Normative reference equations of airway dynamics assessed by whole-body plethysmography during spontaneous breathing evaluated in infants, children, and adults.

Effective specific airway resistance (sReff ), its reciprocal the effective specific airway conductance (sGeff ) are computed as ratios between the integral of the resistive aerodynamic work of breathing (sWOB) and the integral of the tidal flow/volume loop, the reciprocal, respectively. Unfortunately, reference equations to obtain normative values for sReff , sGeff , and sWOB are not yet available. To assess reference equations for sWOB, sReff , and sGeff during tidal breathing at resting level in healthy infants, children, and adults by a multidimensional model. Retrospectively exported data were collected from databases of five Swiss lung function centers, in which plethysmography (Jaeger Würzburg, Germany) was performed for the assessment of airway dynamics, static lung volumes, and forced breathing flow-volume loops, in a collective of 28 healthy infants, 47 children, and 273 adults. From this cohort, reference equations were computed based on anthropometric measures, lung volumes, indices of the breathing pattern, and timing of breathing. By multi-linear modeling reference equations of sReff , sGeff , and sWOB could be defined taking as independent parameters apart from anthropometric parameters, also parameters given by the ratio between the tidal volume and functional residual capacity (FRCpleth /VT ), and the ratio between VT and inspiratory time (VT /TI ). An alternative statistical approach to define reference equations of airway dynamics reveals that apart from the subject's anthropometric measurements, parameters of the magnitude of static lung volumes, the breathing pattern, and the timing of breathing are co-variants of reference equations of airway dynamics over a large age range.

The sensitivity and specificity of the forced oscillation technique in the diagnosis of bronchoconstriction in children.

OBJECTIVE: The forced oscillation technique (FOT) is a useful diagnostic respiratory system for children. However, the final value of the FOT in the diagnosis of bronchoconstriction is still open. The aim of the study was to evaluate the sensitivity and specificity of the FOT vs. body plethysmography tests in the measure of bronchoconstriction in asthmatic children. MATERIALS AND METHODS: A total of 102 children aged 2 to 6 years diagnosed with early-onset asthma and 52 healthy controls were included in this prospective, randomized study. All asthmatic patients and healthy controls underwent a basic FOT as one measurement, according to the recommendation of the Resmon Pro FOT. Then, the reversibility test was performed 20 min after the administration of 200 mg salbutamol using the FOT and body plethysmography in all patients. RESULTS: The mean basic Rrs, Xrs and sRaw in asthmatic patients were, respectively, 11.13 ± 1.28 kPa sL-1, -4.6 ± 1.18 kPa sL-1 and 1.72 ± 0.58 kPa s. Similar parameters were significantly better in the control group (p < 0.05). A total of 73 (71.6%) asthmatic patients had a positive test using the FOT according to Calogero. In 4 (7.7%) patients in the control group, a positive test was obtained. In body plethysmography, similar results were reached, with a positive test in 76 (74.5%) study patients and 5 (9.6%) control patients. CONCLUSIONS: A bronchial reversibility test with the use of the FOT is useful for the diagnosis of bronchial asthma, especially with the use of an Rrs parameter, such as the body plethysmography test.

Diagnostic accuracy of capnovolumetry for the identification of airway obstruction - results of a diagnostic study in ambulatory care.

