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NAVNEET MITTAL UG201210041 COMPUTER SCIENCE AND ENGINEERING I. INTRODUCTION RESPIRATORY airflow measured by lung function tests of maximal forced expiration, spirometry, may provide useful analysis of airflow obstruction; but in children, spirometry is known to be within normal limits in the majority of asthmatic children not suffering from an acute exacerbation [1]. In adults with asthma or ChronicObstructive Pulmonary Disease (COPD), peripheral airways are often inflamed and impaired; but no clinically useful index of small airway impairment (SAI) is yet established. Forced oscillation (FO) has been reported to provide indices that reflect small airway impairment and Impulse Oscillometry, IOS, using aperiodic repetitive pulses of pressure at the mouth, shows changes in low frequency reactance in response to inahled corticosteroid (ics) aerosols delivered to small airways in medical clinical trials. IOS pressure pulses at the mouth generate oscillations in flow, analyzed by fast Fourier transform, FFT, to calculate resistance (R) and reactance (X) spectra at oscillation frequencies, from 5 to 25 Hz. Questions of the relevance toSAI of the fall in R with increase in oscillation frequency, (frequency-dependence of R, fdR), and low frequency X have impeded diagnostic use of FO. Some reports attributed fdR to upper airway artifact, or shunt compliance and offered ameliorating approaches. Whereas upper airway shunt compliance may affect the magnitude of fdR, application of oscillations around the entire head and upper neck, or pressing firmly on the cheeks with both hands to support the cheeks failed to remove fdR in patients with airflow obstruction. The unique contribution of airway compliance in parallel with airway resistance causes fdR in the presence of increased peripheral resistance [10], stimulating our research group to utilize the Mead respiratory system model to analyze data obtained by Impulse Oscillometry (IOS) testing in adults and children with airflow obstruction [11-14]. We reported that the Mead model yields spurious results for calculated lung and chest wall compliance and therefore used derivative models which exclude these parameters . The augmented RIC, aRIC, model includes shunt capacitance for the upper (extrathoracic) airway. The extended RIC, eRIC, model excludes shunt capacitance .The diagram below shows the original Mead model and derivative models used. The present study was undertaken to compare the performance of eRIC and aRIC model parameters in reflecting IOS R and X data in patients with known chronic airflow obstruction to assess potential effects of on model-derived parameters of peripheral airway mechanics.
There are useful analogies between electrical systems and lungs. Voltage= FluidPressure Resistance =Vascular Resistance Capacitance= Compliance Inductance= Fluid Mass or Inertia TERMINOLOGIESCW= chest wall compliance CL= lung compliance RP= peripheral airway resistance RC= central airway resistance CI=capacitative elements for the lung CE=upper airway shunt capacitance

“frequency dependence of resistance. Data analysis. Clinically stable adolescent and young adult patients with Cystic Fibrosis (CF) were studied at annualreview visits at hospitals. stability of pressure calibration was confirmed using a 0. IOS tests were performed with cheeks supported by voluntary contraction of the circumoral muscles to decrease upper airway shunt dissipation of oscillations while avoiding uncomfortable mechanical loading of the chest wall by patients’ lifting their arms and pushing on the cheeks. We tabulated IOS resistance and reactance between 5-25 Hz.The first 20 seconds of each test were omitted to avoid previously observed variability at the onset of testing .” fdR). adult asthmatic patients were studied before andafter treatment with inhaled corticosteroids (ics) and bronchodilator. and volume data were analyzed off-line to reject data adversely affected by swallowing. IOS pressure. METHODS A. The fall in resistance between 5 and 20 Hz wre selected(R5R20. In parallel studies in the US. flow. Impulse Oscillometry. The IOS pneumotachometer was calibrated for volume daily using a 3-liter syringe. B. RESULTS AND CONCLUSION From the above Mead’s model we observe that we can convert a complex system like the respiratory system into simpler isomorphic electrical systems having similar dynamics . C.II. III. Subjects underwent 3 to 6 replicate IOS tests of 60 seconds each. and integrated low frequency reactance (AX) as the IOS indices most related to small airway function. coughing. At weekly intervals. an average of 3 – 5 tests was calculated.2 kPa/L/s reference resistance following the volume calibration. Patients. Forced oscillation utilize impulse oscillation) to measure resistance and reactance between 5 and 25 Hz. or airflow leak .