PT  - JOURNAL ARTICLE
AU  - Zoe Fretheim-Kelly
AU  - Mette Engan
AU  - Hege Clemm
AU  - Tiina Andersen
AU  - John-Helge Heimdal
AU  - Eric Strand
AU  - Thomas Halvorsen
AU  - Ola Røksund
AU  - Maria Vollsæter
TI  - Reliability of translaryngeal airway resistance measurements during maximal exercise
AID  - 10.1183/23120541.00581-2021
DP  - 2022 Jan 01
TA  - ERJ Open Research
PG  - 00581-2021
VI  - 8
IP  - 1
4099  - http://openres.ersjournals.com/content/8/1/00581-2021.short
4100  - http://openres.ersjournals.com/content/8/1/00581-2021.full
SO  - erjor2022 Jan 01; 8
AB  - Objective Exercise-induced laryngeal obstruction is an important cause of exertional dyspnoea. The diagnosis rests on visual judgement of relative changes of the laryngeal inlet during continuous laryngoscopy exercise (CLE) tests, but we lack objective measures that reflect functional consequences. We aimed to investigate repeatability and normal values of translaryngeal airway resistance measured at maximal intensity exercise.Methods 31 healthy nonsmokers without exercise-related breathing problems were recruited. Participants performed two CLE tests with verified positioning of two pressure sensors, one at the tip of the epiglottis (supraglottic) and one by the fifth tracheal ring (subglottic). Airway pressure and flow data were continuously collected breath-by-breath and used to calculate translaryngeal resistance at peak exercise. Laryngeal obstruction was assessed according to a standardised CLE score system.Results Data from 26 participants (16 females) with two successful tests and equal CLE scores on both test sessions were included in the translaryngeal resistance repeatability analyses. The coefficient of repeatability (CR) was 0.62 cmH2O·L−1·s−1, corresponding to a CR% of 21%. Mean±sd translaryngeal airway resistance (cmH2O·L−1·s−1) in participants with no laryngeal obstruction (n=15) was 2.88±0.50 in females and 2.18±0.50 in males. Higher CLE scores correlated with higher translaryngeal resistance in females (r=0.81, p<0.001).Conclusions This study establishes translaryngeal airway resistance obtained during exercise as a reliable parameter in respiratory medicine, opening the door for more informed treatment decisions and future research on the role of the larynx in health and disease.This is the first study to establish translaryngeal airway resistance as a reliable parameter in human respiratory medicine, allowing more informed treatment decisions and future research on the role of the larynx in health and disease https://bit.ly/3rnBRWS