BACKGROUND: One of the known weaknesses of spirometry is its dependence on patients' cooperation, which can only partially be alleviated by educational efforts. Therefore, procedures less dependent on cooperation might be of value in clinical practice. We investigated the diagnostic accuracy of ultrasound-based capnovolumetry for the identification of airway obstruction. METHODS: Consecutive patients from a pulmonary outpatient clinic were included in the diagnostic study. As reference standard, the presence of airway obstruction was evaluated via spirometry and bodyplethysmography. Capnovolumetry was performed as index test with an ultrasound spirometer providing a surrogate measure of exhaled carbon dioxide. Receiver operating characteristic (ROC) analysis was performed using the ratio of slopes of expiratory phases 3 and 2 (s3/s2) ≥ 0.10 as primary capnovolumetric parameter for the recognition of airway obstruction. Logistic regression was performed as secondary analysis to identify further useful capnovolumetric parameters. The diagnostic potential of capnovolumetry to identify more severe degrees of airway obstruction was evaluated additionally. RESULTS: Of 1400 patients recruited, 1287 patients were included into the analysis. Airway obstruction was present in 29% of patients. The area under the ROC-curve (AUC) of s3/s2 was 0.678 (95% CI 0.645, 0.710); sensitivity of s3/s2 ≥ 0.10 was 47.7 (95% CI 42.7, 52.8)%, specificity 79.0 (95% CI 76.3, 81.6)%. When combining this parameter with three other parameters derived from regression analysis (ratio area/volume phase 3, slope phase 3, volume phase 2), an AUC of 0.772 (95% CI 0.743, 0.801) was obtained. For severe airway obstruction (FEV1 ≤ 50% predicted) sensitivity of s3/s2 ≥ 0.10 was 75.9 (95% CI 67.1, 83.0)%, specificity 75.8 (95% CI 73.3, 78.1)%; for very severe airway obstruction (FEV1 ≤ 30% predicted) sensitivity was 86.7 (95% CI 70.3, 94.7)%, specificity 72.8 (95% CI 70.3, 75.2)%. Sensitivities increased and specificities decreased considerably when the combined capnovolumetric score was used as index test. CONCLUSIONS: Capnovolumetry by way of an ultrasound spirometer had a statistically significant albeit moderate potential for the recognition of airway obstruction in a heterogeneous population of patients typically found in clinical practice. Diagnostic accuracy of the capnovolumetric device increased with the severity of airway obstruction. TRIAL REGISTRATION: The study is registered under DRKS00013935 at German Clinical Trials Register (DRKS).

[Body plethysmography (I): Standardisation and quality criteria]. / Pletismografía corporal (I): estandarización y criterios de calidad.

Whole body plethysmography is used to measure lung volumes, capacities and resistances. It is a well standardised technique, and although it is widely used in paediatric chest diseases units, it requires specific equipment, specialist staff, and some cooperation by the patient. Plethysmography uses Boyle's law in order to measure the intrathoracic gas volume or functional residual capacity, and once this is determined, the residual volume and total lung capacity is extrapolated. The measurement of total lung capacity is necessary for the diagnosis of restrictive diseases. Airway resistance is a measurement of obstruction, with the total resistance being able to be measured, which includes chest wall, lung tissue and airway resistance, as well as the specific airway resistance, which is a more stable parameter that is determined by multiplying the measured values of airway resistance and functional residual capacity. The complexity of this technique, the reference equations, the differences in the equipment and their variability, and the conditions in which it is performed, has led to the need for its standardisation. Throughout this article, the practical aspects of plethysmography are analysed, specifying recommendations for performing it, its systematic calibration and the calculations that must be made, as well as the interpretation of the results obtained. The aim of this article is to provide a better understanding of the principles of whole body plethysmography with the aim of optimising the interpretation of the results, leading to improved management of the patient, as well as a consensus among the speciality.

[Recommendation of new reference values for spirometry and body plethysmography]. / Empfehlungen aktueller Referenzwerte für die Spirometrie und Ganzkörperplethysmografie.

BACKGROUND AND METHODS: At the end of 2012, after 5 years of work, a task force of the ERS published new reference values for spirometry (mean values and Lower Limits of Normal, LLN) based on available studies, performed according to generally accepted quality criteria. RESULTS AND CONCLUSIONS: So far this is one of the most comprehensive work on reference values in pneumology (more than 74,000 healthy subjects, age range 3 to 95 years). These reference values are approximately 10 % higher (especially in the elderly population) than the still preferentially used ECCS reference values. It is recommended to combine and use them in combination with new reference values for body plethysmography by replacing the ECCS recommendations of 1983/1993 which show discrepancies to lung function data of our today population.

Ventilatory function assessment in safety pharmacology: optimization of rodent studies using normocapnic or hypercapnic conditions.

