A theoretical analysis of interrupter technique for measuring respiratory mechanics

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Abstract
The application of the flow interrupter technique to series and parallel models of the respiratory system is examined theoretically, assuming instantaneous transmission of pressures and incompressible gases in the lung air spaces. The initial pressure change observed immediately after occlusion divided by the preocclusion flow gives an initial resistance (Rinit) equal to that of the airway tree when the model consists of compartments connected in parallel. When the compartments are connected in series, Rinit is the resistance of the most proximal airway only. In general, the initial pressure change is followed by a second slower change, reflecting equilibration of pressures between the compartments. The total postocclusion pressure change divided by the flow gives a steady-state resistance (Rss) whose value depends on the ventilation history before occlusion. When this history consists of a relaxed expiration Rss asymptotes from Rinit to a value higher than the zero-frequency resistance of the model as the expiratory time increases. However, the relative contributions of serial and parallel pendelluft and viscoelasticity to Rss cannot be determined from pressure and flow measurements made at the airway opening. Therefore in disease, the interrupter method does not permit one to say whether ventilation inhomogeneity or alteration in lung tissue properties is the predominant abnormality.