Reassessment of the interruption technique for measuring flow resistance in humans

1989 ◽  
Vol 67 (3) ◽  
pp. 933-937 ◽  
Author(s):  
G. Liistro ◽  
D. Stanescu ◽  
D. Rodenstein ◽  
C. Veriter
Keyword(s):  
Lung Disease ◽  
Healthy Subjects ◽  
Obstructive Lung Disease ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Whole Body ◽  
Quiet Breathing ◽  
Flow Interruption ◽  
Whole Body Plethysmography ◽  
Closed Airway

We have previously produced evidence that, in patients with obstructive lung disease, compliance of extrathoracic airways is responsible for lack of mouth-to-alveolar pressure equilibration during respiratory efforts against a closed airway. The flow interruption method for measuring respiratory resistance (Rint) is potentially faced with the same problems. We reassessed the merits of the interruption technique by rendering the extrathoracic airways more rigid and by using a rapid shutter. We measured airway resistance (Raw) with whole body plethysmography during panting (at 2 Hz) and Rint during quiet breathing. Rint and Raw were expressed as specific airway (sGaw) and interruptive conductance (sGint), respectively. In nine healthy subjects (cheeks supported), sGint (0.140 +/- 0.050 s-1.cmH2O-1) was lower (P less than 0.02) than sGaw (0.182 +/- 0.043 s-1.cmH2O-1). By contrast, in 12 patients with severe obstructive lung disease (forced expiratory volume in 1 s/vital capacity = 41.0 +/- 19.8%), sGint (0.058 +/- 0.012 s-1.cmH2O-1) was higher (P less than 0.05) than sGaw (0.047 +/- 0.007 s-1.cmH2O-1), when the cheeks were supported. When the mouth floor was also supported, average values of sGaw (0.048 +/- 0.008 s-1.cmH2O-1) and sGint (0.049 +/- 0.014 s-1.cmH2O-1) became similar. In conclusion, we confirm previous findings in healthy subjects of higher values of Rint, with respect to Raw, probably because of differences in glottis opening between quiet breathing and panting. In airflow obstruction, supporting both the cheeks and the mouth floor decreased sGint, which became similar to sGaw.

scholarly journals Association between chronic airflow obstruction and socio-economic position in Morocco: BOLD results

2020 ◽  
Vol 24 (2) ◽  
pp. 202-206
Author(s):  
M. Atassi ◽  
A. C. F. Kava ◽  
C. Nejjari ◽  
M. C. Benjelloun ◽  
M. El Biaze ◽  
...  
Keyword(s):  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Economic Status ◽  
Airflow Obstruction ◽  
Chronic Obstructive Lung Disease ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Socio Economic Status ◽  
Unit Increase ◽  
Disease Study

BACKGROUND: Chronic obstructive lung disease (COPD) is the third most common cause of death in the world. Factors other than smoking, such as socio-economic status, could be involved in the development of COPD.OBJECTIVE: To investigate the association between chronic airflow obstruction and socio-economic status in Morocco.DESIGN: Questionnaires were administered and spirometry tests performed as part of the BOLD (Burden of Obstructive Lung Disease) Study carried out in Fez, Morocco. Socio-economic status was evaluated using a wealth score (0–10) based on household assets. The ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) was used to measure airflow obstruction.RESULTS: A total of 760 subjects were included in the analysis. The mean age was 55.3 years (standard deviation [SD] 10.2); the average wealth score was 7.54 (SD 1.63). After controlling for other factors and potential confounders, FEV1/FVC increased by 0.4% (95%CI 0.01–0.78; P < 0.04) per unit increase in wealth score. Ageing, tobacco smoking, underweight, history of tuberculosis and asthma were also independently associated with a higher risk of airflow obstruction.CONCLUSION: Our findings suggest that airflow obstruction is associated with poverty in Morocco. Further investigations are needed to better understand the mechanisms of this association.

scholarly journals Tiotropio ir olodaterolio derinio vaidmuo lėtinės obstrukcinės plaučių ligos gydyme

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Laima Kondratavičienė
Keyword(s):  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Area Under The Curve ◽  
Forced Expiratory Volume