Although the whole body plethysmography for unrestrained animals is the most widely used method to assess the respiratory risk of new drugs in safety pharmacology, non-appropriate experimental conditions may mask deleterious side effects of some substances. If stimulant or bronchodilatory effects can be easily evidenced in rodents under standard experimental conditions, i.e. normal air breathing and diurnal phase, drug-induced respiratory depression remains more difficult to detect. This study was aimed at comparing the responsiveness of Wistar rats, Duncan Hartley guinea-pigs or BALB/c mice to the respiratory properties of theophylline (50 or 100 mg/kg p.o.) or morphine (30 mg/kg i.p.) under varying conditions (100% air versus 5% CO2-enriched air, light versus dark day phase), in order to select the most appropriate experimental conditions to each species for safety airway investigations. Our results showed that under normocapnia the ventilatory depressant effects of morphine can be easily evidenced in mice, slightly observed in guinea-pigs and not detected in rats in any day phase. Slight hypercapnic conditions enhanced the responsiveness of rats to morphine but not that of guinea-pigs and importantly they did not blunt the airway responsiveness of rats to the stimulation and bronchodilation evoked by theophylline, the most widely used reference agent in safety pharmacology studies. In conclusion, hypercapnic conditions associated with the non-invasive whole body plethysmography should be considered for optimizing the assessment of both the ventilatory depressant potential of morphine-like substances or the respiratory stimulant effects of new drugs in the rat, the most extensively used species in rodent safety and toxicological investigations.

Description of original endoscopic findings and respiratory functional assessment using barometric whole-body plethysmography in dogs suffering from brachycephalic airway obstruction syndrome.

The clinical features of brachycephalic airway obstructive disease in 11 brachycephalic dogs are described in this study. The respiratory strategy was assessed before (n=11) and after (n=6) surgery using barometric whole-body plethysmography (BWBP), with the relationship between BWBP variables and the severity of the clinical signs assessed by the use of a respiratory score based on clinical, radiographic and endoscopic findings. Partial collapse of the left main bronchus was a common finding not previously described as part of the brachycephalic airway obstructive disease syndrome. Epiglottic cysts, laryngeal granulomas and nasopharyngeal turbinates in English Bulldogs were other previously unreported findings. No significant correlation between the respiratory score and any of the BWBP variables was detected. Compared to healthy dogs, brachycephalic dogs had a significantly lower Te/Ti ratio (expiratory time over inspiratory time), peak inspiratory flow (PIF) per kg bodyweight (BW), significantly higher peak expiratory flow (PEF) per kgBW, PEF/PIF, and enhanced pause. These variations are compatible with upper airway obstructions primarily in the extrathoracic airways. Following surgery, a significant decrease in PEF/PIF was detected. The study showed that BWBP could be used to characterise the respiratory strategy in brachycephalic dogs before and after surgery.

Accuracy of whole-body plethysmography requires biological calibration.

BACKGROUND: Specific airway resistance (sRaw) measured by whole-body plethysmography in young children is increasingly used in research and clinical practice. The method is precise and feasible. However, there is no available method for calibration of the resistance measure, which raises concern of accuracy. Our aim was to determine the agreement of sRaw measurements in six centers and expand normative sRaw values for nonasthmatic children including these centers. METHOD: Identical hardware with different software versions was used at the six centers. Measurements followed a standard operating procedure: (1) seven healthy young children were brought to each of the six centers for sRaw measurements; and (2) 105 healthy preschool children (52 boys; mean age, 5.1 years; interquartile range, 4.3 to 6.0) were recruited locally for sRaw measurements. RESULTS: (1) The sRaw of the seven-children study group was significantly lower at two centers compared with the other four centers, and one center had significantly higher sRaw than all the other centers (p < 0.05). Error in the factory settings of the software was subsequently discovered in one of the deviating centers. (2) Normative data (105 preschool children) were generated and were without significant difference between centers and independent of height, weight, age, and gender. We subsequently pooled these normative data (105 children) with our previous data from 121 healthy young children (overall mean sRaw, 1.27; SD, 0.25). CONCLUSION: Control using biological standards revealed errors in the factory setting and highlights the need for developing methods for verification of resistance measures to assure accuracy. Normative data were subsequently generated. Importantly, other centers using such normative data should first consider proper calibration before applying reference values.

