THEORETICAL AND METHODOLOGICAL ASPECTS OF BODY PLETHYSMOGRAPHY AND CLINICAL APPLICATIONS

2016 ◽  
Vol 1 (60) ◽  
pp. 117-124 ◽  
Author(s):  
Савушкина ◽  
Olga Savushkina ◽  
Черняк ◽  
Aleksandr Chernyak
Keyword(s):  
Airway Obstruction ◽  
Total Lung Capacity ◽  
Pulmonary Ventilation ◽  
Ideal Gas ◽  
Absolute Pressure ◽  
Body Plethysmography ◽  
Fixed Amount ◽  
Predictive Values ◽  
Lung Capacity ◽  
Residual Capacity

One of the methods to evaluate lung function is body plethysmography. Body plethysmography allows to measure indicators that cannot be obtained during spirometry, that is: total lung capacity (TLC), bronchial resistance (Raw), and functional residual capacity (FRC). FRC measured by body plethysmography reflects thoracic gas volume (TGV or VTG), and includes both ventilated and poorly ventilated volume. Plethysmographic measurements are based on the principle of the relationship between pressure and volume at constant temperature and fixed amount of gas. This principle states that the absolute pressure exerted by a given mass of an ideal gas is inversely proportional to the volume it occupies if the temperature and amount of gas remain unchanged within a closed system (Boyle-Mariotte Law). In body plethysmography, the following parameters: TGV, vital capacity (VC), expiratory reserve volume (ERV), tidal volume (TV), inspiratory reserve volume (IRV), inspiratory capacity (IC), Raw are obtained. TLC, residual volume (RV) and its share in total lung capacity can be calculated. Reduced TLC allows to diagnose restrictive disorders of pulmonary ventilation. The RV and its share in TLC increase together with airway obstruction indicates air trapping. The TGV increase together with airway obstruction indicates hyperinflation. In the analysis of lung volumes predictive values, which are calculated by the formulas recommended by ATS/ERS statement, are used. The results are expressed as a percentage of the predicted value. Thus, body plethysmography is an important addition to spirometry and image methods of research, allowing to assess the functional state of the lungs more objectively; it helps to conduct the differential diagnosis and control the course of the disease.

Ventilation Heterogeneity in Asthma and COPD: The Value of the Poorly Communicating Fraction as the Ratio of Total Lung Capacity to Alveolar Volume

Respiration ◽  
2021 ◽  
pp. 1-7
Author(s):  
Roberta Pisi ◽  
Marina Aiello ◽  
Luigino Calzetta ◽  
Annalisa Frizzelli ◽  
Veronica Alfieri ◽  
...  
Keyword(s):  
Total Lung Capacity ◽  
Airflow Obstruction ◽  
Diffusing Capacity ◽  
Body Plethysmography ◽  
Alveolar Volume ◽  
Asthmatic Patients ◽  
Lung Capacity ◽  
Copd Patients ◽  
Ventilation Heterogeneity ◽  
Patient Groups

<b><i>Background:</i></b> The ventilation heterogeneity (VH) is reliably assessed by the multiple-breath nitrogen washout (MBNW), which provides indices of conductive (<i>S</i><sub>cond</sub>) and acinar (<i>S</i><sub>acin</sub>) VH as well as the lung clearance index (LCI), an index of global VH. VH can be alternatively measured by the poorly communicating fraction (PCF), that is, the ratio of total lung capacity by body plethysmography to alveolar volume from the single-breath lung diffusing capacity measurement. <b><i>Objectives:</i></b> Our objective was to assess VH by PCF and MBNW in patients with asthma and with COPD and to compare PCF and MBNW parameters in both patient groups. <b><i>Method:</i></b> We studied 35 asthmatic patients and 45 patients with COPD. Each patient performed spirometry, body plethysmography, diffusing capacity, and MBNW test. <b><i>Results:</i></b> Compared to COPD patients, asthmatics showed a significantly lesser degree of airflow obstruction and lung hyperinflation. In asthmatic patients, both PCF and LCI and <i>S</i><sub>acin</sub> values were significantly lower than the corresponding ones of COPD patients. In addition, in both patient groups, PCF showed a positive correlation with LCI (<i>p</i> &#x3c; 0.05) and <i>S</i><sub>acin</sub> (<i>p</i> &#x3c; 0.05), but not with <i>S</i><sub>cond</sub>. Lastly, COPD patients with PCF &#x3e;30% were highly likely to have a value ≥2 of the mMRC dyspnea scale. <b><i>Conclusions:</i></b> These results showed that PCF, a readily measure derived from routine pulmonary function testing, can provide a comprehensive measure of both global and acinar VH in asthma and in COPD patients and can be considered as a comparable tool to the well-established MBNW technique.

