High-frequency Respiratory Impedance Measured by Forced-Oscillation Technique in Infants

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Abstract
Measurements of respiratory input impedance (Zin) in infants using forced oscillations at the airway opening up to 256 Hz have been shown to include a first antiresonance (ar,1). We wondered whether features derived from high-frequency Zin change during methacholine-induced airway obstruction in infants, whether those changes could be explained by a lumped parameter model as in dogs (providing a value for respiratory resistance [Rrs]), or whether they are similar to Zin data in human adults with airway obstruction. In 13 wheezy infants (age 58 +/- 19 wk) Zin(omega) was assessed at baseline, and in nine infants after methacholine challenge, using a provocation dose defined by fall of more than 30% in VmaxFRC (rapid chest-compression technique). Following methacholine challenge, VmaxFRC decreased significantly (p < 0.0005), the frequency at which ar,1 occurred ( far,1) increased significantly (p = 0.0007), and the relative maximum in the real part at far,1 [Zinre( far,1)] increased significantly (p = 0.02), whereas Rrs did not change. We conclude that in wheezy infants ar,1 is highly sensitive to changes in lung mechanics. Although ar,1 cannot be explained by a simple lumped-parameter model, it is likely due to wave propagation phenomena, as in human adults. In either case, far,1 potentially contains information about airway wall compliance, which is important for the understanding of flow limitation in infant wheezing disorders.