical Medicine (ITeM), Furtwangen University, Villingen-Schwenningen, Germany.

C Pretty (C)

University of Canterbury, 8041, Christchurch, New Zealand.

G M Shaw (GM)

Christchurch Hospital, 8011, Christchurch, New Zealand.

T Desaive (T)

University of Lige, Lige, Belgium.

K Möller (K)

Institute of Technical Medicine (ITeM), Furtwangen University, Villingen-Schwenningen, Germany.

J G Chase (JG)

University of Canterbury, 8041, Christchurch, New Zealand.

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Classifications MeSH