Reader Perceptions and Impact of AI on CT Assessment of Air Trapping

Background: Alpha-1 antitrypsin deficiency (AATD) is a hereditary disorder involving lungs, characterized by low serum concentration of the protein alpha-1 antitrypsin (AAT) also called proteinase inhibitor (PI). Asthma is common in AATD patients, but there are only few data on respiratory function in asthmatic patients with AATD. Objectives: The aim of the study was to evaluate lung function in asthmatic outpatients with mutation in the SERPINA1 gene coding for AAT versus asthmatic subjects without mutation. Methods: We performed the quantitative analysis of the serum concentration of AAT in 600 outpatients affected by mild to moderate asthma from the University Hospital of Parma, Italy. Fifty-seven of them underwent the genetic analysis subsequently; they were subdivided into mutated and non-mutated subjects. All the mutated patients had a heterozygous genotype, except 1 (PI*SS). We assessed the lung function through a flow-sensing spirometer and the small airway parameters through an impulse oscillometry system. Results: The values of forced vital capacity (% predicted) and those of the residual volume to total lung capacity ratio (%) were, respectively, lower and higher in patients mutated versus patients without mutation, showing a significantly greater air trapping (p = 0.014 and p = 0.017, respectively). Moreover, patients with mutation in comparison to patients without mutation showed lower forced expiratory volume in 3 s (% predicted) and forced expiratory volume in 6 s (L) spirometric values, reflecting a smaller airways contribution. Conclusions: In asthmatic patients, heterozygosity for AAT with PI*MZ and PI*MS genotypes was associated with small airway dysfunction and with lung air trapping.

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Asthma in elderly is characterized by increased sputum neutrophils, lower airway caliber variability and air trapping

Respiratory Research ◽

10.1186/s12931-021-01619-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

F. Schleich ◽

S. Graff ◽

F. Guissard ◽

M. Henket ◽

V. Paulus ◽

...

Keyword(s):

Bronchial Hyperresponsiveness ◽

Forced Expiratory Volume ◽

Lower Airway ◽

Low Grade ◽

Sputum Induction ◽

Air Trapping ◽

Cell Counts ◽

Airway Caliber ◽

Significant Difference ◽

Long Acting

Abstract Background Elderly asthmatics represent an important group that is often excluded from clinical studies. In this study we wanted to present characteristics of asthmatics older than 70 years old as compared to younger patients. Methods We conducted a retrospective analysis on a series of 758 asthmatics subdivided in three groups: lower than 40, between 40 and 70 and older than 70. All the patients who had a successful sputum induction were included in the study. Results Older patients had a higher Body Mass Index, had less active smokers and were more often treated with Long Acting anti-Muscarinic Agents. We found a significant increase in sputum neutrophil counts with ageing. There was no significant difference in blood inflammatory cell counts whatever the age group. Forced expiratory volume in one second (FEV1) and FEV1/FVC values were significantly lower in elderly who had lower bronchial hyperresponsiveness and signs of air trapping. We found a lower occurrence of the allergic component in advanced ages. Asthmatics older than 70 years old had later onset of the disease and a significant longer disease duration. Conclusion Our study highlights that asthmatics older than 70 years old have higher bronchial neutrophilic inflammation, a poorer lung function, signs of air trapping and lower airway variability. The role of immunosenescence inducing chronic low-grade inflammation in this asthma subtype remains to be elucidated.

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Quantitative Computed Tomography Assessment of Air Trapping in Relapsing Polychondritis

Journal of Computer Assisted Tomography ◽

10.1097/01.rct.0000489975.31610.9e ◽

2016 ◽

Vol 40 (4) ◽

pp. 671

Keyword(s):

Computed Tomography ◽

Quantitative Computed Tomography ◽

Relapsing Polychondritis ◽

Air Trapping

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Application of an Optical Flow Method to Inspiratory and Expiratory Lung MDCT to Assess Regional Air Trapping: A Feasibility Study

American Journal of Roentgenology ◽

10.2214/ajr.05.0911 ◽

2007 ◽

Vol 188 (3) ◽

pp. W276-W280 ◽

Cited By ~ 12

Author(s):

Drew A. Torigian ◽

Warren B. Gefter ◽

John D. Affuso ◽

Kiarash Emami ◽

Lawrence Dougherty

Keyword(s):

Optical Flow ◽

Feasibility Study ◽

Air Trapping ◽

Flow Method ◽

Optical Flow Method

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Exaled nitric oxide and air trapping correlation in asthmatic children

Allergy ◽

10.1111/j.1398-9995.2005.00905.x ◽

2005 ◽

Vol 60 (11) ◽

pp. 1436-1439 ◽

Cited By ~ 8

Author(s):

L. Mappa ◽

F. Cardinale ◽

R. Camodeca ◽

M. L. Tortorella ◽

A. Pietrobelli ◽

...

