Influence of inspiratory flow rate and frequency on O2 cost of resistive breathing in humans

1988 ◽  
Vol 65 (2) ◽  
pp. 760-766 ◽  
Author(s):  
D. S. Dodd ◽  
P. W. Collett ◽  
L. A. Engel

We examined the combined effect of an increase in inspiratory flow rate and frequency on the O2 cost of inspiratory resistive breathing (VO2 resp). In each of three to six pairs of runs we measured VO2 resp in six normal subjects breathing through an inspiratory resistance with a constant tidal volume (VT). One of each pair of runs was performed at an inspiratory muscle contraction frequency of approximately 10/min and the other at approximately 30/min. Inspiratory mouth pressure was 45 +/- 2% (SE) of maximum at the lower contraction frequency and 43 +/- 2% at the higher frequency. Duty cycle (the ratio of contraction time to total cycle time) was constant at 0.51 +/- 0.01. However, during the higher frequency runs, two of every three contractions were against an occluded airway. Because VT and duty cycle were kept constant, mean inspiratory flow rate increased with frequency. Careful selection of appropriate parameters allowed the pairs of runs to be matched both for work rate and pressure-time product. The VO2 resp did not increase, despite approximately threefold increases in both inspiratory flow rate and contraction frequency. On the contrary, there was a trend toward lower values for VO2 resp during the higher frequency runs. Because these were performed at a slightly lower mean lung volume, a second study was designed to measure the VO2 resp of generating the same inspiratory pressure (45% maximum static inspiratory mouth pressure at functional residual capacity) at the same frequency but at two different lung volumes. This was achieved with a negligibly small work rate.(ABSTRACT TRUNCATED AT 250 WORDS)

1990 ◽  
Vol 78 (5) ◽  
pp. 521-525 ◽  
Author(s):  
Manuel J. Barros ◽  
Stefano J. Zammattio ◽  
P. John Rees

1. The cough response to inhalation of citric acid is produced mainly by irritation of the larynx and trachea. Variations in the inspiratory flow rate might lead to changes in deposition of the drug, and consequently in the cough threshold. 2. We have studied the effect of three different inspiratory flow rates in 11 normal, non-smoking subjects (nine males, aged 23–39 years), who inhaled nebulized citric acid (2.5–640 mg/l). The test finished when a cough. was produced at each inhalation (cough threshold) or the maximum concentration was reached. 3. The inspiratory flow rate was limited with a fixed resistance and displayed on a screen so that the subjects could reach a constant inspiratory flow rate of 50, 100 and 150 l/min with a submaximal inspiratory effort. 4. The mean (sd) inspiratory flow rates achieved were 51.4 (5.3), 86.2 (16.6) and 134.4 (22.9) l/min. Baseline forced expiratory volume in 1 s and functional vital capacity were not different on the 3 study days. 5. The cough threshold (geometric mean and 95% confidence intervals) was 21 (9–54) mg/l at an inspiratory flow rate of 50 l/min and 43 (13–141) mg/l at 150 l/min (P <0.05). The amount of drug tolerated by the subjects before the cough threshold was achieved was 5.2 (2.0–13.8) mg at an inspiratory flow rate of 50 l/min and 11.6 (3.4–39.8) mg at 150 l/min (P <0.05). The number of coughs per inhalation was 1.6 (1.1–2.0) at an inspiratory flow rate of 50 l/min and 1.1 (0.7–1.5) at 150 l/min (P <0.05). 6. We conclude that lower inspiratory flow rates were associated with a greater cough stimulus in the citric acid challenge procedure used in this study. This may be related to increased laryngeal deposition. The inspiratory flow rate is a variable which should be controlled in the performance of cough challenges with citric acid.


1988 ◽  
Vol 64 (4) ◽  
pp. 1397-1404 ◽  
Author(s):  
D. S. Dodd ◽  
S. Kelly ◽  
P. W. Collett ◽  
L. A. Engel

We examined the effect of increasing work rate, without a corresponding increase in the pressure-time product, on energy cost and inspiratory muscle endurance (Tlim) in five normal subjects during inspiratory resistive breathing. Tidal volume, mean inspiratory mouth pressure, duty cycle, and hence the pressure-time product were kept constant, whereas work rate was varied by changing the frequency of breathing. There was a linear decrease in Tlim of -2.1 ± 0.5 s.J-1.min-1 (r = 0.87 ± 0.06) with increasing work rate. The data satisfied a model of energy balance during fatiguing runs (Monod and Scherrer. Ergonomics 8: 329-337, 1965) and were consistent with the hypothesis that the rate of energy supply, or respiratory muscle blood flow, is fixed when the pressure-time product is constant. Our results indicate that during inspiratory resistive breathing against fatiguing loads, work rate determines endurance independently of the pressure-time product. On the basis of the model, our results lead to estimates of respiratory muscle blood flow and available energy stores under the conditions of our experiment.


2005 ◽  
Vol 69 (1-2) ◽  
pp. 95-100 ◽  
Author(s):  
Einar Wilder-Smith ◽  
Linda Liu ◽  
Khin Thein Ma Ma ◽  
Benjamin K.C. Ong

1993 ◽  
Vol 21 (1) ◽  
pp. 67-71 ◽  
Author(s):  
A. D. Bersten ◽  
A. J. Rutten ◽  
A. E. Vedig

Breathing through an endotracheal tube, connector, and ventilator demand valve imposes an added load on the respiratory muscles. As respiratory muscle fatigue is thought to be a frequent cause of ventilator dependence, we sought to examine the efficacy of five different ventilators in reducing this imposed work through the application of pressure support ventilation. Using a model of spontaneous breathing, we examined the apparatus work imposed by the Servo 900-C, Puritan Bennett 7200a, Engstrom Erica, Drager EV-A or Hamilton Veolar ventilators, a size 7.0 and 8.0 mm endotracheal tube, and inspiratory flow rates of 40 and 60 l/min. Pressure support of 0, 5, 10, 15, 20 and 30 cm H2O was tested at each experimental condition. Apparatus work was greater with increased inspiratory flow rate and decreased endotracheal tube size, and was lowest for the Servo 900-C and Puritan Bennett 7200a ventilators. Apparatus work fell in a curvilinear fashion when pressure support was applied, with no major difference noted between the five ventilators tested. At an inspiratory flow rate of 40 l/min, a pressure support of 5 and 8 cm H2O compensated for apparatus work through size 8.0 and 7.0 endotracheal tubes and the Servo 900-C and Puritan Bennett 7200a ventilators. However, the maximum negative pressure was greater for the Servo 900-C. The added work of breathing through endotracheal tubes and ventilator demand valves may be compensated for by the application of pressure support. The level of pressure support required depends on inspiratory flow rate, endotracheal tube size, and type of ventilator.


1999 ◽  
Vol 46 (5) ◽  
pp. 654
Author(s):  
Chang Hyeok An ◽  
Byung Hun Lee ◽  
Yong Bum Park ◽  
Jae Chul Choi ◽  
Hyun Suk Jee ◽  
...  

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A1171-A1172
Author(s):  
Jill Ohar ◽  
FCCP ◽  
Donald Mahler ◽  
Chris Barnes ◽  
Glenn Crater

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