Interaction of clothing and body mass index affects validity of air-displacement plethysmography in adults.

OBJECTIVE: We determined the effect of clothing type on the validity of air-displacement plethysmography (ADP) to estimate percentage of body fat (%BF) and ascertain if these effects differ by body mass index (BMI). METHODS: The %BF by dual x-ray absorptiometry (DXA) and %BF, density, and body volume by ADP were assessed in 132 healthy adults classified by normal (N; 18.5-24.9 kg/m2), overweight (OW; 25-29.9 kg/m2), and obese (OB; 30-39.9 kg/m2) BMIs. RESULTS: Compared with DXA, ADP underestimated (P < 0.0001) %BF from scrubs (SC) and t-shirt/shorts (TS) in N (11.4%; 8.6%) and OW (6.8%; 4.9%) BMI groups, respectively. ADP compared with DXA overestimated (P < 0.0006) %BF in the OW group (1.2%), but underestimated (P < 0.0001) it in the N group (2.4%). ADP also overestimated (P < 0.006) %BF in the OB group wearing spandex (SP; 4.8%), but not in those wearing SC (0.7%; P = 0.10) and TS (0.5%; P = 0.22) versus DXA. CONCLUSION: All three clothing types showed significant error in estimating %BF with ADP compared with DXA in N and OW BMI. Use of spandex provided the least error and is the preferred attire to obtain valid body composition results when testing N and OW subjects. However, SP provided the greatest error in the OB group. Error in ADP %BF in OB was minimal in SC and TS and similar to the within-subject variability in %BF estimates with ADP. Thus, TS and SC are acceptable alternatives to SP in adults with excess body weight.

Comparison of barometric whole body plethysmography and its derived parameter enhanced pause (PENH) with conventional respiratory mechanics in healthy Beagle dogs.

The purpose of the study was to compare barometric whole body plethysmography (BWBP) and its derived parameter, enhanced pause (PENH), with conventional respiratory mechanics measurements. Resistance (RL), dynamic compliance (Cdyn) and pleural pressure changes were measured in six healthy anaesthetised Beagle dogs using a pneumotachograph and oesophageal balloon technique consecutive to BWBP-derived variables. Upper airway airflow limitation was established (1) by a filter or (2) by insertion of a narrow endotracheal tube. Bronchoconstriction was induced by nebulisation of carbachol at increasing concentrations until PENH exceeded 300% baseline. Upper airway narrowing significantly increased resistance (baseline RL 2.0+/-0.3, RL filter 11.8+/-3.2, RL luminal narrowing 21.1+/-2.3cm H(2)O/L/s; P <0.03), whereas PENH did not change significantly (baseline PENH 0.55+/-0.17, PENH filter 0.49+/-0.10; PENH luminal narrowing 0.50+/-0.18; P >0.05). Carbachol-induced bronchoconstriction caused a significant increase in PENH (baseline PENH 0.43+/-0.14, PENH carbachol 2.62+/-2.14; P <0.02) and resistance (baseline RL 2.1+/-0.3, RL carbachol 28.8+/-13.0 cm H2O/L/s; P <0.01), and a pronounced drop in compliance (baseline Cdyn 163.3+/-73.9, Cdyn carbachol 9.7+/-2.9mL/cmH2O; P <0.02). It was concluded that BWBP detects airflow limitation due to bronchoconstriction but not due to upper airway obstruction in healthy dogs. BWBP represents a valid, although not very sensitive screening tool for respiratory function testing.

Acoustic plethysmography measures breathing in unrestrained neonatal mice.