Keyword(s):

Nitric Oxide ◽

Air Trapping ◽

Asthmatic Children

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Localized Bowel Distension in the Newborn: A Review of the Plain Film Analysis and Differential Diagnosis

PEDIATRICS ◽

10.1542/peds.73.2.206 ◽

1984 ◽

Vol 73 (2) ◽

pp. 206-215

Author(s):

J. Fred Johnson ◽

Lawrence H. Robinson

Keyword(s):

Differential Diagnosis ◽

Plain Film ◽

Left Colon ◽

Lower Abdomen ◽

Air Trapping ◽

Bowel Distension ◽

Distended Bowel ◽

Plain Films ◽

Small Bowel Atresia ◽

Bowel Atresia

Neonatal abdominal plain films were prospectively analyzed over a 41-month period in order to generate a differential diagnosis for focal bowel distension during the first 6 weeks of life. A total of 31 examples of locally distended bowel were collected. The study discredits the concept that asymmetrically distended bowel in the newborn is usually caused by necrotizing enterocolitis (only 9/31 cases) and indicates that distended bowel in the lower abdomen or left upper quadrant is often caused by air trapping in normal but redundant rectosigmoid (11 cases) or in distal transverse colon (three cases). Five other pathologic conditions not normally specified in differential diagnoses of focally distended bowel included inguinal hernia (three cases), small bowel atresia (two cases), midgut volvulus (one case), Hirschsprung's disease (one case), and small left colon (one case). The study emphasizes the value of sequential supine and prone filming for distinguishing normal from pathologic dilated loops of bowel.

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Air trapping and arboreal locomotor adaptation in primates: A review of experiments on humans

Zeitschrift für Morphologie und Anthropologie ◽

10.1127/zma/83/2002/149 ◽

2002 ◽

Vol 83 (2-3) ◽

pp. 149-159

Author(s):

Sugio Hayama ◽

Kiyoshi Honda ◽

Hideo Oka ◽

Morihiko Okada

Keyword(s):

Air Trapping ◽

Locomotor Adaptation

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Effect of the Ti/Te ratio on mean intratracheal pressure in high-frequency oscillatory ventilation

Journal of Applied Physiology ◽

10.1152/jappl.1998.84.5.1520 ◽

1998 ◽

Vol 84 (5) ◽

pp. 1520-1527 ◽

Cited By ~ 16

Author(s):

Ulrich Thome ◽

Frank Pohlandt

Keyword(s):

High Frequency ◽

Airway Pressure ◽

High Frequency Oscillatory Ventilation ◽

Inspiratory Time ◽

Mean Airway Pressure ◽

Air Trapping ◽

Oscillatory Ventilation ◽

Mean Pressure ◽

Oscillation Frequencies ◽

High Frequency Oscillatory

In high-frequency oscillatory ventilation (HFOV), an adequate mean airway pressure is crucial for successful ventilation and optimal gas exchange, but air trapping cannot be detected by the usual measurement at the y piece. Intratracheal pressures produced by the high-frequency oscillators HFV-Infantstar (IS), Babylog 8000 (BL), and the SensorMedics 3100A (SM) [the latter with either 30% (SM30) or 50% (SM50) inspiratory time] were investigated in four anesthetized tracheotomized female piglets that were 1 day old and weighed 1.6–1.9 kg (mean 1.76 kg). The endotracheal tube was repeatedly clamped while the piglets were ventilated with an oscillation frequency of 10 Hz, and the airway pressure distal of the clamp was recorded as a measure of average intrapulmonary pressure during oscillation. Clamping resulted in a significant decrease of mean airway pressure when the piglets were ventilated with SM30(−0.86 cmH2O), BL (−0.66 cmH2O), and IS (−0.71 cmH2O), but airway pressure increased by a mean of 0.76 cmH2O with SM50. Intratracheal pressure, when measured by a catheter pressure transducer at various oscillation frequencies, was lower than at the y piece by 0.4–0.9 cmH2O (SM30), 0.3–3 cmH2O (BL), and 1–4.7 cmH2O (IS) but was 0.4–0.7 cmH2O higher with SM50. We conclude that the inspiratory-to-expiratory time (Ti/Te) ratio influences the intratracheal and intrapulmonary pressures in HFOV and may sustain a mean pressure gradient between the y piece and the trachea. A Ti/Te ratio < 1:1 may be useful to avoid air trapping when HFOV is used.

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