Abdominal distension alters regional pleural pressures and chest wall mechanics in pigs in vivo

1991 ◽  
Vol 70 (6) ◽  
pp. 2611-2618 ◽  
Author(s):  
T. Mutoh ◽  
W. J. Lamm ◽  
L. J. Embree ◽  
J. Hildebrandt ◽  
R. K. Albert

Abdominal distension (AD) occurs in pregnancy and is also commonly seen in patients with ascites from various causes. Because the abdomen forms part of the "chest wall," the purpose of this study was to clarify the effects of AD on ventilatory mechanics. Airway pressure, four (vertical) regional pleural pressures, and abdominal pressure were measured in five anesthetized, paralyzed, and ventilated upright pigs. The effects of AD on the lung and chest wall were studied by inflating a liquid-filled balloon placed in the abdominal cavity. Respiratory system, chest wall, and lung pressure-volume (PV) relationships were measured on deflation from total lung capacity to residual volume, as well as in the tidal breathing range, before and 15 min after abdominal pressure was raised. Increasing abdominal pressure from 3 to 15 cmH2O decreased total lung capacity and functional residual capacity by approximately 40% and shifted the respiratory system and chest wall PV curves downward and to the right. Much smaller downward shifts in lung deflation curves were seen, with no change in the transdiaphragmatic PV relationship. All regional pleural pressures increased (became less negative) and, in the dependent region, approached 0 cmH2O at functional residual capacity. Tidal compliances of the respiratory system, chest wall, and lung were decreased 43, 42, and 48%, respectively. AD markedly alters respiratory system mechanics primarily by "stiffening" the diaphragm/abdomen part of the chest wall and secondarily by restricting lung expansion, thus shifting the lung PV curve as seen after chest strapping. The less negative pleural pressures in the dependent lung regions suggest that nonuniformities of ventilation could also be accentuated and gas exchange impaired by AD.

1992 ◽  
Vol 72 (2) ◽  
pp. 575-582 ◽  
Author(s):  
T. Mutoh ◽  
W. J. Lamm ◽  
L. J. Embree ◽  
J. Hildebrandt ◽  
R. K. Albert

The effect of severe generalized edema on respiratory system mechanics is not well described. We measured airway pressure, gastric pressure, and four vertical pleural pressures in 13 anesthetized paralyzed pigs ventilated in the upright position. Pressure-volume relationships of the respiratory system, chest wall, and lung were measured on deflation from total lung capacity to residual volume and during tidal breathing both before (control) and 50 min after one of two interventions. In one series of experiments, a volume equal to 15–20% of the pig's body weight was infused intravenously. In a second series, a balloon was placed in the peritoneal space to distend the abdomen to the same gastric pressures as achieved in the first series. Measurements were compared before and after either abdominal balloon inflation or volume infusion. Volume infusion increased the pleural pressure in dependent lung regions, decreased both total lung capacity (34%) and functional residual capacity (62%) (both P less than 0.05), and markedly shifted the respiratory system and chest wall pressure-volume curves to the right, but it only moderately affected the lung deflation curve. Tidal compliances of the respiratory system, chest wall, and lung decreased 36, 31, and 49%, respectively (all P less than 0.05). The effect of abdominal balloon inflation on respiratory system mechanics was similar to that of volume infusion. We conclude that infusing large volumes of fluid markedly alters chest wall mechanics, mainly by causing abdominal distension that prohibits descent of the diaphragm.


1998 ◽  
Vol 85 (2) ◽  
pp. 451-458 ◽  
Author(s):  
Jennifer Beck ◽  
Christer Sinderby ◽  
Lars Lindström ◽  
Alex Grassino

