Expiratory flow limitation and operating lung volumes during exercise in older and younger adults

2017 ◽  
Vol 240 ◽  
pp. 26-31 ◽  
Author(s):  
Joshua R. Smith ◽  
Stephanie P. Kurti ◽  
Kayla Meskimen ◽  
Craig A. Harms
Keyword(s):  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Younger Adults ◽  
Lung Volumes ◽  
Expiratory Flow

Lung volumes and expiratory flow limitation during exercise in interstitial lung disease

1994 ◽  
Vol 77 (2) ◽  
pp. 963-973 ◽  
Author(s):  
D. D. Marciniuk ◽  
G. Sridhar ◽  
R. E. Clemens ◽  
T. A. Zintel ◽  
C. G. Gallagher
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Lung Volume ◽  
Total Lung Capacity ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Ventilatory Capacity ◽  
Expiratory Flow

Lung volumes were measured at rest and during exercise by an open-circuit N2-washout technique in patients with interstitial lung disease (ILD). Exercise tidal flow-volume (F-V) curves were also compared with maximal F-V curves to investigate whether these patients demonstrated flow limitation. Seven patients underwent 4 min of constant work rate bicycle ergometer exercise at 40, 70, and 90% of their previously determined maximal work rates. End-expiratory lung volume and total lung capacity were measured at rest and near the end of each period of exercise. There was no significant change in end-expiratory lung volume or total lung capacity when resting measurements were compared with measurements at 40, 70, and 90% work rates. During exercise, expiratory flow limitation was evident in four patients who reported stopping exercise because of dyspnea. In the remaining patients who discontinued exercise because of leg fatigue, no flow limitation was evident. In all patients, the mean ratio of maximal minute ventilation to maximal ventilatory capacity (calculated from maximal F-V curves) was 67%. We conclude that lung volumes during exercise do not significantly differ from those at rest in this population and that patients with ILD may demonstrate expiratory flow limitation during exercise. Furthermore, because most patients with ILD are not breathing near their maximal ventilatory capacity at the end of exercise, we suggest that respiratory mechanics are not the primary cause of their exercise limitation.

scholarly journals Attenuation of induced bronchoconstriction in healthy subjects: effects of breathing depth

2005 ◽  
Vol 98 (3) ◽  
pp. 817-821 ◽  
Author(s):  
Francesco G. Salerno ◽  
Riccardo Pellegrino ◽  
Gianluca Trocchio ◽  
Antonio Spanevello ◽  
Vito Brusasco ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Vital Capacity ◽  
Total Lung Capacity ◽  
Flow Limitation ◽  
Residual Volume ◽  
Expiratory Flow Limitation ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Forced Expiratory Flow ◽  
Expiratory Flow

The effects of breathing depth in attenuating induced bronchoconstriction were studied in 12 healthy subjects. On four separate, randomized occasions, the depth of a series of five breaths taken soon (∼1 min) after methacholine (MCh) inhalation was varied from spontaneous tidal volume to lung volumes terminating at ∼80, ∼90, and 100% of total lung capacity (TLC). Partial forced expiratory flow at 40% of control forced vital capacity (V̇part) and residual volume (RV) were measured at control and again at 2, 7, and 11 min after MCh. The decrease in V̇part and the increase in RV were significantly less when the depth of the five-breath series was progressively increased ( P < 0.001), with a linear relationship. The attenuating effects of deep breaths of any amplitude were significantly greater on RV than V̇part ( P < 0.01) and lasted as long as 11 min, despite a slight decrease with time when the end-inspiratory lung volume was 100% of TLC. In conclusion, in healthy subjects exposed to MCh, a series of breaths of different depth up to TLC caused a progressive and sustained attenuation of bronchoconstriction. The effects of the depth of the five-breath series were more evident on the RV than on V̇part, likely due to the different mechanisms that regulate airway closure and expiratory flow limitation.

