scholarly journals Reduction of total lung capacity in obese men: comparison of total intrathoracic and gas volumes

2010 ◽  
Vol 108 (6) ◽  
pp. 1605-1612 ◽  
Author(s):  
R. A. Watson ◽  
N. B. Pride ◽  
E. Louise Thomas ◽  
J. Fitzpatrick ◽  
G. Durighel ◽  
...  
Keyword(s):  
Total Lung Capacity ◽  
Lung Capacity ◽  
Control Heart ◽  
Lung Expansion ◽  
Residual Capacity ◽  
Obese Subjects ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri ◽  
And Control ◽  
Gas Volume

Restriction of total lung capacity (TLC) is found in some obese subjects, but the mechanism is unclear. Two hypotheses are as follows: 1) increased abdominal volume prevents full descent of the diaphragm; and 2) increased intrathoracic fat reduces space for full lung expansion. We have measured total intrathoracic volume at full inflation using magnetic resonance imaging (MRI) in 14 asymptomatic obese men [mean age 52 yr, body mass index (BMI) 35–45 kg/m2] and 7 control men (mean age 50 yr, BMI 22–27 kg/m2). MRI volumes were compared with gas volumes at TLC. All measurements were made with subjects supine. Obese men had smaller functional residual capacity (FRC) and FRC-to-TLC ratio than control men. There was a 12% predicted difference in mean TLC between obese (84% predicted) and control men (96% predicted). In contrast, differences in total intrathoracic volume (MRI) at full inflation were only 4% predicted TLC (obese 116% predicted TLC, control 120% predicted TLC), because mediastinal volume was larger in obese than in control [heart and major vessels (obese 1.10 liter, control 0.87 liter, P = 0.016) and intrathoracic fat (obese 0.68 liter, control 0.23 liter, P < 0.0001)]. As a consequence of increased mediastinal volume, intrathoracic volume at FRC in obese men was considerably larger than indicated by the gas volume at FRC. The difference in gas volume at TLC between the six obese men with restriction, TLC < 80% predicted (OR), and the eight obese men with TLC > 80% predicted (ON) was 26% predicted TLC. Mediastinal volume was similar in OR (1.84 liter) and ON (1.73 liter), but total intrathoracic volume was 19% predicted TLC smaller in OR than in ON. We conclude that the major factor restricting TLC in some obese men was reduced thoracic expansion at full inflation.

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
Keyword(s):  
Chest Wall ◽  
Respiratory System ◽  
Functional Residual Capacity ◽  
Total Lung Capacity ◽  
Abdominal Cavity ◽  
Abdominal Distension ◽  
Abdominal Pressure ◽  
Lung Capacity ◽  
Lung Expansion ◽  
Residual Capacity

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.

Temperature and surface forces in excised rabbit lungs

1981 ◽  
Vol 51 (4) ◽  
pp. 823-829 ◽  
Author(s):  
H. Inoue ◽  
C. Inoue ◽  
J. Hildebrandt
Keyword(s):  
Total Lung Capacity ◽  
Peak Pressure ◽  
Surface Forces ◽  
Temperature Changes ◽  
Lung Capacity ◽  
Lung Expansion ◽  
Rigid Lining ◽  
Effects Of Temperature ◽  
The Right ◽  
Gas Volume

This study was designed to determine whether the effects of temperature on lung pressure-volume (PV) curves were influenced by the state of the surface lining at the time of warming or cooling. In successive runs, temperature was varied (21, 37, or 5 degrees C) with lung gas volume fixed at either 55% total lung capacity (TLC) or 0% TLC (degassed), followed by PV curves to TLC. Peak inflation volume in a given lung was made identical at all temperatures. The starting pressure at 55% TLC remained fixed during temperature changes, whereas peak pressure ranged from 24 cmH2O at 37 degrees C to 40 cmH2O at 5 degrees C. However, below 75% TLC all deflation curves differed by less than 1 cmH2O, and the lowest recoil occurred at 5 degrees C. At 0% TLC, a similar dispersion in pressures appeared at TLC. However, on deflation, recoil at 37 degrees C was always less than at 21 degrees C, whereas at 5 degrees C a drastic shift to the right occurred. First-cycle hysteresis and midinflation pressure also increased with cooling. Thus, with cooling, the spreading and adsorption of surfactant during lung expansion are inhibited, and during deflation aggregation is greatly facilitated, accounting for the above results. When an already spread surface is cooled, then expanded, as at 55% TLC, the more rigid lining causes some rise in peak pressure at TLC but little change elsewhere. However, when lungs are degassed and then cooled, the aggregated surfactant spreads extremely poorly, leading to greatly increased recoil throughout the cycle. Changes in pressure at TLC may depend considerably on tissue effects.

