Dynamic airway function during exercise in COPD assessed via impulse oscillometry before and after inhaled bronchodilators.

2021 ◽  
Author(s):  
Nicholas B. Tiller ◽  
Min Cao ◽  
Fang Lin ◽  
Wei Yuan ◽  
Chu-yi Wang ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Airway Resistance ◽  
Pulmonary Ventilation ◽  
Peak Exercise ◽  
Impulse Oscillometry ◽  
Airway Function ◽  
Volume Curve ◽  
Copd Patients ◽  
Before And After ◽  
Flow Volume Curve

Introduction. Assessing airway function during exercise provides useful information regarding mechanical properties of the airways and extent of ventilatory limitation in COPD. The primary aim of this study was to use impulse oscillometry (IOS) to assess dynamic changes in airway impedance across a range of exercise intensities in GOLD 1-4 patients, before and after albuterol. A secondary aim was to assess reproducibility of IOS measures during exercise. Methods. Fifteen COPD patients (8 male; age=66±8 y; pre-bronchodilator FEV1=54.3±23.6%Pred) performed incremental cycle ergometry before and 90-min after inhaled albuterol. Pulmonary ventilation and gas exchange were measured continuously, and IOS-derived indices of airway impedance were measured every 2 min immediately preceding inspiratory capacity manoeuvres. Test-retest reproducibility of exercise IOS was assessed as mean difference between replicate tests in five healthy subjects (3 male). Results. At rest and during exercise, albuterol significantly increased airway reactance (X5), and decreased airway resistance (R5, R5-20), impedance (Z5), and end-expiratory lung volume (60±12 vs. 58±12%TLC, main effect p=0.003). At peak exercise, there were moderate-to-strong associations between IOS variables and IC, and between IOS and concavity in the expiratory limb of the flow-volume curve. Exercise IOS exhibited moderate reproducibility in healthy subjects which was strongest with R5 (mean diff. -0.01±0.05 kPa/L/s; ICC=0.68), R5-20 (mean diff. -0.004±0.028 kPa/L/s; ICC=0.65), and Z5 (mean diff. -0.006±0.021 kPa/L/s; ICC=0.69). Conclusions. Exercise evoked increases in airway resistance and decreases in reactance that were ameliorated by inhaled bronchodilators. The technique of exercise IOS may aid in the clinical assessment of dynamic airway function during exercise.

scholarly journals Relationship Between Spontaneous Expiratory Flow-Volume Curve Pattern and Air-Flow Obstruction in Elderly COPD Patients

2013 ◽  
Vol 58 (10) ◽  
pp. 1643-1648 ◽  
Author(s):  
M. Nozoe ◽  
K. Mase ◽  
S. Murakami ◽  
M. Okada ◽  
T. Ogino ◽  
...  
Keyword(s):  
Air Flow ◽  
Flow Volume ◽  
Curve Pattern ◽  
Volume Curve ◽  
Copd Patients ◽  
Flow Volume Curve ◽  
Expiratory Flow

scholarly journals To the informative value of flow-volume curve in forced expiration

2008 ◽  
pp. 91-97 ◽  
Author(s):  
G. A. Lyubimov ◽  
I. M. Skobeleva ◽  
G. M. Sakharova ◽  
A. V. Suvorov
Keyword(s):  
Airway Resistance ◽  
Lung Compliance ◽  
Forced Expiration ◽  
Flow Volume ◽  
Functional Tests ◽  
Lung Volumes ◽  
Volume Curve ◽  
Quitting Smoking ◽  
Flow Volume Curve ◽  
Airway Walls

This report introduces a mathematical model of forced expiration to analyze pulmonary function. Results of 3-year lung function monitoring of an ex-smoker have been shown in the paper. Actual values of lung volumes and airway resistance were used for modeling. The computerized data were compared to the flow-volume curve parameters and lung volumes measured during the forced expiration. Weak correlation between the "flow-volume" curve parameters and the time after quitting smoking together with significant change in the lung volumes and the airway resistance seen in the study could be due to some processes which have not been followed in this study (lung compliance, airway resistance at forced expiration, and elastic properties of airway walls).The results demonstrated that mathematical models could increase informative value of pulmonary functional tests. In addition, the model could emphasize additional functional tests for better diagnostic usefulness of functional investigations.