Įkvepiamieji bronchus plečiamieji vaistai yra lėtinės obstrukcinės plaučių ligosmedikamentinio gydymo pagrindas, siūlomas ir Pasaulinės lėtinės obstrukcinės plaučių ligos iniciatyvos (angl. Global Obstructive Lung Disease Initiative, GOLD). Ilgo veikimo įkvepiamieji muskarino receptorių blokatoriai (IVMB) ir ilgo veikimo β2 agonistai (IVBA) kartu derinyje yra veiksmingesni nei įprasti trumpo veikimo vaistai, o jų farmokologiniai profiliai efektyviai vienas kitą papildo. Rezultatai, gauti atlikus dvigubos terapijos tyrimus, parodė, kad šie vaistai gali būti derinami, o kompleksinė IVMB ir IVBA terapija sustiprina gydomąjį poveikį. Remiantis šiais duomenimis, pradėta dešimties III fazės klinikinių tyrimų programa ToviTO, kuri plačiai ištyrė kompleksinio gydymo tiotropio su olodateroliu viename inhaliatoriuje naudą. Tiotropio ir olodotareolio 5/5 µg derinys reikšmingai pagerino forsuoto iškvėpimo tūrio per pirmąją sekundę (angl. Forced Expiratory Volume in First Second, FEV1) plotą po kreive (angl. Area Under the Curve) nuo 0 iki 3 val. (FEV1 AUC0–3 val.), FEV1 rodiklius prieš kitos tiriamo vaisto dozės suvartojimą, gyvenimo kokybę, sumažino dusulio pojūtį bei padidino fizinio krūvio toleranciją, lyginant sumonoterapija ir placebu.

scholarly journals Maximal mid-expiratory flow detects early lung disease in α1-antitrypsin deficiency

2017 ◽  
Vol 49 (3) ◽  
pp. 1602055 ◽  
Author(s):  
James A. Stockley ◽  
Asem M. Ismail ◽  
Siân M. Hughes ◽  
Ross Edgar ◽  
Robert A. Stockley ◽  
...  
Keyword(s):  
Health Status ◽  
Lung Disease ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Small Airways ◽  
Antitrypsin Deficiency ◽  
Expiratory Flow ◽  
Group 2 ◽  
Group 1

Pathological studies suggest that loss of small airways precedes airflow obstruction and emphysema in chronic obstructive pulmonary disease (COPD). Not all α1-antitrypsin deficiency (AATD) patients develop COPD, and measures of small airways function might be able to detect those at risk.Maximal mid-expiratory flow (MMEF), forced expiratory volume in 1 s (FEV1), ratio of FEV1/forced vital capacity (FVC), health status, presence of emphysema (computed tomography (CT) densitometry) and subsequent decline in FEV1 were assessed in 196 AATD patients.FEV1/FVC, FEV1 % predicted and lung densitometry related to MMEF % pred (r2=0.778, p<0.0001; r2=0.787, p<0.0001; r2=0.594, p<0.0001, respectively) in a curvilinear fashion. Patients could be divided into those with normal FEV1/FVC and MMEF (group 1), normal FEV1/FVC and reduced MMEF (group 2) and those with spirometrically defined COPD (group 3). Patients in group 2 had worse health status than group 1 (median total St George's Respiratory Questionnaire (SGRQ) 23.15 (interquartile range (IQR) 7.09–39.63) versus 9.67 (IQR 1.83–22.35); p=0.006) and had a greater subsequent decline in FEV1 (median change in FEV1 −1.09% pred per year (IQR −1.91–0.04% pred per year) versus −0.04% pred per year (IQR −0.67–0.03% pred per year); p=0.007).A reduction in MMEF is an early feature of lung disease in AATD and is associated with impaired health status and a faster decline in FEV1.

scholarly journals Glucagon-Like Peptide-1 (GLP-1) Reduces Mortality and Improves Lung Function in a Model of Experimental Obstructive Lung Disease in Female Mice

Endocrinology ◽  
2013 ◽  
Vol 154 (12) ◽  
pp. 4503-4511 ◽  
Author(s):  
Niels-Erik Viby ◽  
Marie S. Isidor ◽  
Katrine B. Buggeskov ◽  
Steen S. Poulsen ◽  
Jacob B. Hansen ◽  
...  
Keyword(s):  
Lung Function ◽  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Whole Body ◽  
Control Group ◽  
Chronic Obstructive ◽  
Mrna Levels ◽  
Female Mice ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

