Impact of frequency range and input impedance on airway-tissue separation implied from transfer impedance

Abstract

In humans, application of the DuBois (DuBois et al. J. Appl. Physiol. 8: 587–594, 1956) six-element model to respiratory transfer impedance (Ztr) data has been proposed as a means to noninvasively estimate airway and tissue properties. This approach requires prior knowledge of alveolar gas compressibility (Cg). With input impedance (Zin), prior knowledge of Cg is not required, but the data do not support a reliable separation of airway from tissue properties. In this study, we investigated the separation of airway and tissue properties when Ztr and Zin data are measured and analyzed simultaneously over a larger frequency range than usual. In 10 healthy adults, we measured Ztr and Zin from 2 to 64 Hz. Zin was measured using both the standard approach with oscillations directly into the airway opening (Zst) and the head generator approach (Zhg) with oscillations applied around the head. With Ztr data alone, we found that the airway resistance and inertance estimates were reliable with only 2- to 32-Hz data and were unaffected by including the additional 32- to 64-Hz data. Conversely, the estimates of tissue resistance and inertance were highly unreliable unless the 32- to 64-Hz data are included. Because of enhanced sensitivity of Ztr to Cg from 32 to 64 Hz, inaccuracies in the assigned Cg will distort the estimated tissue but not airway properties. The Ztr-based parameters predicted Zhg data far better than Zst data, which is consistent with Zhg data being less influenced by upper airway shunting over this frequency range. There was no apparent advantage to combining Ztr and Zhg data during parameter estimation. With Cg unfixed, the estimated Cg was 50–100% higher than expected from an independent measurement of functional residual capacity. These results confirm that Ztr alone can provide a reliable distinction of lumped respiratory airway and tissue properties that are little influenced by upper airway wall shunting but only if 2- to 64-Hz data are analyzed. This distinction, however, requires an accurate prior measurement of Cg, and this requirement cannot be removed by combining Ztr and Zin data.