Effect of lung volume and positional changes on pulmonary diffusing capacity and its components

1991 ◽  
Vol 71 (4) ◽  
pp. 1477-1488 ◽  
Author(s):  
H. Stam ◽  
F. J. Kreuzer ◽  
A. Versprille
Keyword(s):  
Lung Volume ◽  
Supine Position ◽  
Body Position ◽  
Membrane Conductance ◽  
Normal Subjects ◽  
Negative Slope ◽  
Sitting Position ◽  
Diffusing Capacity ◽  
Alveolar Volume ◽  
Residual Capacity

Normal subjects have a larger diffusing capacity normalized per liter alveolar volume (DL/VA) in the supine than in the sitting position. Body position changes total lung diffusing capacity (DL), DL/VA, membrane conductance (Dm), and effective pulmonary capillary blood volume (Qc) as a function of alveolar volume (VA). These functions were studied in 37 healthy volunteers. DL/VA vs. VA yields a linear relationship in sitting as well as in supine position. Both have a negative slope but usually do not run parallel. In normal subjects up to 50 yr old DL/VA and DL increased significantly when subjects moved from a sitting to a supine posture at volumes between 50 and 100% of total lung capacity (TLC). In subjects greater than 50 yr old the responses of DL/VA and DL to change in body position were not significant at TLC. Functional residual capacity (FRC) decreases and DL/VA increases in all normal subjects when they change position from sitting to supine. When DL/VA increases more than predicted from the DL/VA vs. VA relationship in a sitting position, we may infer an increase in effective Qc in the supine position. In 56% of the volunteers, supine DL was smaller than sitting DL despite a higher DL/VA at FRC in the supine position because of the relatively larger decrease in FRC. When the positional response at TLC is studied, an estimation obtained accidentally at a volume lower than TLC may influence results. Above 80% of TLC, Dm decreased significantly from sitting to supine. Below this lung volume the decrease was not significant. The relationship between Qc and VA was best described by a second-order polynomial characterized by a maximum Qc at a VA greater than 60% of TLC. Qc was significantly higher in the supine position than in the sitting position, but the difference became smaller with increasing age. In observing the sitting and supine positions, we saw a decrease in maximum Qc normalized per square meter of body surface area with age.

Effects of gravity on lung diffusing capacity and cardiac output in prone and supine humans

2003 ◽  
Vol 95 (1) ◽  
pp. 3-10 ◽  
Author(s):  
M. Rohdin ◽  
J. Petersson ◽  
P. Sundblad ◽  
M. Mure ◽  
R. W. Glenny ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Normal Subjects ◽  
Arterial Oxygenation ◽  
Diffusing Capacity ◽  
Alveolar Volume ◽  
Pulmonary Capillary Blood Flow ◽  
Pulmonary Capillary ◽  
Supine Posture ◽  
Pulmonary Capillary Blood ◽  
Residual Capacity

Both in normal subjects exposed to hypergravity and in patients with acute respiratory distress syndrome, there are increased hydrostatic pressure gradients down the lung. Also, both conditions show an impaired arterial oxygenation, which is less severe in the prone than in the supine posture. The aim of this study was to use hypergravity to further investigate the mechanisms behind the differences in arterial oxygenation between the prone and the supine posture. Ten healthy subjects were studied in a human centrifuge while exposed to 1 and 5 times normal gravity (1 G, 5 G) in the anterioposterior (supine) and posterioanterior (prone) direction. They performed one rebreathing maneuver after ∼5 min at each G level and posture. Lung diffusing capacity decreased in hypergravity compared with 1 G (ANOVA, P = 0.002); it decreased by 46% in the supine posture compared with 25% in the prone ( P = 0.01 for supine vs. prone). At the same time, functional residual capacity decreased by 33 and 23%, respectively ( P < 0.001 for supine vs. prone), and cardiac output by 40 and 31% ( P = 0.007 for supine vs. prone), despite an increase in heart rate of 16 and 28% ( P < 0.001 for supine vs. prone), respectively. The finding of a more impaired diffusing capacity in the supine posture compared with the prone at 5 G supports our previous observations of more severe arterial hypoxemia in the supine posture during hypergravity. A reduced pulmonary-capillary blood flow and a reduced estimated alveolar volume can explain most of the reduction in diffusing capacity when supine.

