Within-breath changes in respiratory system impedance in children with cystic fibrosis.

Abstract

The aim of this study was to assess within-breath respiratory system impedance by the forced oscillation technique (FOT) in children with cystic fibrosis (CF) and relate it to the underlying lung disease. Thirty-three children with CF (median [range] age 12.0 [6-17] years) underwent FOT at 8 Hz during tidal breathing, multiple breath nitrogen washout (LCI), spirometry (FEV1), body plethysmography (RV/TLC), and magnetic resonance imaging (MRI). FOT outcomes included: mean inspiratory, expiratory, and whole breath resistance (R8INSP , R8EXP , R8TOT ) and reactance (X8INSP , X8EXP , X8TOT ), and the differences between X8INSP and X8EXP (ΔX8). Morphological changes were evaluated by MRI using CF-specific morphological scores. Spearman correlation was performed to examine the correlation between FOT indices and other parameters. FEV1 was negatively correlated with R8EXP (r = -0.52, P = 0.002) and ΔX8 (r = -0.55, P = 0.001), and positively correlated with and X8EXP (r = 0.56, P < 0.001). RV/TLC was positively correlated with R8EXP (r = 0.43, P = 0.013), and ΔX8 (r = 0.54, P = 0.001) and negatively correlated with X8EXP (r = -0.54, P = 0.001). We found poor correlation between FOT parameters and LCI and no correlation between FOT parameters and MRI scores. In children with CF, changes in within-breath FOT parameters are consistent with peripheral obstruction and dynamic airway compression, while they are not associated with ventilation heterogeneities and morphological alterations.