scholarly journals Heliox administration in anesthetized rabbits with spontaneous inspiratory flow limitation

Author(s):  
Edgardo Giacomo D'Angelo ◽  
Matteo M. Pecchiari ◽  
François Bellemare ◽  
Gabriele Cevenini ◽  
Paolo Barbini

We investigated the effects of heliox administration (80% Helium in O2) on tidal inspiratory flow limitation (tIFL) occurring in supine anesthetized spontaneously breathing rabbits, regarded as an animal model of obstructive apnea-hypopnea syndrome. 22 rabbits were instrumented to record oro-nasal mask flow, airway opening, tracheal and esophageal pressures and diaphragm and genioglossus electromyographic activities while breathing either room air or heliox, and, in 12 rabbits, also during the application of continuous positive airway pressure (CPAP; 6 cmH2O). For the group, heliox increased peak inspiratory flow, ventilation (18±11%), peak inspiratory tracheal and dynamic transpulmonary pressures, but in no animal eliminated tIFL, as instead CPAP did in all. Muscle activities were unaffected by heliox. In the presence of IFL the increase in flow with heliox (ΔV̇IFL) varied markedly among rabbits (2 to 49%), allowing the distinction between responders and non-responders. None of the baseline variables discriminated responders and non-responders. However, fitting the Rohrer equation (R=K1+K2V̇) to the tracheal pressure-flow relationship over the first 0.1s of inspiration while breathing air allowed such discrimination on the basis of larger K2 in responders (0.005±.002 vs 0.002±.001 cmH2O·s2·ml-2; p<0.001), suggesting a corresponding difference in the relative contribution of laminar and turbulent flow. The differences in ΔV̇IFL between responders and non-responders were simulated by modeling the collapsible segment of the upper airways as a non-linear resistor and varying its pressure-volume curve, length and diameter, thus showing the importance of mechanical and geometrical factors in determining the response to heliox in the presence of tIFL.

1995 ◽  
Vol 88 (6) ◽  
pp. 707-712 ◽  
Author(s):  
Frédéric Sériès ◽  
Isabelle Marc

1. Inspiratory flow limitation is involved in the pathophysiology of sleep-related breathing disorders. Since the definition of flow-limited cycle is based on a dissociation between flow and respiratory efforts, identification of inspiratory flow limitation requires upper airway or intrathoracic pressure measurements. We examined the accuracy of the analysis of the flow—volume loop of a tidal breath in identifying inspiratory flow limitation during sleep in ten patients with a sleep apnoea—hypopnoea syndrome. 2. Measurements were taken during continuous positive airway pressure trials. After data acquisition, the presence of inspiratory flow limitation was identified by the presence of an inspiratory plateau or decrease in inspiratory flow independently of the increase in inspiratory efforts. The flow—volume loop was reconstructed for each breathing cycle by plotting the instantaneous flow and the tidal volume. The instantaneous inspiratory and expiratory flows were measured at 50% of the respective portion of the tidal volume, and a breath-by-breath analysis of the midtidal volume—flow ratio (inspiratory/expiratory ratio) was obtained. The analysis of the flow—volume loop was compared with standard inspiratory flow limitation criteria using different values of the inspiratory/expiratory ratio threshold, below which breathing cycles were classified as flow-limited. With a lower limit of the normal inspiratory/expiratory ratio threshold of 0.97, the sensitivity and specificity of the method were both 76%. In each subject, the proportion of breathing cycles identified as flow-limited according to the inspiratory/expiratory ratio progressively decreased with an increasing positive pressure level. 3. We conclude that analysis of the flow—volume curve is accurate in identifying most of the inspiratory flow limitation breathings in sleep apnoea—hypopnoea syndrome.


2004 ◽  
Vol 97 (2) ◽  
pp. 592-598 ◽  
Author(s):  
Z. Hantos ◽  
J. Tolnai ◽  
T. Asztalos ◽  
F. Peták ◽  
Á. Adamicza ◽  
...  

The aim of this study was to test the hypothesis that the mechanism of recruitment and the lower knee of the pressure-volume curve in the normal lung are primarily determined by airway reopenings via avalanches rather than simple alveolar recruitments. In isolated dog lung lobes, the pressure-volume loops were measured, and crackle sounds were recorded intrabronchially during both the first inflation from the collapsed state to total lobe capacity and a second inflation without prior degassing. The inflation flow contained transients that were accompanied by a series of crackles. Discrete volume increments were estimated from the flow transients, and the energy levels of the corresponding crackles were calculated from the sound recordings. Crackles were concentrated in the early phase of inflation, with the cumulative energy exceeding 90% of its final value by the lower knee of the pressure-volume curve. The values of volume increments were correlated with crackle energy during the flow transient for both the first and the second inflations ( r2 = 0.29–0.73 and 0.68–0.82, respectively). Because the distribution of volume increments followed a power law, the correlation between crackle energy and discrete volume increments suggests that an avalanche-like airway opening process governs the recruitment of collapsed normal lungs.


2015 ◽  
Vol 205 ◽  
pp. 16-20 ◽  
Author(s):  
Yoshihiro Uzawa ◽  
Mikiya Otsuji ◽  
Koichi Nakazawa ◽  
Wei Fan ◽  
Yoshitsugu Yamada

1976 ◽  
Vol 40 (4) ◽  
pp. 508-513 ◽  
Author(s):  
S. J. Lai-Fook ◽  
T. A. Wilson ◽  
R. E. Hyatt ◽  
J. R. Rodarte

The elastic constants of dog lungs were determined at various degrees of inflation. In one set of experiments, the lobes were subjected to deformations that approximated the conditions of uniaxial loading. These data, together with the bulk modulus data obtained from the local slope of the pressure-volume curve, were used to determine the two elastic moduli that are needed to describe small nonuniform deformations about an initial state of uniform inflation. The bulk modulus was approximately 4 times the inflation pressure, and Young's modulus was approximately 1.5 times the inflation pressure. In a second set of experiments, lobes were subjected to indentation tests using cylindric punches 1–3 cm in diameter. The value for Young's modulus obtained from these data was slightly higher, approximately twice the inflation pressure. These experiments indicate that the lung is much more easily deformable in shear than in dilatation and that the Poisson ratio for the lung is high, approximately 0.43.


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