Influence of body position on dynamic compliance in young subjects

1977 ◽  
Vol 42 (5) ◽  
pp. 706-710 ◽  
Author(s):  
H. Sasaki ◽  
W. Hida ◽  
T. Takishima
Keyword(s):  
Frequency Dependence ◽  
Lung Volume ◽  
Body Position ◽  
Pulmonary Ventilation ◽  
Dynamic Compliance ◽  
Normal Subjects ◽  
Supine Posture ◽  
Significant Difference ◽  
Residual Capacity ◽  
Young Subjects

We studied the effect of a postural change from the erect to the supine position on the unevenness of pulmonary ventilation in six normal subjects. Static pressure-volume curves had a similar shape in both positions but the supine curves were shifted such that all transpulmonary pressures were 5–8 cmH2O lower. Dynamic compliance (Cdyn) was measured in seated and supine postures at functional residual capacity (FRC) and also while the seated subjects maintained end-expiratory lung volume at the level of supine FRC. Frequency dependence of Cdyn increased relative to that measured in the seated position at FRC when the subject remained seated but decreased his lung volume, or when he assumed the supine posture. There was no significant difference between Cdyn measured in the supine posture and in the seated at supine FRC. We conclude that the increased frequency dependence seen in the supine posture is largely attributed to the associated decrease of lung volume rather than to position per se.

Effect of volume history on changes in DLcoSB-3EQ with lung volume in normal subjects

1992 ◽  
Vol 73 (2) ◽  
pp. 434-439 ◽  
Author(s):  
D. J. Cotton ◽  
F. Taher ◽  
J. T. Mink ◽  
B. L. Graham
Keyword(s):  
Lung Volume ◽  
Normal Subjects ◽  
Breath Holding ◽  
Diffusing Capacity ◽  
Tidal Breathing ◽  
Inspiratory Capacity ◽  
Deep Breath ◽  
Residual Capacity ◽  
The Relationship ◽  
Volume History

The purpose of this study was to determine the relationship between the three-equation diffusing capacity for carbon monoxide (DLcoSB-3EQ) and lung volume and to determine how this relationship was altered when maneuvers were immediately preceded by a deep breath. DLcoSB-3EQ maneuvers were performed in nine healthy subjects either immediately after a deep breath or after tidal breathing for 10 min. The maneuvers consisted of slow inhalation of test gas from functional residual capacity to 25, 50, 75, or 100% of the inspiratory capacity and, without breath holding, slow exhalation to residual volume. After either a deep breath or tidal breathing, we found that DLcoSB-3EQ decreased nonlinearly with decreasing lung volume. At all lung volumes, DLcoSB-3EQ was significantly greater when measured after a deep breath than after tidal breathing. This effect increased as lung volume decreased, so that the greatest difference between DLcoSB-3EQ after a deep breath and that after tidal breathing occurred at the lowest lung volume. We conclude that a deep breath or spontaneous sigh has a role in reestablishing the pathway for gas exchange during tidal breathing.

The effect of conductive ventilation heterogeneity on diffusing capacity measurement

2008 ◽  
Vol 104 (4) ◽  
pp. 1094-1100 ◽  
Author(s):  
Sylvia Verbanck ◽  
Daniel Schuermans ◽  
Sophie Van Malderen ◽  
Walter Vincken ◽  
Bruce Thompson
Keyword(s):  
Carbon Monoxide ◽  
Vital Capacity ◽  
Experimental Situation ◽  
Normal Subjects ◽  
Diffusing Capacity ◽  
Capacity Measurement ◽  
Alveolar Volume ◽  
Estimation Errors ◽  
Single Breath ◽  
Ventilation Heterogeneity

