Comparison of the Hyperoxic Test and the Alternate Breath Test in Infants

Peripheral chemoreceptor function has been tested using either the hyperoxic test (HT), which decreases minute ventilation (V E) by causing physiologic chemodenervation, or the alternate breath test (ABT), which induces V E alternations by delivering rapid hypoxic stimuli through breath-by-breath al...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2002-01, Vol.165 (2), p.206-210
Main Authors: BOUFERRACHE, BELKACEM, FILTCHEV, SLAVI, LEKE, ANDRE, FREVILLE, MICHEL, GALLEGO, JORGE, GAULTIER, CLAUDE
Format: Article
Language:English
Subjects:
Biological and medical sciences
Breath Tests
Chemoreceptor Cells - physiopathology
Humans
Hyperoxia - physiopathology
Infant
Infant, Newborn
Inspiratory Reserve Volume - physiology
Investigative techniques of respiratory function
Investigative techniques, diagnostic techniques (general aspects)
Medical sciences
Principal Component Analysis
Pulmonary Gas Exchange - physiology
Pulmonary Ventilation - physiology
Random Allocation
Reproducibility of Results
Tidal Volume - physiology
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Summary:Peripheral chemoreceptor function has been tested using either the hyperoxic test (HT), which decreases minute ventilation (V E) by causing physiologic chemodenervation, or the alternate breath test (ABT), which induces V E alternations by delivering rapid hypoxic stimuli through breath-by-breath alternations in fractional inspired O(2) between normoxia (0.21) and hypoxia (0.15). No previous studies have compared ventilatory responses to both tests in the same infants. We hypothesized that the V E decrease during HT would be significantly related to V E alternations during ABT. Eighteen infants (postnatal age 21 +/- 14 d) underwent two 30-s HTs and two ABTs (quiet sleep, face mask, and pneumotachograph; mass spectrometry measurement of inspired and expired O(2) and CO(2) fractions; and breath-by-breath analysis). The tests were done in random order. Decreases in V E and mean inspiratory flow (tidal volume over inspiratory time, VT/TI) during HTs were significantly correlated to their respective percentage coefficients of alternation during ABTs (r = 0.69 and 0.70, respectively, p < 0.01). Principal components analysis showed that the V E and VT/TI decreases during HTs were due chiefly to a fall in VT, whereas V E and VT/TI alternations were ascribable to alternations in both VT and TI. Intraindividual coefficients of variation of V E changes were significantly lower during HTs than during ABTs. We conclude that (1) ventilatory responses to HT and ABT are significantly correlated despite differences in the mechanisms of the V E changes; (2) the better reproducibility of the V E response to HT as compared with ABT may be an advantage in clinical practice.
ISSN:1073-449X
1535-4970
DOI:10.1164/ajrccm.165.2.2009061