The incretin hormone glucagon-like peptide-1 (GLP-1) is an important insulin secretagogue and GLP-1 analogs are used for the treatment of type 2 diabetes. GLP-1 displays antiinflammatory and surfactant-releasing effects. Thus, we hypothesize that treatment with GLP-1 analogs will improve pulmonary function in a mouse model of obstructive lung disease. Female mice were sensitized with injected ovalbumin and treated with GLP-1 receptor (GLP-1R) agonists. Exacerbation was induced with inhalations of ovalbumin and lipopolysaccharide. Lung function was evaluated with a measurement of enhanced pause in a whole-body plethysmograph. mRNA levels of GLP-1R, surfactants (SFTPs), and a number of inflammatory markers were measured. GLP-1R was highly expressed in lung tissue. Mice treated with GLP-1R agonists had a noticeably better clinical appearance than the control group. Enhanced pause increased dramatically at day 17 in all control mice, but the increase was significantly less in the groups of GLP-1R agonist-treated mice (P &lt; .001). Survival proportions were significantly increased in GLP-1R agonist-treated mice (P &lt; .01). SFTPB and SFTPA were down-regulated and the expression of inflammatory cytokines were increased in mice with obstructive lung disease, but levels were largely unaffected by GLP-1R agonist treatment. These results show that GLP-1R agonists have potential therapeutic potential in the treatment of obstructive pulmonary diseases, such as chronic obstructive pulmonary disease, by decreasing the severity of acute exacerbations. The mechanism of action does not seem to be the modulation of inflammation and SFTP expression.

Increased pain sensitivity, postural abnormalities, and functional balance impairment in obstructive lung disease compared to healthy subjects

Heart & Lung ◽  
2019 ◽  
Vol 48 (4) ◽  
pp. 351-355 ◽  
Author(s):  
Naciye Vardar-Yagli ◽  
Melda Saglam ◽  
Ebru Calik-Kutukcu ◽  
Deniz Inal-Ince ◽  
Hulya Arikan ◽  
...  
Keyword(s):  
Lung Disease ◽  
Healthy Subjects ◽  
Obstructive Lung Disease ◽  
Pain Sensitivity ◽  
Balance Impairment ◽  
Functional Balance ◽  
Postural Abnormalities

scholarly journals Regional airflow obstruction after bronchoconstriction and subsequent bronchodilation in subjects without pulmonary disease

2019 ◽  
Vol 127 (1) ◽  
pp. 31-39 ◽  
Author(s):  
E. T. Geier ◽  
R. J. Theilmann ◽  
G. K. Prisk ◽  
R. C. Sá
Keyword(s):  
Healthy Subjects ◽  
Standard Dose ◽  
Airway Remodeling ◽  
Airflow Obstruction ◽  
Normal Subjects ◽  
Forced Expiratory Volume ◽  
Bronchodilator Therapy ◽  
Ventilation Imaging ◽  
Ventilation Heterogeneity ◽  
Healthy Lung

Some subjects with asthma have ventilation defects that are resistant to bronchodilator therapy, and it is thought that these resistant defects may be due to ongoing inflammation or chronic airway remodeling. However, it is unclear whether regional obstruction due to bronchospasm alone persists after bronchodilator therapy. To investigate this, six young, healthy subjects, in whom inflammation and remodeling were assumed to be absent, were bronchoconstricted with a PC20 [the concentration of methacholine that elicits a 20% drop in forced expiratory volume in 1 s (FEV1)] dose of methacholine and subsequently bronchodilated with a standard dose of albuterol on three separate occasions. Specific ventilation imaging, a proton MRI technique, was used to spatially map specific ventilation across 80% of each subject’s right lung in each condition. The ratio between regional specific ventilation at baseline and after intervention was used to classify areas that had constricted. After albuterol rescue from methacholine bronchoconstriction, 12% (SD 9) of the lung was classified as constricted. Of the 12% of lung units that were classified as constricted after albuterol, approximately half [7% (SD 7)] had constricted after methacholine and failed to recover, whereas half [6% (SD 4)] had remained open after methacholine but became constricted after albuterol. The incomplete regional recovery was not reflected in the subjects’ FEV1 measurements, which did not decrease from baseline ( P = 0.97), nor was it detectable as an increase in specific ventilation heterogeneity ( P = 0.78). NEW & NOTEWORTHY In normal subjects bronchoconstricted with methacholine and subsequently treated with albuterol, not all regions of the healthy lung returned to their prebronchoconstricted specific ventilation after albuterol, despite full recovery of integrative lung indexes (forced expiratory volume in 1 s and specific ventilation heterogeneity). The regions that remained bronchoconstricted following albuterol were those with the highest specific ventilation at baseline, which suggests that they may have received the highest methacholine dose.

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