It has long been assumed that the ventilation heterogeneity associated with lung disease could, in itself, affect the measurement of carbon monoxide transfer factor. The aim of this study was to investigate the potential estimation errors of carbon monoxide diffusing capacity (DlCO) measurement that are specifically due to conductive ventilation heterogeneity, i.e., due to a combination of ventilation heterogeneity and flow asynchrony between lung units larger than acini. We induced conductive airway ventilation heterogeneity in 35 never-smoker normal subjects by histamine provocation and related the resulting changes in conductive ventilation heterogeneity (derived from the multiple-breath washout test) to corresponding changes in diffusing capacity, alveolar volume, and inspired vital capacity (derived from the single-breath DlCO method). Average conductive ventilation heterogeneity doubled ( P < 0.001), whereas DlCO decreased by 6% ( P < 0.001), with no correlation between individual data ( P > 0.1). Average inspired vital capacity and alveolar volume both decreased significantly by, respectively, 6 and 3%, and the individual changes in alveolar volume and in conductive ventilation heterogeneity were correlated ( r = −0.46; P = 0.006). These findings can be brought in agreement with recent modeling work, where specific ventilation heterogeneity resulting from different distributions of either inspired volume or end-expiratory lung volume have been shown to affect DlCO estimation errors in opposite ways. Even in the presence of flow asynchrony, these errors appear to largely cancel out in our experimental situation of histamine-induced conductive ventilation heterogeneity. Finally, we also predicted which alternative combination of specific ventilation heterogeneity and flow asynchrony could affect DlCO estimate in a more substantial fashion in diseased lungs, irrespective of any diffusion-dependent effects.

Effects of body position change on thoracoabdominal motion

1978 ◽  
Vol 45 (4) ◽  
pp. 581-589 ◽  
Author(s):  
V. P. Vellody ◽  
M. Nassery ◽  
W. S. Druz ◽  
J. T. Sharp
Keyword(s):  
Supine Position ◽  
Muscle Force ◽  
Body Position ◽  
Tidal Breathing ◽  
Position Change ◽  
Rib Cage ◽  
Inspiratory Muscles ◽  
Residual Capacity ◽  
Lateral Decubitus ◽  
Local Compliance

With a linearized respiratory magnetometer, measurements of anteroposterior and lateral diameters of both the rib cage and the abdomen were made at functional residual capacity and continuously during tidal breathing. Twenty-five subjects with normal respiratory systems were studied in the sitting, supine, lateral decubitus, and prone body positions. When subjects changed from sitting to supine position anteroposterior diameters of both rib cage and abdomen decreased while their lateral diameters increased. Both anteroposterior and lateral tidal excursions of the rib cage decreased; those of the abdomen increased. When subjects turned from supine to lateral decubitus position both anteroposterior diameters increased and the lateral diameters decreased. This was associated with an increase in both lateral excursions and a decrease in the abdominal anteroposterior excursions. Diameters and tidal excursions in the prone position resembled those in the supine position. Diameter changes could be explained by gravitational effects. Differences in tidal excursions accompanying body position change were probably related to 1) differences in the distribution of respiratory muscle force, 2) differences in the activity or mechanical advantage of various inspiratory muscles, and 3) local compliance changes in parts of the rib cage and abdomen.

Diffusing capacity dependent on lung volume and age in normal subjects

1994 ◽  
Vol 76 (6) ◽  
pp. 2356-2363 ◽  
Author(s):  
H. Stam ◽  
V. Hrachovina ◽  
T. Stijnen ◽  
A. Versprille
Keyword(s):  
Reference Values ◽  
Linear Method ◽  
Hemoglobin Concentration ◽  
Normal Subjects ◽  
Random Coefficients ◽  
Diffusing Capacity ◽  
Alveolar Volume ◽  
Lung Volumes ◽  
Conversion Method ◽  
Older Subjects