Measurement of breathing volumes in neonatal mice is of growing importance in order to characterize the influence of development and genetic modifications on respiratory control to evaluate hypotheses concerned with human infant deficits that may affect sudden infant death syndrome, for example. Current techniques require undesirable physical constraints or incur possible artifacts specific to very small animals. We have examined the utility of a recently proposed approach using an acoustic resonance procedure that does not require undue physical constraint beyond placement in the acoustic plethysmograph. We show here that this approach can be applied to baby mice 5 days after birth and that it can be accurately calibrated. In addition, this approach should be useful to study unrestrained neonatal mice under conditions where body temperature approaches environmental temperature and barometric plethysmography cannot be used.

Validation of a 3-dimensional photonic scanner for the measurement of body volumes, dimensions, and percentage body fat.

BACKGROUND: The 3-dimensional photonic scan (3DPS) technique has been used during the past decade in the fashion industry and for epidemiologic surveys to estimate human body sizes. OBJECTIVE: The objective of the study was to validate the accuracy of a recently developed 3DPS (C9036-02; Hamamatsu Photonics KK, Hamamatsu, Japan) for the measurement of body volume, circumferences, lengths, and percentage body fat with the use of underwater weighing (UWW) and tape measures as criterion methods. DESIGN: Ninety-two subjects (44 females and 48 males) aged 6-83 y and weighing 23-182 kg (52-400 lbs) participated in the study. The subjects were measured while they wore minimal clothing and a head cap. Similar measurements were performed on a mannequin with and without clothing RESULTS: All subjects were measured with 3DPS and a tape measure; 63 subjects underwent UWW and residual lung volume measurements. The values obtained with 3DPS were slightly but significantly greater than those obtained with UWW for body volume (81.9 +/- 4.0 L compared with 81.5 +/- 4.0 L, P < 0.0001) and those obtained with a tape measure for circumferences (P < 0.001), but the values for percentage body fat were not significantly different between 3DPS and UWW (P = 0.648). The values obtained with 3DPS were significantly greater than those obtained by UWW and a tape measure for the clothed mannequin, but the values were not uniformly significantly different for the mannequin without clothing. CONCLUSIONS: The 3DPS measures body volume, circumferences, and length rapidly and accurately. However, to generate an accurate total-body volume measurement with 3DPS to estimate percentage body fat, the subjects must wear close-fitting minimal clothing and be able to stand motionless for 10 s (normal scan mode) while holding their breath, which is done immediately after a maximum expiration.

Evaluation of respiratory function by barometric whole-body plethysmography in healthy dogs.

The objective of the present study was to assess the validity of barometric whole-body plethysmography (BWBP), to establish reference values, and to standardise a bronchoprovocative test to investigate airway responsiveness using BWBP in healthy dogs. BWBP measurements were obtained from six healthy beagle dogs using different protocols: (1) during three consecutive periods (3.5min each) in two morning and two evening sessions; (2) before and after administration of two protocols of sedation; (3) before and after nebulisation of saline and increasing concentrations of carbachol and histamine both in conscious dogs and in dogs under both protocols of sedation. Enhanced pause (PENH) was used as index of bronchoconstriction. Basal BWBP measurements were also obtained in 22 healthy dogs of different breeds, age and weight. No significant influence of either time spent in the chamber or daytime was found for most respiratory variables but a significant dog effect was detected for most variables. A significant body weight effect was found on tidal volume and peak flow values (P<0.05). Response to carbachol was not reproducible and always associated with side effects. Nebulisation of histamine induced a significant increase in respiratory rate, peak expiratory flow, peak expiratory flow/peak inspiratory flow ratio and PENH (P<0.05). The response was reproduced in each dog at different concentrations of histamine. Sedation with acepromazine+buprenorphine had little influence on basal measurements and did not change the results of histamine challenge. It was concluded that BWBP is a safe, non invasive and reliable technique of investigation of lung function in dogs which provides new opportunities to characterise respiratory status, to evaluate airway hyperresponsiveness and to assess therapeutic interventions.

Plethysmograph and interrupter resistance measurements in prematurely born young children.