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.

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.

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 Reproducibility of airway luminal size in asthma measured by HRCT

2017 ◽  
Vol 123 (4) ◽  
pp. 876-883 ◽  
Author(s):  
Robert H. Brown ◽  
Robert J. Henderson ◽  
Elizabeth A. Sugar ◽  
Janet T. Holbrook ◽  
Robert A. Wise
Keyword(s):  
High Resolution ◽  
Functional Residual Capacity ◽  
Total Lung Capacity ◽  
Ct Imaging ◽  
Disease State ◽  
Air Trapping ◽  
Lung Capacity ◽  
Residual Capacity ◽  
Normal Variability ◽  
Over Time

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.

Physical Signs in Childhood Asthma

PEDIATRICS ◽  
1976 ◽  
Vol 58 (4) ◽  
pp. 537-541
Author(s):  
J. O. O. Commey ◽  
Henry Levison
Keyword(s):  
Pulmonary Function ◽  
Airway Obstruction ◽  
Pulmonary Function Tests ◽  
Severe Disease ◽  
Airway Disease ◽  
Chronic Obstructive ◽  
Scalene Muscle ◽  
Lung Capacity ◽  
Residual Capacity ◽  
Severe Airway Obstruction

In 62 children with bronchial asthma, the presence of subjective dyspnea and wheeze, and some physical signs commonly associated with chronic obstructive airway disease in older patients, were compared with results of routine pulmonary function tests. Overall, airway resistance and the relationships of residual volume and functional residual capacity to total lung capacity were increased and other measurements of pulmonary function were moderately decreased. The time-honored subjective dyspnea, wheeze, rhonchi, and prolonged expiration were least useful as indices of severity of disease. Most of the patients, particularly those in whom laboratory testing revealed marked impairment, had notable rhonchi, prolonged expiration, scalene muscle and sternocleidomastoid contraction, and supraclavicular indrawing. Only sternocleidomastoid contraction and supraclavicular indrawing clearly correlated with the severity of airway obstruction. A call is made for a search for these useful signs, whose presence may be the only clue to moderately severe disease; however, their absence does not guarantee absence of severe airway obstruction.

scholarly journals The Strain on Airway Smooth Muscle During a Deep Inspiration to Total Lung Capacity

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Ynuk Bossé
Keyword(s):  
Smooth Muscle ◽  
Airway Smooth Muscle ◽  
Total Lung Capacity ◽  
In Vitro Studies ◽  
Deep Inspiration ◽  
Bronchodilator Effect ◽  
Lung Capacity ◽  
Residual Capacity

The deep inspiration (DI) maneuver entices a great deal of interest because of its ability to temporarily ease the flow of air into the lungs. This salutary effect of a DI is proposed to be mediated, at least partially, by momentarily increasing the operating length of airway smooth muscle (ASM). Concerningly, this premise is largely derived from a growing body of in vitro studies investigating the effect of stretching ASM by different magnitudes on its contractility. The relevance of these in vitro findings remains uncertain, as the real range of strains ASM undergoes in vivo during a DI is somewhat elusive. In order to understand the regulation of ASM contractility by a DI and to infer on its putative contribution to the bronchodilator effect of a DI, it is imperative that in vitro studies incorporate levels of strains that are physiologically relevant. This review summarizes the methods that may be used in vivo in humans to estimate the strain experienced by ASM during a DI from functional residual capacity (FRC) to total lung capacity (TLC). The strengths and limitations of each method, as well as the potential confounders, are also discussed. A rough estimated range of ASM strains is provided for the purpose of guiding future in vitro studies that aim at quantifying the regulatory effect of DI on ASM contractility. However, it is emphasized that, owing to the many limitations and confounders, more studies will be needed to reach conclusive statements.