Modeling expiratory flow from excised tracheal tube laws

1999 ◽  
Vol 87 (5) ◽  
pp. 1973-1980 ◽  
Author(s):  
Nikolai Aljuri ◽  
Lutz Freitag ◽  
José G. Venegas
Keyword(s):  
Static Pressure ◽  
Pressure Recovery ◽  
High Frequency Ventilation ◽  
Flow Limitation ◽  
Flow Conditions ◽  
Expiratory Flow Limitation ◽  
Elastic Tubes ◽  
Viscous Losses ◽  
Forced Expiratory Flow ◽  
Expiratory Flow

Flow limitation during forced exhalation and gas trapping during high-frequency ventilation are affected by upstream viscous losses and by the relationship between transmural pressure (Ptm) and cross-sectional area ( A tr) of the airways, i.e., tube law (TL). Our objective was to test the validity of a simple lumped-parameter model of expiratory flow limitation, including the measured TL, static pressure recovery, and upstream viscous losses. To accomplish this objective, we assessed the TLs of various excised animal tracheae in controlled conditions of quasi-static (no flow) and steady forced expiratory flow. A tr was measured from digitized images of inner tracheal walls delineated by transillumination at an axial location defining the minimal area during forced expiratory flow. Tracheal TLs followed closely the exponential form proposed by Shapiro (A. H. Shapiro. J. Biomech. Eng. 99: 126–147, 1977) for elastic tubes: Ptm = K p[( A tr/ A tr0)− n − 1], where A tr0 is A tr at Ptm = 0 and K p is a parametric factor related to the stiffness of the tube wall. Using these TLs, we found that the simple model of expiratory flow limitation described well the experimental data. Independent of upstream resistance, all tracheae with an exponent n < 2 experienced flow limitation, whereas a trachea with n > 2 did not. Upstream viscous losses, as expected, reduced maximal expiratory flow. The TL measured under steady-flow conditions was stiffer than that measured under expiratory no-flow conditions, only if a significant static pressure recovery from the choke point to atmosphere was assumed in the measurement.

scholarly journals Clinical characteristics of COPD patients with tidal expiratory flow limitation

2017 ◽  
Vol Volume 12 ◽  
pp. 1503-1506 ◽  
Author(s):  
James Dean ◽  
Umme Kolsum ◽  
Paul Hitchen ◽  
Vanadana Gupta ◽  
Dave Singh
Keyword(s):  
Clinical Characteristics ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Copd Patients ◽  
Expiratory Flow

Expiratory flow limitation during exercise in prepubescent boys and girls: prevalence and implications

2010 ◽  
Vol 108 (5) ◽  
pp. 1267-1274 ◽  
Author(s):  
Katherine E. Swain ◽  
Sara K. Rosenkranz ◽  
Bethany Beckman ◽  
Craig A. Harms
Keyword(s):  
Body Composition ◽  
Oxygen Saturation ◽  
Tidal Volume ◽  
Lean Body Mass ◽  
Lung Volume ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Expiratory Flow

The purpose of this study was to compare the prevalence and implications of expiratory flow limitation (EFL) during exercise in boys and girls. Forty healthy, prepubescent boys (B; n = 20) and girls (G; n = 20) were tested. Subjects completed pulmonary function tests and an incremental cycle maximal oxygen uptake (V̇o2max) test. EFL was recorded at the end of each exercise stage using the % tidal volume overlap method. Ventilatory and metabolic data were recorded throughout exercise. Arterial oxygen saturation (SpO2) was determined via pulse oximetry. Body composition was determined using dual-energy X-ray absorptiometry. There were no differences ( P > 0.05) in height, weight, or body composition between boys and girls. At rest, boys had significantly higher lung volumes (total lung capacity, B = 2.6 ± 0.5 liters, G = 2.1 ± 0.5 liters) and peak expiratory flow rates (B = 3.6 ± 0.6 l/s; G = 1.6 ± 0.3 l/s). Boys also had significantly higher V̇o2max (B = 46.9 ± 5.9 ml·kg lean body mass−1·min−1, G = 41.7 ± 6.6 ml·kg lean body mass−1·min−1) and maximal ventilation (B = 49.8 ± 8.8 l/min, G = 41.2 ± 8.3 l/min) compared with girls. There were no sex differences ( P > 0.05) at V̇o2max in VE /Vco2, end-tidal Pco2, heart rate, respiratory exchange ratio, or SpO2. The prevalence (B = 19/20 vs. G = 18/20) and severity (B = 58 ± 7% vs. G = 43 ± 8% tidal volume) of EFL was not significantly different in boys compared with girls at V̇o2max. A significant relationship existed between % EFL at V̇o2max and the change in end-expiratory lung volume from rest to maximal exercise in boys ( r = 0.77) and girls ( r = 0.75). In summary, our data suggests that EFL is highly and equally prevalent in prepubescent boys and girls during heavy exercise, which led to an increased end-expiratory lung volume but not to decreases in arterial oxygen saturation.