BACKGROUND: Airways obstruction in premature infants is often assessed by plethysmography, which requires sedation. The interrupter (Rint) technique does not require sedation, but has rarely been examined in children under 2 years of age. OBJECTIVE: To compare Rint results with plethysmographic measurements of airway resistance (Raw) in prematurely born, young children. DESIGN: Prospective study. SETTING: Infant and Paediatric Lung Function Laboratories. PATIENTS: Thirty children with a median gestational age of 25-29 weeks and median postnatal age of 13 months. INTERVENTIONS AND MAIN OUTCOME MEASURES: The infants were sedated, airway resistance was measured by total body plethysmography (Raw), and Rint measurements were made using a MicroRint device. Further Raw and Rint measurements were made after salbutamol administration if the children remained asleep. RESULTS: Baseline measurements of Raw and Rint were obtained from 30 and 26 respectively of the children. Mean baseline Rint values were higher than mean baseline Raw results (3.45 v 2.84 kPa/l/s, p = 0.006). Limits of agreement for the mean difference between Rint and Raw were -1.52 to 2.74 kPa/l/s. Ten infants received salbutamol, after which the mean Rint result was 3.6 kPa/l/s and mean Raw was 3.1 kPa/l/s (limits of agreement -0.28 to 1.44 kPa/l/s). CONCLUSION: The poor agreement between Rint and Raw results suggests that Rint measurements cannot substitute for plethysmographic measurements in sedated prematurely born infants.

Plethysmographic measurements of specific airway resistance in young children.

Validated methods for lung function measurements in young children are lacking. Plethysmographic measurement of specific airway resistance (sRaw) provides such a method applicable from 2 years of age. sRaw gauges airway resistance from the measurements of the pressure changes driving the airflow during tidal breathing. These measurements require no active cooperation and are therefore feasible in children from 2 years of age. The within-observer and between-observer variability of sRaw in young children compare favorably with alternative methods. Reference values are available for sRaw and have allowed discrimination of young children with respiratory disease. Bronchial hyperresponsiveness can be determined with acceptable short-term and long-term repeatability and provides good discrimination between asthmatics and healthy young children. The effects of the major antiasthmatic therapies have also been documented by this technique, and sRaw has recently been used in longitudinal studies of young children with chronic pulmonary diseases. Future developments should provide improved algorithms for thermal correction of the respired volumes and adapt the equipment to the special needs of young children. This article reviews the method, and proposes a protocol and criteria for quality assurance for assessment of sRaw in preschool children from 2 years of age. sRaw measurements offers a method for clinical monitoring and research during this critical period of growth and development early in life.

Use of hand-to-hand impedancemetry to predict body composition of African women as measured by air displacement plethysmography.

OBJECTIVES: To test the validity of a simple, rapid, field-adapted, portable hand-held impedancemeter (HHI) for the estimation of lean body mass (LBM) and percentage body fat (%BF) in African women, and to develop specific predictive equations. DESIGN: Cross-sectional observational study. SETTINGS: Dakar, the capital city of Senegal, West Africa. SUBJECTS: A total sample of 146 women volunteered. Their mean age was of 31.0 y (s.d. 9.1), weight 60.9 kg (s.d. 13.1) and BMI 22.6 kg/m(2) (s.d. 4.5). METHODS: Body composition values estimated by HHI were compared to those measured by whole body densitometry performed by air displacement plethysmography (ADP). The specific density of LBM in black subjects was taken into account for the calculation of %BF from body density. RESULTS: : Estimations from HHI showed a large bias (mean difference) of 5.6 kg LBM (P<10(-4)) and -8.8 %BF (P<10(-4)) and errors (s.d. of the bias) of 2.6 kg LBM and 3.7 %BF. In order to correct for the bias, specific predictive equations were developed. With the HHI result as a single predictor, error values were of 1.9 kg LBM and 3.7 %BF in the prediction group (n=100), and of 2.2 kg LBM and 3.6 %BF in the cross-validation group (n=46). Addition of anthropometrical predictors was not necessary. CONCLUSIONS: The HHI analyser significantly overestimated LBM and underestimated %BF in African women. After correction for the bias, the body compartments could easily be estimated in African women by using the HHI result in an appropriate prediction equation with a good precision. It remains to be seen whether a combination of arm and leg impedancemetry in order to take into account lower limbs would further improve the prediction of body composition in Africans.