Density dependence of maximal expiratory flow before and during tracheal constriction in dogs

1986 ◽  
Vol 60 (3) ◽  
pp. 1060-1066 ◽  
Author(s):  
R. G. Castile ◽  
O. F. Pedersen ◽  
J. M. Drazen ◽  
R. H. Ingram
Keyword(s):  
Density Dependence ◽  
Lung Volumes ◽  
Maximal Expiratory Flow ◽  
Volume Curve ◽  
Before And After ◽  
Lower Lung ◽  
Flow Volume Curve ◽  
Expiratory Flow ◽  
Longitudinal Extension ◽  
Central Airway

The effect of carbachol-induced central bronchoconstriction on density dependence of maximal expiratory flow (MEF) was assessed in five dogs. MEFs were measured on air and an 80% He-20% O2 mixture before and after local application of carbachol to the trachea. Airway pressures were measured using a pitot-static probe, from which central airway areas were estimated. At lower concentrations of carbachol the flow-limiting site remained in the trachea over most of the vital capacity (VC), and tracheal area and compliance decreased in all five dogs. In four dogs, decreases in choke point area predominated and produced decreases in flows. In one dog the increase in airway “stiffness” apparently offset the fall in area to account for an increase in MEF. Density dependence measured as the ratio of MEF on HeO2 to MEF on air at 50% of VC increased in all five dogs. Increases in density dependence appeared to be related to increases in airway stiffness at the choke point rather than decreases in gas-related airway pressure differences. Lower concentrations produced a localized decrease in tracheal area and extended the plateau of the flow-volume curve to lower lung volumes. Higher concentrations caused further reductions in tracheal area and greater longitudinal extension of bronchoconstriction, resulting in upstream movement of the site of flow limitation at higher lung volumes. Density dependence increased if the flow-limiting sites remained in the trachea at mid-VC but fell if the flow-limiting site had moved upstream by that volume.

Detection of expiratory flow limitation during exercise in COPD patients

1997 ◽  
Vol 82 (3) ◽  
pp. 723-731 ◽  
Author(s):  
Nickolaos G. Koulouris ◽  
Ioanna Dimopoulou ◽  
Päivi Valta ◽  
Richard Finkelstein ◽  
Manuel G. Cosio ◽  
...  
Keyword(s):  
Normal Subjects ◽  
Chronic Obstructive ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Obstructive Pulmonary Disease ◽  
Normal Limits ◽  
Volume Curve ◽  
Copd Patients ◽  
Flow Volume Curve ◽  
Expiratory Flow

Koulouris, Nickolaos G., Ioanna Dimopoulou, Päivi Valta, Richard Finkelstein, Manuel G. Cosio, and J. Milic-Emili.Detection of expiratory flow limitation during exercise in COPD patients. J. Appl. Physiol. 82(3): 723–731, 1997.—The negative expiratory pressure (NEP) method was used to detect expiratory flow limitation at rest and at different exercise levels in 4 normal subjects and 14 patients with chronic obstructive pulmonary disease (COPD). This method does not require performance of forced expirations, nor does it require use of body plethysmography. It consists in applying negative pressure (−5 cmH2O) at the mouth during early expiration and comparing the flow-volume curve of the ensuing expiration with that of the preceding control breath. Subjects in whom application of NEP does not elicit an increase in flow during part or all of the tidal expiration are considered flow limited. The four normal subjects were not flow limited up to 90% of maximal exercise power output (W˙max). Five COPD patients were flow limited at rest, 9 were flow limited at one-third W˙max, and 12 were flow limited at two-thirdsW˙max. Whereas in all patients who were flow limited at rest the maximal O2 uptake was below the normal limits, this was not the case in most of the other patients. In conclusion, NEP provides a rapid and reliable method to detect expiratory flow limitation at rest and during exercise.

