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多次呼气氮清除数据的模型分析:对呼吸模式变化的稳健性

Model analysis of multiple breath nitrogen washout data: robustness to variations in breathing pattern.

作者信息

Bates Jason H T, Milne Stephen, Handley Blake M, Rutting Sandra, Chapman David G, King Gregory G, Farah Claude S, Robinson Paul D, Thamrin Cindy

机构信息

Department of Medicine, University Vermont, 149 Beaumont Avenue, Burlington, VT, USA.

Woolcock Institute of Medical Research, University of Sydney, Glebe, Sydney, Australia.

出版信息

J Clin Monit Comput. 2023 Apr;37(2):409-420. doi: 10.1007/s10877-022-00915-0. Epub 2022 Sep 23.

Abstract

We recently developed a model-based method for analyzing multiple breath nitrogen washout data that does not require identification of Phase-III. In the present study, we assessed the effect of irregular breathing patterns on the intra-subject variabilities of the model parameters. Nitrogen fraction at the mouth was measured in 18 healthy and 20 asthmatic subjects during triplicate performances of multiple breath nitrogen washout, during controlled (target tidal volume 1 L at 8-12 breaths per minute) and free (unrestricted) breathing. The parameters S, S and functional residual capacity (FRC) were obtained by conventional analysis of the slope of Phase-III. Fitting the model to the washout data provided functional residual capacity (FRC), dead space volume (V), the coefficient of variation of regional specific ventilation ([Formula: see text]), and the model equivalent of S (S). Intra-participant coefficients of variation for the model parameters for both health and asthma were FRC < 5.2%, V < 5.4%, [Formula: see text] < 9.0%, and S < 45.6% for controlled breathing, and FRC < 4.6%, V < 5.3%, [Formula: see text] < 13.2%, and S < 103.2% for free breathing. The coefficients of variation limits for conventional parameters were FRC < 6.1%, with S < 73.6% and S < 49.2% for controlled breathing and S < 35.0% and S < 74.4% for free breathing. The model-fitting approach to multiple breath nitrogen washout analysis provides a measure of regional ventilation heterogeneity in [Formula: see text] that is less affected by irregularities in the breathing pattern than its corresponding Phase-III slope analysis parameter S.

摘要

我们最近开发了一种基于模型的方法来分析多次呼气氮清除数据,该方法无需识别第三阶段。在本研究中,我们评估了不规则呼吸模式对模型参数个体内变异性的影响。在18名健康受试者和20名哮喘受试者进行多次呼气氮清除的三次重复过程中,在控制呼吸(目标潮气量1升,每分钟8 - 12次呼吸)和自由呼吸(无限制)期间,测量口腔处的氮分数。通过对第三阶段斜率的传统分析获得参数S、S和功能残气量(FRC)。将模型拟合到清除数据可得到功能残气量(FRC)、死腔容积(V)、区域特异性通气变异系数([公式:见原文])以及S的模型等效值(S)。健康组和哮喘组模型参数的个体内变异系数在控制呼吸时为FRC < 5.2%,V < 5.4%,[公式:见原文]< 9.0%,S < 45.6%;在自由呼吸时为FRC < 4.6%,V < 5.3%,[公式:见原文]< 13.2%,S < 103.2%。传统参数的变异系数限值在控制呼吸时为FRC < 6.1%,S < 73.6%,S < 49.2%;在自由呼吸时为S < 35.0%,S < 74.4%。多次呼气氮清除分析的模型拟合方法提供了一种[公式:见原文]区域通气异质性的测量方法,与相应的第三阶段斜率分析参数S相比,其受呼吸模式不规则性的影响较小。

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