A novel approach for quality control of total lung capacity in the clinical pulmonary function laboratory: a study in a veteran population.

OBJECTIVE: Quality control in the clinical pulmonary function laboratory has been well developed for spirometry and diffusing capacity but not for the measurement of TLC. The purpose of the present study was to test two approaches to this problem. First, we compared TLC by body plethysmography (TLCb) with a value predicted from TLC measured by multibreath helium dilution (TLCm). Concordance between the measured and predicted values would imply the validity of the measurements. Second, we measured the test-retest variability of TLCb, TLCm and TLC measured by single breath helium dilution (TLCs) to assess the consistency of the measurements. METHODOLOGY: We performed a prospective study of 815 veterans. RESULTS: The prediction of TLCb from TLCm improved (r2 increased from 0.44 to 0.64) when FEV1/FVC and the difference between TLCm and TLCs were added to the model. The coefficient of variation for test-retest of TLCs, TLCm and TLCb were 8.9, 7.1 and 5.4%, respectively. Of all tests, 5.9% were inconsistent based on pathophysiology or measurement error and attributed mostly to TLCm. CONCLUSIONS: Prediction of TLCb from TLCm was not sufficiently accurate as to be useful for quality control. Comparison of TLCs, TLCm and TLCb may be useful for determining the internal data validity.

A reevaluation of the validity of unrestrained plethysmography in mice.

Presently, unrestrained plethysmography is widely used to assess bronchial responsiveness in mice. An empirical quantity known as enhanced pause is derived from the plethysmographic box pressure [P(b)(t), where t is time] and assumed to be an index of bronchoconstriction. We show that P(b)(t) is determined largely by gas conditioning when normal mice breathe spontaneously inside a closed chamber in which the air is at ambient conditions. When the air in the chamber is heated and humidified to body conditions, the changes in P(b)(t) are reduced by about two-thirds. The remaining changes are thus due to gas compression and expansion within the lung and are amplified when the animals breathe through increased resistances. We show that the time integral of P(b)(t) over inspiration is accurately predicted by a term containing airway resistance, functional residual capacity, and tidal volume. We conclude that unrestrained plethysmography can be used to accurately characterize changes in airway resistance only if functional residual capacity and tidal volume are measured independently and the chamber gas is preconditioned to body temperature and humidity.

Effects of clothing on accuracy and reliability of air displacement plethysmography.

PURPOSE: The purpose of this investigation was to quantify the effects of different attire on the accuracy and reliability of estimating percent body fat (%fat) by using air displacement plethysmography (ADP). METHODS: Fifteen adults were tested four times on four separate occasions. Each session consisted of estimating %fat with ADP wearing a swimsuit (ADP(SS)), a hospital gown (ADP(HG)), and in the nude (ADP(N)), plus assessment by hydrostatic weighing (HW). RESULTS: An ANOVA revealed no significant differences within any of the four methods over the 4 days. Intraclass correlation coefficients revealed a strong relationship for repeated measures in ADP(SS) (r = 0.981), ADP(HG) (r = 0.993), ADP(N) (r = 0.989), and HW (r = 0.976). Mean data for each condition indicated a significant underestimation (P < 0.05) of %fat while wearing a hospital gown (13.8 +/- 7.7%) compared with ADP(SS) (22.0 +/- 7.8%), ADP(N) (23.5 +/- 7.5%), and HW (22.6 +/- 6.8%). CONCLUSION: Reliability of ADP does not appear to be compromised by clothing; however, wearing a hospital gown significantly affects accuracy, reducing %fat estimations by approximately 9% compared with the recommended swimsuit. Measurement in the nude does not provide more reliable or accurate measures than wearing a swimsuit.