Affiliations: [a] Section of Experimental Anaesthesiology, Clinic of Anaesthesiology, University Hospital Freiburg, Germany | [b] Center of Data Analysis and Model Building, University of Freiburg, Germany
Correspondence:
[**]
Address for correspondence: S. Reisch, Section of Experimental Anaesthesiology, Clinic of Anaesthesiology, University of Freiburg, Hugstetterstrasse 55, D-79106 Freiburg, Germany. Tel.: +49 761 270 2333; Fax: +49 761 270 2396; E-mail: [email protected]-freiburg.de.
Note: [*] Presented in part at the 30th Congress of Biomedical Engineering, Zürich, 1996.
Abstract: The forced oscillation technique (FOT) is a non-invasive method which may be suitable for assessing upper airway obstruction in obstructive sleep apnea/hypopnea syndrome (OSAS) patients. The aim of this study was to determine in vitro if FOT can provide an early detection index of total or partial upper airway occlusion. A respiratory system analog was developed which includes an upper airway analog that allows simulation of upper airway collapse (thus mimicking the situation in patients with OSAS). We simulated different degrees of upper airway obstructions ranging from 0 (unobstructed airways) to 1 (total occlusion). Furthermore, we imitated the collapsible upper airway wall by means of elastic membranes with ten different wall compliances ranging from 3.3×10−4 to 1 l/mbar. For the two stiffest rubber membranes (Cwall=0.01 and 3.3×10−4 l/mbar) the absolute value of the impedance (|Z|) showed a marked increase for obstructions greater than 0.6. For the two membranes with the highest wall compliances (Cwall=0.03 and 1 l/mbar) obstructions with an increase in |Z| could not be detected before the obstruction reached 0.8. For degrees of obstruction less than 0.6 the phase angle of collapsible membranes with low compliance (stiff airway wall) were about 1.5π which significantly differed from phase angles of 1.7π measured in membranes with high compliance (elastic airway wall); p<0.01. We hypothesized that stiffness of upper airway walls corresponds with their muscle tone, i.e., stiff airway walls are related with high muscle tone and vice versa. Thus, a decrease in upper airway muscle activity would cause an increase of upper airway wall elasticity that enables upper airway collapse. As a consequence the phase angle ϕ could be expected to change from values characterizing stiff membranes to values characterizing more elastic membranes which could be used as early indicator for obstructive respiratory events. We have frequently observed such changes in morphology of ϕ(t) data obtained from patients with OSAS.