The purpose of this study was to evaluate the influence of velocity of shortening on the relationship between diaphragm activation and pressure generation in humans. This was achieved by relating the root mean square (RMS) of the diaphragm electromyogram to the transdiaphragmatic pressure (Pdi) generated during dynamic contractions at different inspiratory flow rates. Five healthy subjects inspired from functional residual capacity to total lung capacity at different flow rates while reproducing identical Pdi and chest wall configuration profiles. To change the inspiratory flow rate, subjects performed the inspirations while breathing across two different inspiratory resistances (10 and 100 cmH2O ⋅ l−1 ⋅ s), at mouth pressure targets of −10, −20, −40, and −60 cmH2O. The diaphragm electromyogram was recorded and analyzed with control of signal contamination and electrode positioning. RMS values obtained for inspirations with identical Pdi and chest wall configuration profiles were compared at the same percentage of inspiratory duration. At inspiratory flows ranging between 0.1 and 1.4 l/s, there was no difference in the RMS for the inspirations from functional residual capacity to total lung capacity when Pdi and chest wall configuration profiles were reproduced ( n = 4). At higher inspiratory flow rates, subjects were not able to reproduce their chest wall displacements and adopted different recruitment patterns. In conclusion, there was no evidence for increased demand of diaphragm activation when healthy subjects breathe with similar chest wall configuration and Pdi profiles, at increasing flow rates up to 1.4 l/s.


2003 ◽  
Vol 95 (4) ◽  
pp. 1695-1705 ◽  
Author(s):  
Zoltán Hantos ◽  
Rachel A. Collins ◽  
Debra J. Turner ◽  
Tibor Z. Jánosi ◽  
Peter D. Sly

A tracking impedance estimation technique was developed to follow the changes in total respiratory impedance (Zrs) during slow total lung capacity maneuvers in six anesthetized and mechanically ventilated BALB/c mice. Zrs was measured with the wave-tube technique and pseudorandom forced oscillations at nine frequencies between 4 and 38 Hz during inflation from a transrespiratory pressure of 0-20 cmH2O and subsequent deflation, each lasting for ∼20 s. Zrs was averaged for 0.125 s and fitted by a model featuring airway resistance (Raw) and inertance, and tissue damping and elastance ( H). Lower airway conductance (Glaw) was linearly related to volume above functional residual capacity (V) between 0 and 75-95% maximum V, with a mean slope of dGlaw/dV = 13.6 ± 4.6 cmH2O-1 · s-1. The interdependence of Raw and H was characterized by two distinct and closely linear relationships for the low- and high-volume regions, separated at ∼40% maximum V. Comparison of Raw with the highest-frequency resistance of the total respiratory system revealed a marked volume-dependent contribution of tissue resistance to total respiratory system resistance, resulting in the overestimation of Raw by 19 ± 8 and 163 ± 40% at functional residual capacity and total lung capacity, respectively, whereas the lowest frequency reactance was proportional to H; these findings indicate that single-frequency resistance values may become inappropriate as surrogates of Raw when tissue impedance is changing.


1978 ◽  
Vol 45 (2) ◽  
pp. 255-260 ◽  
Author(s):  
Y. L. Lai ◽  
J. Hildebrandt

Functional residual capacity (FRC) and pressure-volume (PV) curves of the lung, chest wall, and total respiratory system were studied in 15 anesthetized rats, weighing 307 +/- 10 (SE) g. Pleural pressure was estimated from the esophageal pressure measured with a water-filled catheter. The FRC determined by body plethysmograph was slightly and significantly larger than FRC determined from saline displacement of excised lungs. The difference may be accounted for by O2 uptake by lung tissue, escape of CO2 through the pleura, and abdominal gas. Paralysis in the prone position did not affect FRC, and abdominal gas content contributed only slightly to the FRC measured by body plethysmograph. Values of various pulmonary parameters (mean +/- SE) were as follows: residual volume, 1.26 +/- 0.13 ml; FRC, 2.51 +/- 0.20 ml; total lung capacity, 12.23 +/- 0.55 ml; compliance of the lung, 0.90 +/- 0.06 ml/cmH2O; chest wall compliance, 1.50 +/- 0.11 ml/cmH2O; and respiratory system compliance, 0.57 +/- 0.03 ml/cmH2O. The lung PV curve did not show a consistent change after the chest was opened.


