Comparing pulmonary resistance measured with an esophageal balloon to resistance measurements with an airflow perturbation device

The airflow perturbation device (APD) perturbs flow and mouth pressure during regular breathing. Ratios of mouth pressure perturbation magnitudes to flow perturbation magnitudes were used to calculate inspiratory, expiratory and average respiratory resistances. Resistance measurements with the APD were compared to pulmonary resistances directly measured with an esophageal balloon. Six healthy subjects were tested during tidal breathing when known external resistances were added during inspiration, during expiration and during both inspiration and expiration. When the baseline averaged balloon measured pulmonary resistance was subtracted from the baseline averaged APD measured resistance, the difference between them was 0.92 ± 1.25 (mean ± SD) cmH₂O L^–1 s^–1. Compared to the magnitude of the known increase in the added resistance, the APD measured resistance increased by 79%, whereas directly measured pulmonary resistance increased only by 56%. During addition of external resistances to both inspiration and expiration, the changes in inspiratory and expiratory pulmonary resistance were only 36% and 62% of the added resistance, respectively. On the other hand, the APD inhalation and exhalation resistance measured between 82% and 76% of the added resistance. We conclude that the APD detects changes in external resistance at least as well as, and probably better than, classical measurements of pulmonary resistance