Kinematics and mechanics of midcostal diaphragm of dog

1997 ◽  
Vol 83 (4) ◽  
pp. 1068-1075 ◽  
Author(s):  
Aladin M. Boriek ◽  
Joseph R. Rodarte ◽  
Theodore A. Wilson
Keyword(s):  
Functional Residual Capacity ◽  
Spontaneous Breathing ◽  
Total Lung Capacity ◽  
Radius Of Curvature ◽  
Transdiaphragmatic Pressure ◽  
Lung Capacity ◽  
Circular Arcs ◽  
Residual Capacity ◽  
Three Bundles ◽  
Marker Location

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).

Changes in lung volume and rib cage configuration with abdominal binding in quadriplegia

1986 ◽  
Vol 60 (4) ◽  
pp. 1198-1202 ◽  
Author(s):  
F. D. McCool ◽  
B. M. Pichurko ◽  
A. S. Slutsky ◽  
M. Sarkarati ◽  
A. Rossier ◽  
...  
Keyword(s):  
Total Lung Capacity ◽  
Normal Subjects ◽  
Tidal Range ◽  
Dilution Technique ◽  
Inspiratory Capacity ◽  
Rib Cage ◽  
Lung Capacity ◽  
Residual Capacity ◽  
Helium Dilution ◽  
Combined Data

Previous studies suggest that abdominal binding may affect the interaction of the rib cage and the diaphragm over the tidal range of breathing in quadriplegia. To determine whether abdominal binding influences rib cage motion over the entire range of inspiratory capacity, we used spirometry and the helium-dilution technique to measure functional residual capacity (FRC), inspiratory capacity, and total lung capacity (TLC) in eight quadriplegic and five normal subjects in supine, tilted (37 degrees), and seated positions. Combined data in all three positions indicated that, with abdominal binding, FRC and TLC decreased in normal subjects [delta FRC = -0.33 + 0.151 (SD) P less than 0.01); delta TLC = -0.16 + 0.121, P less than 0.05]. In quadriplegia there was also a reduction in FRC with binding (delta FRC = -0.32 + 0.101, P less than 0.001). However, TLC increased in quadriplegia (delta TLC = 0.07 + 0.061, P less than 0.025). In an additional six quadriplegic and five normal subjects, we used magnetometers to define the influences of abdominal binding on rib cage dimensions and TLC. In quadriplegia, rib cage dimensions were increased at TLC with abdominal binding, whereas there was no change in normals. Our data suggest that this inspiratory effect of abdominal binding on augmenting rib cage volume in quadriplegia is greater than the effect of impeding diaphragm descent, and thus abdominal binding produces a net increase in TLC in quadriplegia.

Effect of body posture on lung volumes

1961 ◽  
Vol 16 (1) ◽  
pp. 27-29 ◽  
Author(s):  
Francisco Moreno ◽  
Harold A. Lyons
Keyword(s):  
Tidal Volume ◽  
Prone Position ◽  
Supine Position ◽  
Total Lung Capacity ◽  
Minute Ventilation ◽  
Normal Subjects ◽  
Body Posture ◽  
Mean Values ◽  
Lung Capacity ◽  
Residual Capacity

The changes produced by body posture on total lung capacity and its subdivisions have been reported for all positions except the prone position. Twenty normal subjects, twelve males and eight females, had determinations of total lung capacity in the three body positions, sitting, supine and prone. Tidal volume, minute ventilation and O2 consumption were also measured. The changes found on assumption of the supine position from the sitting position were similar to those previously reported. For the prone position, a smaller inspiratory capacity and a larger expiratory reserve volume were found. The mean values were changed, respectively, –8% and +37%. Associated with these changes was a significant increase of the functional residual capacity by 636 ml. Ventilation did not change significantly from that found during sitting, unlike the findings associated with the supine position, in which position the tidal volume was decreased. Respiratory frequency remained the same for all positions. Submitted on April 5, 1960

Sign in / Sign up

Export Citation Format

Share Document