Effect of body orientation on regional lung expansion: a computed tomographic approach

1985 ◽  
Vol 59 (1) ◽  
pp. 283-283
Author(s):  
E. A. Hoffman
Keyword(s):  
Transverse Section ◽  
Total Lung Capacity ◽  
Body Orientation ◽  
Computed Tomographic ◽  
Lung Capacity ◽  
Lung Expansion ◽  
Regional Lung ◽  
Residual Capacity ◽  
Anesthetized Dogs ◽  
Tomographic Approach

Page 468: E. A. Hoffman. “Effect of body orientation on regional lung expansion: a computed tomographic approach.” Page 476: the third and fourth sentences of Fig. 9 legend should read: Shown here are data from 2 anesthetized dogs. One dog was scanned supine at functional residual capacity (FRC) and at total lung capacity (TLC) ( upper 2 left transverse sections, respectively) and prone at FRC ( upper right transverse section).

Effect of acute alterations of blood volume on circulatory performance in humans

1981 ◽  
Vol 50 (2) ◽  
pp. 292-298 ◽  
Author(s):  
S. M. Fortney ◽  
E. R. Nadel ◽  
C. B. Wenger ◽  
J. R. Bove
Keyword(s):  
Bacterial Pneumonia ◽  
Pneumococcal Pneumonia ◽  
Total Lung Capacity ◽  
Lower Lobe ◽  
Pulmonary Mechanics ◽  
Tidal Breathing ◽  
Initial Value ◽  
Lung Capacity ◽  
Residual Capacity ◽  
Gas Volume

We produced left lower lobe (LLL) pneumococcal pneumonia in seven dogs and measured lung volumes and pulmonary mechanics before (day 1) and 48 h after (day 3) development of the infection. Compared with seven control dogs, total lung capacity (TLC) and functional residual capacity (FRC) decreased 550 and 140 ml, respectively, representing a 15% reduction from the initial value in both cases. Compliance measured during tidal breathing decreased by 30%, and even when corrected for the smaller FRC on day 3, specific compliance (CLsp) was reduced. At autopsy, the infected LLL had an excess weight of 89 g, and its 50% reduction in gas volume accounted for the decrease in TLC from day 1 to day 3. Compared with control dogs, there were no changes in the deflation pressure-volume curves of the noninfected lung of the pneumonia dogs. These results indicate that the reduction in TLC in bacterial lobar pneumonia was small and resulted from the reduced gas volume of the infected lobe. Assuming that the increased weight gain in the LLL represented 89 ml of exudate that filled alveoli, we propose that bacterial pneumonia reduced gas volume at FRC by filling alveoli with inflammatory exudate and further decreased TLC by preventing these alveoli from inflating. The reduced CLsp suggested nonventilation of air spaces in addition to those that were liquid filled and was consistent with nonventilation of the entire LLL.

Concurrent measurements of functional residual capacity by three methods

1962 ◽  
Vol 17 (6) ◽  
pp. 871-873 ◽  
Author(s):  
Donald F. Tierney ◽  
Jay A. Nadel
Keyword(s):  
Functional Residual Capacity ◽  
Total Lung Capacity ◽  
Open Circuit ◽  
The Body ◽  
Lung Capacity ◽  
Thoracic Gas Volume ◽  
Nitrogen Dilution ◽  
Residual Capacity ◽  
The Mean ◽  
Gas Volume

We made concurrent measurements of the functional residual capacity (FRC) with the body plethysmograph (thoracic gas volume) and by 7-min and prolonged open-circuit nitrogen dilution methods (communicating gas volume). The mean difference between the 7-min communicating gas volume and the thoracic gas volume in 13 healthy subjects was only 0.13 liters. The thoracic gas volume averaged 0.99 liters larger than the communicating gas volume after 7 min of O2 breathing in 13 patients with emphysema. The communicating gas volume at 12–18 min was the same as the thoracic gas volume in 11 of 13 patients but was smaller in the other 2. When the thoracic gas volume was used to measure FRC, the total lung capacity averaged 142% of predicted normal in 13 patients with emphysema. Submitted on January 4, 1962

Effect of pneumococcal lobar pneumonia on canine lung mechanics

1981 ◽  
Vol 50 (2) ◽  
pp. 283-291 ◽  
Author(s):  
S. N. Mink ◽  
R. B. Light ◽  
L. D. Wood
Keyword(s):  
Total Lung Capacity ◽  
Lower Lobe ◽  
Lung Mechanics ◽  
Pulmonary Mechanics ◽  
Tidal Breathing ◽  
Initial Value ◽  
Lobar Pneumonia ◽  
Lung Capacity ◽  
Residual Capacity ◽  
Gas Volume

We produced left lower lobe (LLL) pneumococcal pneumonia in seven dogs and measured lung volumes and pulmonary mechanics before (day 1) and 48 h after (day 3) development of the infection. Compared with seven control dogs, total lung capacity (TLC) and functional residual capacity (FRC) decreased 550 and 140 ml, respectively, representing a 15% reduction from the initial value in both cases. Compliance measured during tidal breathing decreased by 30%, and even when corrected for the smaller FRC on day 3, specific compliance (CLsp) was reduced. At autopsy, the infected LLL had an excess weight of 89 g, and its 50% reduction in gas volume accounted for the decrease in TLC from day 1 to day 3. Compared with control dogs, there were no changes in the deflation pressure-volume curves of the noninfected lung of the pneumonia dogs. These results indicate that the reduction in TLC in bacterial lobar pneumonia was small and resulted from the reduced gas volume of the infected lobe. Assuming that the increased weight gain in the LLL represented 89 ml of exudate that filled alveoli, we propose that bacterial pneumonia reduced gas volume at FRC by filling alveoli with inflammatory exudate and further decreased TLC by preventing these alveoli from inflating. The reduced CLsp suggested nonventilation of air spaces in addition to those that were liquid filled and was consistent with nonventilation of the entire LLL.