Mechanism of reduced maximum expiratory flow in dogs with compensatory lung growth

1986 ◽  
Vol 60 (2) ◽  
pp. 441-448 ◽  
Author(s):  
H. W. Greville ◽  
M. E. Arnup ◽  
S. N. Mink ◽  
L. Oppenheimer ◽  
N. R. Anthonisen
Keyword(s):  
Control Flow ◽  
Sham Operation ◽  
Forced Expiration ◽  
Flow Limitation ◽  
Lung Growth ◽  
Lung Volumes ◽  
Flow Rates ◽  
Compensatory Lung Growth ◽  
Maximum Expiratory Flow ◽  
Expiratory Flow

We examined the mechanism of the reduced maximum expiratory flow rates (Vmax) in a dog model of postpneumonectomy compensatory lung growth. During forced expiration, a Pitot-static tube was used to locate the airway site of flow limitation, or choke point, and to measure dynamic intrabronchial pressures. The factors determining Vmax were calculated and the results analyzed in terms of the wave-speed theory of flow limitation. Measurements were made at multiple lung volumes and during ventilation both with air and with HeO2. Five of the puppies had undergone a left pneumonectomy at 10 wk of age, and 5 littermate controls had undergone a sham operation. All dogs were studied at 26 wk of age, at which time compensatory lung growth had occurred in the postpneumonectomy group. Vmax was markedly decreased in the postpneumonectomy group compared with control, averaging 42% of the control flow rates from 58 to 35% of the vital capacity (VC). At 23% of the VC, Vmax was 15% less than control. Choke points were more peripheral in the postpneumonectomy dogs compared with controls at all volumes. The total airway pressure was the same at the choke-point airway in the postpneumonectomy dogs as that in the same airway in the control dogs, suggesting that the airways of the postpneumonectomy dogs displayed different bronchial area-pressure behavior from the control dogs. Despite the decreased Vmax on both air and HeO2, the density dependence of flow was high in the postpneumonectomy dogs and the same as controls at all lung volumes examined.

Influence of airway geometry on expiratory flow limitation and density dependence

1983 ◽  
Vol 52 (1) ◽  
pp. 113-123 ◽  
Author(s):  
Ronald J. Knudson ◽  
Robert C. Schroter ◽  
Dwyn E. Knudson ◽  
Stuart Sugihara
Keyword(s):  
Density Dependence ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Expiratory Flow

scholarly journals Maximal Oxygen Uptake Validation in Children With Expiratory Flow Limitation

2013 ◽  
Vol 25 (1) ◽  
pp. 84-100 ◽  
Author(s):  
Katherine E. Robben ◽  
David C. Poole ◽  
Craig A. Harms
Keyword(s):  
Oxygen Uptake ◽  
Maximal Oxygen Uptake ◽  
Constant Load ◽  
Work Rate ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Test Protocol ◽  
Wide Range ◽  
Rate Relationship ◽  
Expiratory Flow

A two-test protocol (incremental/ramp (IWT) + supramaximal constant-load (CWR)) to affirm max and obviate reliance on secondary criteria has only been validated in highly fit children. In girls (n = 15) and boys (n = 12) with a wide range of VO2max (17–47 ml/kg/min), we hypothesized that this procedure would evince a VO2-WR plateau and unambiguous VO2max even in the presence of expiratory flow limitation (EFL). A plateau in the VO2-work rate relationship occurred in 75% of subjects irrespective of EFL There was a range in RER at max exercise for girls (0.97–1.14; mean 1.06 ± 0.04) and boys (0.98−1.09; mean 1.03 ± 0.03) such that 3/15 girls and 2/12 boys did not achieve the criterion RER. Moreover, in girls with RER > 1.0 it would have been possible to achieve this criterion at 78% VO2max. Boys achieved 92% VO2max at RER = 1.0. This was true also for HRmax where 8/15 girls’ and 6/12 boys’ VO2max would have been rejected based on HRmax being < 90% of age-predicted HRmax. In those who achieved the HRmax criterion, it represented a VO2 of 86% (girls) and 87% (boys) VO2max. We conclude that this two-test protocol confirms VO2max in children across a threefold range of VO2max irrespective of EFL and circumvents reliance on secondary criteria.

Plethysmographic assessment of tidal expiratory flow limitation

2021 ◽  
pp. 103801
Author(s):  
Edgardo D’Angelo ◽  
Dejan Radovanovic ◽  
Paolo Barbini ◽  
Pierachille Santus ◽  
Matteo Pecchiari
Keyword(s):  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Expiratory Flow
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