2017 ◽  
Vol 123 (4) ◽  
pp. 876-883 ◽  
Author(s):  
Robert H. Brown ◽  
Robert J. Henderson ◽  
Elizabeth A. Sugar ◽  
Janet T. Holbrook ◽  
Robert A. Wise

Brown RH, Henderson RJ, Sugar EA, Holbrook JT, Wise RA, on behalf of the American Lung Association Airways Clinical Research Centers. Reproducibility of airway luminal size in asthma measured by HRCT. J Appl Physiol 123: 876–883, 2017. First published July 13, 2017; doi:10.1152/japplphysiol.00307.2017.—High-resolution CT (HRCT) is a well-established imaging technology used to measure lung and airway morphology in vivo. However, there is a surprising lack of studies examining HRCT reproducibility. The CPAP Trial was a multicenter, randomized, three-parallel-arm, sham-controlled 12-wk clinical trial to assess the use of a nocturnal continuous positive airway pressure (CPAP) device on airway reactivity to methacholine. The lack of a treatment effect of CPAP on clinical or HRCT measures provided an opportunity for the current analysis. We assessed the reproducibility of HRCT imaging over 12 wk. Intraclass correlation coefficients (ICCs) were calculated for individual airway segments, individual lung lobes, both lungs, and air trapping. The ICC [95% confidence interval (CI)] for airway luminal size at total lung capacity ranged from 0.95 (0.91, 0.97) to 0.47 (0.27, 0.69). The ICC (95% CI) for airway luminal size at functional residual capacity ranged from 0.91 (0.85, 0.95) to 0.32 (0.11, 0.65). The ICC measurements for airway distensibility index and wall thickness were lower, ranging from poor (0.08) to moderate (0.63) agreement. The ICC for air trapping at functional residual capacity was 0.89 (0.81, 0.94) and varied only modestly by lobe from 0.76 (0.61, 0.87) to 0.95 (0.92, 0.97). In stable well-controlled asthmatic subjects, it is possible to reproducibly image unstimulated airway luminal areas over time, by region, and by size at total lung capacity throughout the lungs. Therefore, any changes in luminal size on repeat CT imaging are more likely due to changes in disease state and less likely due to normal variability. NEW & NOTEWORTHY There is a surprising lack of studies examining the reproducibility of high-resolution CT in asthma. The current study examined reproducibility of airway measurements. In stable well-controlled asthmatic subjects, it is possible to reproducibly image airway luminal areas over time, by region, and by size at total lung capacity throughout the lungs. Therefore, any changes in luminal size on repeat CT imaging are more likely due to changes in disease state and less likely due to normal variability.


1997 ◽  
Vol 83 (4) ◽  
pp. 1068-1075 ◽  
Author(s):  
Aladin M. Boriek ◽  
Joseph R. Rodarte ◽  
Theodore A. Wilson

Boriek, Aladin M., Joseph R. Rodarte, and Theodore A. Wilson. Kinematics and mechanics of midcostal diaphragm of dog. J. Appl. Physiol. 83(4): 1068–1075, 1997.—Radiopaque markers were attached to the peritoneal surface of three neighboring muscle bundles in the midcostal diaphragm of four dogs, and the locations of the markers were tracked by biplanar video fluoroscopy during quiet spontaneous breathing and during inspiratory efforts against an occluded airway at three lung volumes from functional residual capacity to total lung capacity in both the prone and supine postures. Length and curvature of the muscle bundles were determined from the data on marker location. Muscle lengths for the inspiratory states, as a fraction of length at functional residual capacity, ranged from 0.89 ± 0.04 at end inspiration during spontaneous breathing down to 0.68 ± 0.07 during inspiratory efforts at total lung capacity. The muscle bundles were found to have the shape of circular arcs, with the three bundles forming a section of a right circular cylinder. With increasing lung volume and diaphragm displacement, the circular arcs rotate around the line of insertion on the chest wall, the arcs shorten, but the radius of curvature remains nearly constant. Maximal transdiaphragmatic pressure was calculated from muscle curvature and maximal tension-length data from the literature. The calculated maximal transdiaphragmatic pressure-length curve agrees well with the data of Road et al. ( J. Appl. Physiol. 60: 63–67, 1986).