In this study we determined reference values of total diffusing capacity of carbon monoxide (DLCO) and DLCO per liter alveolar volume (DLCO/VA) at total lung capacity (TLC) and at lung volumes below TLC in sitting position. In 55 healthy nonsmoking volunteers (20–85 yr old), we determined reference values at TLC level in which age was the only parameter. In a subgroup (n = 16) these references did not change by correction for normal variability in hemoglobin concentration. In all volunteers DLCO decreased and DLCO/VA increased with decreasing VA. The increase in DLCO/VA was linear and less in older subjects. We derived equations to calculate reference values of DLCO/VA for lung volumes at and below TLC with two methods: 1) “random coefficients linear” model, which calculates the reference values directly, and 2) a conversion method, which calculates DLCO/VA for lower VA levels from reference values at TLC. An advantage of the conversion method is the suitability of DLCO/VA reference values at TLC of other populations. A disadvantage is the greater standard deviation of these reference values compared with those obtained by the random coefficients linear method. DLCO can be found by multiplying DLCO/VA with VA.

Inspiratory muscles during exercise: a problem of supply and demand

1988 ◽  
Vol 64 (6) ◽  
pp. 2482-2489 ◽  
Author(s):  
P. Leblanc ◽  
E. Summers ◽  
M. D. Inman ◽  
N. L. Jones ◽  
E. J. Campbell ◽  
...  
Keyword(s):  
Lung Volume ◽  
Static Pressure ◽  
Total Lung Capacity ◽  
Supply And Demand ◽  
Normal Subjects ◽  
Esophageal Pressure ◽  
Maximum Exercise ◽  
Lung Capacity ◽  
Inspiratory Muscles ◽  
Residual Capacity

The capacity of inspiratory muscles to generate esophageal pressure at several lung volumes from functional residual capacity (FRC) to total lung capacity (TLC) and several flow rates from zero to maximal flow was measured in five normal subjects. Static capacity was 126 +/- 14.6 cmH2O at FRC, remained unchanged between 30 and 55% TLC, and decreased to 40 +/- 6.8 cmH2O at TLC. Dynamic capacity declined by a further 5.0 +/- 0.35% from the static pressure at any given lung volume for every liter per second increase in inspiratory flow. The subjects underwent progressive incremental exercise to maximum power and achieved 1,800 +/- 45 kpm/min and maximum O2 uptake of 3,518 +/- 222 ml/min. During exercise peak esophageal pressure increased from 9.4 +/- 1.81 to 38.2 +/- 5.70 cmH2O and end-inspiratory esophageal pressure increased from 7.8 +/- 0.52 to 22.5 +/- 2.03 cmH2O from rest to maximum exercise. Because the estimated capacity available to meet these demands is critically dependent on end-inspiratory lung volume, the changes in lung volume during exercise were measured in three of the subjects using He dilution. End-expiratory volume was 52.3 +/- 2.42% TLC at rest and 38.5 +/- 0.79% TLC at maximum exercise.

scholarly journals Lung elastic recoil during breathing at increased lung volume

1999 ◽  
Vol 87 (4) ◽  
pp. 1491-1495 ◽  
Author(s):  
Joseph R. Rodarte ◽  
Gassan Noredin ◽  
Charles Miller ◽  
Vito Brusasco ◽  
Riccardo Pellegrino ◽  
...  
Keyword(s):  
Stress Relaxation ◽  
Tidal Volume ◽  
Lung Volume ◽  
Normal Subjects ◽  
Dynamic Hyperinflation ◽  
Airway Closure ◽  
Elastic Recoil ◽  
Volume Increase ◽  
Before And After ◽  
Residual Capacity

During dynamic hyperinflation with induced bronchoconstriction, there is a reduction in lung elastic recoil at constant lung volume (R. Pellegrino, O. Wilson, G. Jenouri, and J. R. Rodarte. J. Appl. Physiol. 81: 964–975, 1996). In the present study, lung elastic recoil at control end inspiration was measured in normal subjects in a volume displacement plethysmograph before and after voluntary increases in mean lung volume, which were achieved by one tidal volume increase in functional residual capacity (FRC) with constant tidal volume and by doubling tidal volume with constant FRC. Lung elastic recoil at control end inspiration was significantly decreased by ∼10% within four breaths of increasing FRC. When tidal volume was doubled, the decrease in computed lung recoil at control end inspiration was not significant. Because voluntary increases of lung volume should not produce airway closure, we conclude that stress relaxation was responsible for the decrease in lung recoil.