Density dependence of maximal flow in dogs with central and peripheral obstruction

1983 ◽  
Vol 55 (3) ◽  
pp. 717-725 ◽  
Author(s):  
R. G. Castile ◽  
O. F. Pedersen ◽  
J. M. Drazen ◽  
R. H. Ingram
Keyword(s):  
Density Dependence ◽  
Vital Capacity ◽  
Forced Expiration ◽  
Flow Volume ◽  
Partial Obstruction ◽  
Volume Curve ◽  
Before And After ◽  
Lower Lung ◽  
Maximum Expiratory Flow ◽  
Flow Volume Curve

In 12 anesthetized, tracheotomized, vagotomized, open-chested, mongrel dogs we measured end and side hole airway pressures during forced expiration using a Pitot static probe. Volume was obtained as the integral of flow from a dog plethysmograph with frequency response adequate to 20 Hz. Equal pressure points (EPPs) and choke points (CPs) were located with dogs breathing air or a mixture of 80% helium-20% oxygen (HeO2) before and after partial obstruction of the trachea and intravenous histamine and propranolol. At 50% of vital capacity (VC) the CP was in the trachea in 11 of 12 dogs. Partial obstruction of the trachea decreased flow during the plateau of the maximum expiratory flow-volume curve (MEFVC) with the CP remaining in the trachea. The MEFVC plateau was extended to a lower lung volume. At 50% of VC the EPP moved downstream and density dependence remained high. Histamine and propranolol caused EPPs and CPs to move towards the periphery and density dependence to decrease. The shape of the MEFVC changed as the plateau was shortened and, in some instances, abolished. A plateau on the MEFVC could be regenerated by partial obstruction of the trachea. This was accompanied by return of the CP to the trachea and an increase in density dependence. Changes in density dependence were found to be a result of both the relocation of sites of flow limitation and differences in local CP areas with HeO2 and air.

Changes in flow-volume curve configuration with bronchoconstriction and bronchodilation

1986 ◽  
Vol 61 (6) ◽  
pp. 2243-2251 ◽  
Author(s):  
C. R. O'Donnell ◽  
R. G. Castile ◽  
J. Mead
Keyword(s):  
Vital Capacity ◽  
Normal Subjects ◽  
Flow Volume ◽  
Slope Ratio ◽  
Lung Volumes ◽  
Volume Curve ◽  
Before And After ◽  
Lower Lung ◽  
Maximum Expiratory Flow ◽  
Flow Volume Curve

Changes in the configuration of maximum expiratory flow-volume (MEFV) curves following mild degrees of bronchodilation or bronchoconstriction were studied in five normal and five asthmatic subjects. In a volume-displacement plethysmograph, MEFV curves were performed before and after inhalation of aerosolized isoproterenol (I) or histamine (H). Five filtered MEFV curves were averaged, and slope ratio vs. volume (SR-V) plots were obtained from averaged curves. Following I, maximal flows at 75% of the vital capacity (VC) were decreased in asthmatics but not in normal subjects. Flows at 50 and 25% of the VC increased in normal subjects and asthmatics, whereas VC′s were unchanged. In asthmatics, sudden large decreases in flow (bumps) occurred at lower lung volumes following I. H reduced flows over the entire VC, with greater reductions occurring in asthmatics than in normals, particularly at low lung volumes. In asthmatics, VC was slightly reduced, and bumps in MEFV curve configuration occurred at higher lung volumes or were abolished entirely following H. A reduction in the amount of configurational detail appreciable in MEFV curves following histamine in asthmatics was best seen in SR-V plots. Following H, SR′s decreased regularly with decreasing lung volume in all the asthmatics but in none of the normals. This was the single most striking finding of this study. Mild I- and H-induced perturbations of airway bronchomotor tone produced small but consistent changes in MEFV curve configuration.(ABSTRACT TRUNCATED AT 250 WORDS)

