When methacholine inhalation tests were performed on asthmatic children using an Astograph, a new apparatus developed by Takishima, 17 percent of them showed a fall of respiratory resistance (Rrs) curve in spite of the induced broncheal constriction. In order to explain this strange phenomenon, contributing factors to Rrs, i.e. mouth pressure (P) and flow at the mouth (V) were examined. It was found that in the group showing Rrs fall, the difference of phase angle between the two waves was remarkable with the resultant excessively underestimated vale of P. It was considered that this was the most important contributing factor for the occurrence of the above phenomenon. On the other hand, when P-V lissajous'figures (P-V diagrams) in the group showing Rrs fall were analysed, the angles of the lissajous'inclinations before and after methacholine inhalation were both large. Moreover, this finding was consistent with the decreased %FEV_1 of the tested children before provocation with methacholine. From these results, it was suggested that Rrs fall might occur when inhalation tests were performed on patients in whom there was some degree of broncheal constriction even before testing. It would seem that other factors, i.e. the respiratory pattern of the child, the size of the thorax, the site of broncheal obstruction and the presence of air trapping did not contribute to the occurrence of Rrs fall.
View full abstract