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Pre/Postbronchodilator Interrupter Resistance Values in Healthy Young Children

Physiology Departments of the Robert Debré Teaching Hospital, Saint-Vincent-de-Paul Teaching Hospital, and Trousseau Teaching Hospital, Paris; Public Health Department of the Robert Debré Teaching Hospital, Paris; Pediatric Department, Arnaud de Villeneuve Teaching Hospital, Montpellier; Physiology Departments, Morvan Teaching Hospital, Brest; Poitiers Teaching Hospital, Poitiers; Calmette Teaching Hospital, Lille; and Grenoble Teaching Hospital, Grenoble, France

Correspondence should be addressed to Claude Gaultier, Service de Physiologie, Hôpital Robert Debré, 48 Bd Serurier, 75019, Paris, France. E-mail: claude.gaultier{at}rdb.ap-hop-paris.fr

The interrupter technique estimates flow resistance. It entails occlusion of the airways during tidal breathing while flow and mouth pressure are recorded. This noninvasive technique is easy to use in young children. The aim of the present study was to measure inspiratory and expiratory interrupter resistance (Rint_insp, Rint_exp) before and after bronchodilator administration in young healthy white children. We designed a multicenter study using a standardized procedure for Rint measurements. Centers in five French cities studied 91 children (48 boys and 43 girls; height, 92 to 129 cm; mean age 5.3 ± 1.4 years). Mean values were not significantly different for Rint_insp and Rint_exp (0.78 ± 0.21 versus 0.78 ± 0.20 KPa · L^-1 · second). However, the difference between Rint_insp and Rint_exp decreased significantly with age and being positive before 5 years and negative later on (p < 0.02). Rint_insp and Rint_exp decreased significantly with height (Rint_insp [KPa · L^-1 · second] = 2.289 - 1.37 . 10^-2 · H [cm], Rint_exp [KPa · L^-1 · second] = 2.021 - 1.12.10^-2 · H [cm]; p < 0.001). Bronchodilator (salbutamol) administration significantly decreased Rint_insp and Rint_exp (p < 0.001). Bronchodilator-induced changes (% of predicted values) in mean Rint_insp and mean Rint_exp were -15% (95% confidence interval, -46 to +15%) and -12% (95% confidence interval, -46 to +22%), respectively. Sex did not affect pre- or postbronchodilator values. Data from the present study may prove useful for testing lung function in young children with respiratory disorders who failed to cooperate with forced expiratory maneuvers.

Key Words: inspiratory and expiratory interrupter resistance • reference values • preschool children

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