Relationship between airway microvascular leakage, edema, and baseline airway functions

1998 ◽  
Vol 84 (1) ◽  
pp. 77-81
Author(s):  
Melissa Matheson ◽  
Ann-Christine Rynell ◽  
Melissa McClean ◽  
Norbert Berend
Keyword(s):  
Evans Blue ◽  
Airway Resistance ◽  
Respiratory Physiology ◽  
Blue Dye ◽  
Wall Area ◽  
Evans Blue Dye ◽  
Microvascular Leakage ◽  
Airway Function ◽  
Significant Difference ◽  
Before And After

Matheson, Melissa, Ann-Christine Rynell, Melissa McClean, and Norbert Berend. Relationship between airway microvascular leakage, edema, and baseline airway functions. J. Appl. Physiol. 84(1): 77–81, 1998.—This study was designed to examine the relationship among microvascular leakage, edema, and baseline airway function. Microvascular leakage was induced in the airways of anesthetized, tracheostomized New Zealand White rabbits ( n = 22) by using nebulized N-formyl-methionyl-leucyl-phenylalanine (10 mg) and was measured in the trachea by using the Evans blue dye technique. Airway wall thickness was assessed morphometrically in the right main bronchus after Formalin fixation at a pressure of 25 cmH2O. Areas calculated included the mucosal wall area, the adventitial wall area, the total wall area, and the percentage of total wall area consisting of blood vessels. A neutrophil count was also performed by analyzing numbers of cells in both the mucosal wall area and the adventitial wall area. Airway function was assessed before and 30 min after challenge with N-formyl-methionyl-leucyl-phenylalanine by determining airway resistance, functional residual capacity, specific airway resistance, and flow-volume and pressure-volume curves (after paralysis of the animals with suxamethonium). The concentration of Evans blue dye in tracheal tissue ranged from 31.3 to 131.2 μg. There was a significant correlation between this concentration and both the adventitial wall area ( P < 0.01) and mucosal neutrophil numbers ( P < 0.005). There was no correlation between Evans blue concentration and either blood vessel area or changes in respiratory physiology parameters before and after challenge. There was no significant difference between any respiratory physiology measurements before and after challenge. We conclude that an increase in microvascular leakage correlates with airway edema in the adventitia; however, these airway changes have no significant effect on airway elastic or resistive properties.

Practical Importance of a Preceding Full Inhalation or Exhalation upon the Measurement of Airway Resistance

1980 ◽  
Vol 58 (3) ◽  
pp. 249-253 ◽  
Author(s):  
T. Higenbottam ◽  
T. J. H. Clark
Keyword(s):  
Airway Resistance ◽  
Practical Importance ◽  
Normal Male ◽  
Indirect Measurements ◽  
Lung Capacity ◽  
Airway Function ◽  
Before And After ◽  
Residual Capacity ◽  
Normal Men ◽  
Male Subjects

1. Airway resistance was measured close to functional residual capacity before and after a full inhalation of total lung capacity, as well as before and after a full exhalation to residual volume. 2. The effects of these volume manoeuvres upon airway resistance (and associated lung volume) were determined in four resting normal male subjects and in six normal men during experimentally induced bronchoconstriction after breathing an air/histamine mist from a Wright's nebulizer. 3. In four men the duration of the effect of a full inhalation upon airway resistance after induced bronchoconstriction was assessed separately. 4. Neither a full inhalation nor a full exhalation altered airway resistance under normal conditions. However, a full inhalation reduced airway resistance in the presence of bronchoconstriction and this effect lasted for a period of 45 s. Even with bronchoconstriction, a full exhalation had no effect on airway resistance. 5. Account must therefore be taken of the potential reduction in airway resistance which may result from a full inhalation, particularly when indirect measurements of airway function which involve a full inhalation, such as forced spirometry, are used to assess airway obstruction.

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