1979 ◽  
Vol 46 (1) ◽  
pp. 67-73 ◽  
Author(s):  
C. R. Inners ◽  
P. B. Terry ◽  
R. J. Traystman ◽  
H. A. Menkes

The effects of changing lung volume (VL) on collateral resistance (Rcoll) and total airways resistance (Raw) were compared in six young volunteers. At functional residual capacity (FRC) = 55% total lung capacity (TLC), mean Rcoll was 4,664 +/- 1,518 (SE) cmH2O/(l/s) and mean Raw was 1.57 +/- 0.11 (SE) cmH2O/l/s). When VL increased to 80% TLC, Rcoll decreased by 63.3 +/- 7.8%, and Raw decreased by 50.3 +/- 4.2 (SE) %. The decrease in Rcoll with increasing lung volume was not statistically different from that of Raw (P less than 0.05). If the airways obstructed for measurements of Rcoll served between 2 and 5% of the lungs, then Rcoll was approximately 50 times as great as the resistance to flow through airways serving the same volume of lung at FRC. The relationship did not change significantly when VL increased by 25% TLC. If changes in Raw reflect changes in airways supplying sublobar portions of lung, these results indicate that there is no tendency for the redistribution of ventilation through airways and collateral pathways with changes in VL in young subjects.


1989 ◽  
Vol 67 (2) ◽  
pp. 707-712 ◽  
Author(s):  
S. S. Margulies ◽  
J. R. Rodarte ◽  
E. A. Hoffman

Five anesthetized supine beagle dogs were scanned using a fast, multislice computed tomographic X-ray technique to determine the orientation of the ribs at total lung capacity (TLC) and functional residual capacity (FRC). A plane was fit to each rib using a coordinate system in which the z-axis was aligned approximately cephalocaudally and the x-z-plane coincided with the sagittal midplane. The orientation of each plane was described by “pump-handle” and “bucket-handle” angles. The ribs rotated downward and inward during a passive deflation of the lungs from TLC to FRC. Rib displacement was not uniform: bucket-handle motion was predominant in the upper ribs, and pump- and bucket-handle motions were equal in the lower ribs. The change in the pump-handle angles between TLC and FRC was approximately 6 degrees for ribs 3–8, and the change in the bucket-handle angles decreased with rib number from 16 degrees for rib 3 to 6 degrees for rib 8. Rib shape was described by fitting an ellipse to the data for each rib; the ribs became larger and more circular with increasing rib number.


1990 ◽  
Vol 68 (1) ◽  
pp. 35-43 ◽  
Author(s):  
M. Decramer ◽  
T. X. Jiang ◽  
M. B. Reid

We attempted to measure diaphragmatic tension by measuring changes in diaphragmatic intramuscular pressure (Pim) in the costal and crural parts of the diaphragm in 10 supine anesthetized dogs with Gaeltec 12 CT minitransducers. During phrenic nerve stimulation or direct stimulation of the costal and crural parts of the diaphragm in an animal with the chest and abdomen open, Pim invariably increased and a linear relationship between Pim and the force exerted on the central tendon was found (r greater than or equal to 0.93). During quiet inspiration Pim in general decreased in the costal part (-3.9 +/- 3.3 cmH2O), whereas it either increased or slightly decreased in the crural part (+3.3 +/- 9.4 cmH2O, P less than 0.05). Similar differences were obtained during loaded and occluded inspiration. After bilateral phrenicotomy Pim invariably decreased during inspiration in both parts (costal -4.3 +/- 6.4 cmH2O, crural -3.1 +/- 0.6 cmH2O). Contrary to the expected changes in tension in the muscle, but in conformity with the pressure applied to the muscle, Pim invariably increased during passive inflation from functional residual capacity to total lung capacity (costal +30 +/- 23 cmH2O, crural +18 +/- 18 cmH2O). Similarly, during passive deflation from functional residual capacity to residual volume, Pim invariably decreased (costal -12 +/- 19 cmH2O, crural -12 +/- 14 cmH2O). In two experiments similar observations were made with saline-filled catheters. We conclude that although Pim increases during contraction as in other muscles, Pim during respiratory maneuvers is primarily determined by the pleural and abdominal pressures applied to the muscle rather than by the tension developed by it.


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