2003 OPEN FORUM Abstracts
CLINICAL MEANING OF RAPID CUFF PRESSURE RISING IN CHEST WALL PRESSURE MONITOR
Tetsuo Miyagawa PhD,RRT,RPT,RCET, Department of Physical Therapeutics. School of Nursing and Rehabilitation Sciences. Showa University. Yokohama. Japan. Norio Kihara, MD, Department of Respiratory Medicine. Kihara Hospital. Tokyo. Japan. Hiroki Goshima BS, Research & Develop Center. The First Medical Team. SECOM Co. LTD. Tokyo. Japan.
INTRODUCTION:We already reported the accuracy, reproducibility and disease specificity of chest wall pressure monitor that we developed in healthy subjects and patients with respiratory disease in AARC International Respiratory Congress 47th and 48th. The purpose of this study was to assess the clinical meaning of rapid cuff pressures rising in FVC maneuver using the new chest wall pressure monitor in patients with chronic respiratory disease.
METHODS: We analyzed chest and abdominal wave forms of cuff pressure and compared with the measurements of pulmonary function testing, respiratory muscle strength and chest auscultation. We also measured several times to know the reproducibility of this monitor in ten patients with bronchial asthma and ten patients with chronic emphysema in the trial.
RESULTS: Rapid cuff pressures rising in FVC maneuver were recognized 78.6%(22/28 times) in asthma patients and 33.3%(6/18 times) in emphysema patients. Appearance frequency of rapid cuff pressure rising between asthma and emphysema was recognized significantly difference by two-tailed asymptotic significance probability (p<0.002). Expiratory wheeze was recognized in all patients have rapid cuff pressures rising, and the timing of appearance was same in wheeze and rapid cuff pressures rising. However, appearance frequency of rapid cuff pressure rising was 32.1%(9/28 times) in FEV 1.0% less than 70% by pulmonary function testing. The negative correlation coefficients between cuff pressure and FEV 1.0%, PEF at spirometry were in highly significant (r= -0.615, p<0.001). Rapid cuff pressures rising had high correlation coefficients with respiratory muscle strength and cuff pressure in resting ventilation, FEV 1.0% and PEF(r= 0.33~0.72, p<0.05~0.003)
CONCLUSIONS: It seemed that the rapid cuff pressure rising in FVC maneuver suggested airflow limitation. Our chest wall pressure monitor has high detective ratio compared with pulmonary function testing.