Gravity effects on upper airway area and lung volumes during parabolic flight

1998 ◽  
Vol 84 (5) ◽  
pp. 1639-1645 ◽  
Author(s):  
Maurice Beaumont ◽  
Redouane Fodil ◽  
Daniel Isabey ◽  
Frédéric Lofaso ◽  
Dominique Touchard ◽  
...  
Keyword(s):  
Lung Volume ◽  
Parabolic Flight ◽  
Upper Airway ◽  
Normal Subjects ◽  
Lung Volumes ◽  
Acoustic Reflection ◽  
Volume Functional ◽  
Airway Caliber ◽  
Gravity Effects ◽  
Residual Capacity

We measured upper airway caliber and lung volumes in six normal subjects in the sitting and supine positions during 20-s periods in normogravity, hypergravity [1.8 + head-to-foot acceleration (Gz)], and microgravity (∼0 Gz) induced by parabolic flights. Airway caliber and lung volumes were inferred by the acoustic reflection method and inductance plethysmography, respectively. In subjects in the sitting position, an increase in gravity from 0 to 1.8 +Gz was associated with increases in the calibers of the retrobasitongue and palatopharyngeal regions (+20 and +30%, respectively) and with a concomitant 0.5-liter increase in end-expiratory lung volume (functional residual capacity, FRC). In subjects in the supine position, no changes in the areas of these regions were observed, despite significant decreases in FRC from microgravity to normogravity (−0.6 liter) and from microgravity to hypergravity (−0.5 liter). Laryngeal narrowing also occurred in both positions (about −15%) when gravity increased from 0 to 1.8 +Gz. We concluded that variation in lung volume is insufficient to explain all upper airway caliber variation but that direct gravity effects on tissues surrounding the upper airway should be taken into account.

Respiratory movements of the vocal cords

1983 ◽  
Vol 54 (5) ◽  
pp. 1269-1276 ◽  
Author(s):  
T. Brancatisano ◽  
P. W. Collett ◽  
L. A. Engel
Keyword(s):  
Lung Volume ◽  
Respiratory Control ◽  
Respiratory Muscles ◽  
Normal Subjects ◽  
Tight Coupling ◽  
Tidal Breathing ◽  
Vocal Cords ◽  
Residual Capacity ◽  
The Relationship ◽  
Respiratory Movements

We examined the movements of the vocal cords during tidal breathing, panting, and large changes in lung volume in 12 normal subjects. The glottis was observed with a fiber-optic bronchoscope, and the glottic image was recorded together with flow, volume, and a time marker onto videotape. Phasic respiratory swings in glottic width (dg) and glottic area (Ag) were reproducible in all subjects but differed substantially between subjects. In the group as a whole dg and Ag increased during inspiration to 10.1 +/- 5.6 mm and 126 +/- 8 mm2 (mean +/- SE), respectively, whereas during expiration the lowest values were 5.7 +/- 0.5 mm and 70 +/- 7 mm2, respectively. These extreme dimensions corresponded closely to the midtidal volume points in the respiratory cycle. Glottic width during vital capacity (VC) expirations was nearly 30% greater at a flow of 1.2 l/s than at 0.5 l/s, but the relationship between dg and lung volume differed between subjects. When swings in dg were minimized by panting, there was no difference in dg between functional residual capacity (FRC) and a volume corresponding to midinspiratory capacity. However, tidal breathing at this lung volume was associated with a 20% decrease in dg compared with breathing at FRC. Our observations indicate a tight coupling between the pattern of glottic movement and the respiratory volume cycle. The results suggest that during voluntary respiratory maneuvers both intrinsic laryngeal and respiratory muscles are recruited, participating as effector organs in ventilatory and respiratory control.

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