scholarly journals Relation between trunk fat volume and reduction of total lung capacity in obese men

2012 ◽  
Vol 112 (1) ◽  
pp. 118-126 ◽  
Author(s):  
R. A. Watson ◽  
N. B. Pride ◽  
E. Louise Thomas ◽  
P. W. Ind ◽  
J. D. Bell
Keyword(s):  
Body Mass Index ◽  
Total Lung Capacity ◽  
Subcutaneous Fat ◽  
Abdominal Fat ◽  
Thoracic Cavity ◽  
Lung Capacity ◽  
Residual Capacity ◽  
Helium Dilution ◽  
Gas Volume ◽  
Fat Volume

Reduction in total lung capacity (TLC) in obese men is associated with restricted expansion of the thoracic cavity at full inflation. We hypothesized that thoracic expansion was reduced by the load imposed by increased total trunk fat volume or its distribution. Using MRI, we measured internal and subcutaneous trunk fat and total abdominal and thoracic volumes at full inflation in 14 obese men [mean age: 52.4 yr, body mass index (BMI): 38.8 (range: 36–44) kg/m2] and 7 control men [mean age: 50.1 yr, BMI: 25.0 (range: 22–27.5) kg/m2]. TLC was measured by multibreath helium dilution and was restricted (<80% of the predicted value) in six obese men (the OR subgroup). All measurements were made with subjects in the supine position. Mean total trunk fat volume was 16.65 (range: 12.6–21.8) liters in obese men and 6.98 (range: 3.0–10.8) liters in control men. Anthropometry and mean total trunk fat volumes were similar in OR men and obese men without restriction (the ON subgroup). Mean total intraabdominal volume was 9.41 liters in OR men and 11.15 liters in ON men. In obese men, reduced thoracic expansion at full inflation and restriction of TLC were not inversely related to a large volume of 1) intra-abdominal or total abdominal fat, 2) subcutaneous fat volume around the thorax, or 3) total trunk fat volume. In addition, trunk fat volumes in obese men were not inversely related to gas volume or estimated intrathoracic volume at supine functional residual capacity. In conclusion, this study failed to support the hypotheses that restriction of TLC or impaired expansion of the thorax at full inflation in middle-aged obese men was simply a consequence of a large abdominal volume or total trunk fat volume or its distribution.

STUDIES OF RESPIRATORY PHYSIOLOGY IN CHILDREN

PEDIATRICS ◽  
1959 ◽  
Vol 24 (2) ◽  
pp. 181-193
Author(s):  
C. D. Cook ◽  
P. J. Helliesen ◽  
L. Kulczycki ◽  
H. Barrie ◽  
L. Friedlander ◽  
...  
Keyword(s):  
Tidal Volume ◽  
Respiratory Rate ◽  
Vital Capacity ◽  
Total Lung Capacity ◽  
Lung Compliance ◽  
Respiratory Physiology ◽  
Residual Volume ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Residual Capacity

Tidal volume, respiratory rate and lung volumes have been measured in 64 patients with cystic fibrosis of the pancreas while lung compliance and resistance were measured in 42 of these. Serial studies of lung volumes were done in 43. Tidal volume was reduced and the respiratory rate increased only in the most severely ill patients. Excluding the three patients with lobectomies, residual volume and functional residual capacity were found to be significantly increased in 46 and 21%, respectively. These changes correlated well with the roentgenographic evaluation of emphysema. Vital capacity was significantly reduced in 34% while total lung capacity was, on the average, relatively unchanged. Seventy per cent of the 61 patients had a signficantly elevated RV/TLC ratio. Lung compliance was significantly reduced in only the most severely ill patients but resistance was significantly increased in 35% of the patients studied. The serial studies of lung volumes showed no consistent trends among the groups of patients in the period between studies. However, 10% of the surviving patients showed evidence of significant improvement while 15% deteriorated. [See Fig. 8. in Source Pdf.] Although there were individual discrepancies, there was a definite correlation between the clinical evaluation and tests of respiratory function, especially the changes in residual volume, the vital capacity, RV/ TLC ratio and the lung compliance and resistance.

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.

Respiratory mechanics in the anesthetized rat

1978 ◽  
Vol 45 (2) ◽  
pp. 255-260 ◽  
Author(s):  
Y. L. Lai ◽  
J. Hildebrandt
Keyword(s):  
Chest Wall ◽  
Respiratory System ◽  
Esophageal Pressure ◽  
Gas Content ◽  
Lung Capacity ◽  
Consistent Change ◽  
Residual Capacity ◽  
Wall Compliance ◽  
The Difference ◽  
Body Plethysmograph

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.

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