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Comparative Study
. 2005 Feb;59(2):152-9.
doi: 10.1111/j.1365-2125.2004.2262.x.

A comparison of plethysmography, spirometry and oscillometry for assessing the pulmonary effects of inhaled ipratropium bromide in healthy subjects and patients with asthma

C M Houghton  1 , A A Woodcock, D Singh
Affiliations
Comparative Study

A comparison of plethysmography, spirometry and oscillometry for assessing the pulmonary effects of inhaled ipratropium bromide in healthy subjects and patients with asthma

C M Houghton et al. Br J Clin Pharmacol. 2005 Feb.

Abstract

Aims: We have compared the ability of plethysmography (sGaw), impulse oscillometry (IOS) and spirometry (FEV(1), MMEF) to detect bronchodilation in response to an anticholinergic.

Methods: IOS (R5, R20, X5, RF), sGaw and spirometry were measured in 12 healthy subjects and 12 asthmatics. Variability was assessed by performing two measurements, 30 min apart and the effect of increasing the number of readings for each sGaw measurement was also studied. Ipratropium bromide (IB) 10, 20, 100 and 200 microg was administered and the sensitivity of the methods compared by determining the lowest dose that caused changes greater than variability.

Results: In healthy subjects significant changes (P < or = 0.05) occurred at 10 microg for FEV(1) (mean [95% CI]; 1.3%[0.3-2.3]), R5 (mean [95% CI]; -7.9%, [-13.2-2.6]) and R20 (mean [95% CI], -6.4%, [-11.4-1.4]). No significant change was detected when the mean of 3 sGaw readings was used, but with 10 readings significant change was observed at 20 microg; (mean increase [95% CI] 15.2%[8.3-22.1]). In asthmatics significant changes (P < or = 0.05) occurred with IB 10 microg for sGaw (mean [95% CI] 25.6%[11.1-40.1]), R5 (mean [95% CI]-11.3%, [-15.5-7.2]), RF (mean [95% CI] 11.7%[6.1-16.3]), FEV(1) (mean [95% CI] 5.1%[2.6-7.7]) and MMEF (mean [95% CI] 12.3%[2.3-22.2]).

Conclusion: IOS and spirometry are more sensitive than sGaw in healthy subjects, but the sensitivity of sGaw improved when the number of readings was increased. The most sensitive method for assessing bronchodilation in asthmatics was sGaw.

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Figures

Figure 1
Figure 1
Mean (%) within day difference (error bars = 95% CI) in healthy subjects related to number of sGaw readings analysed
Figure 2
Figure 2
Comparison of the change in sGaw post ipratropium bromide with within day variability in healthy subjects.Dashed line = upper 95% CI for within day variabilityDiamonds = mean % change in sGaw (error bars = lower 95% CI)
Figure 3
Figure 3
Changes in sGaw, R5 and FEV1 after increasing doses of ipratopium bromide. Mean (%) change from baseline
Figure 3
Figure 3
Changes in sGaw, R5 and FEV1 after increasing doses of ipratopium bromide. Mean (%) change from baseline
See this image and copyright information in PMC

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