Performance and work of nasal breathing

2021 ◽  
Vol 11 (41) ◽  
pp. 11-17
Author(s):  
Anita Bergmane ◽  
Klaus Vogt ◽  
Biruta Sloka
Keyword(s):  
Airway Resistance ◽  
Interquartile Range ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Nasal Breathing ◽  
First Line ◽  
Significant Difference ◽  
Before And After ◽  
Potential Parameters ◽  
Inspiratory Work

Abstract OBJECTIVE. To evaluate performance (Q) and work (W) of nasal breathing as potential parameters in functional diagnostic of nasal obstruction. MATERIAL AND METHODS. We included in our study 250 patients and we measured by 4-phase-rhinomanometry with decongestion test. We calculated performance Q of the “representative breath” in inspiration and expiration and in total breath, maximal performance Q (Qmax), Work W of nasal breathing in mJ and in mJ/litre and Q in J/min. RESULTS. The interquartile range of Win for representative breath before decongestion is 356 mJ/l, Wex 308 mJ/l, while after decongestion Win is 264 mJ/l and Wex 220 mJ/l. There is no significant difference between work before and after decongestion (p<0.001). Interquartile range for nasal breathing Q before decongestion is 19.2 J/min and after – 14.3 J/min. A significant correlation exists between logarithmic vertex resistance for inspiration and expiration and Qmax for inspiration and expiration (p<0.001). That means that the performance required by breathing depends in the first line on nasal resistance. CONCLUSION. Inspiratory work is 1.2 times higher than expiration work. Increase in nasal airway resistance is followed by increase in maximal nasal performance.

Dyspnea following Experimentally Induced Increased Nasal Airway Resistance

1996 ◽  
Vol 33 (3) ◽  
pp. 231-235 ◽  
Author(s):  
Donald W. Warren ◽  
Robert Mayo ◽  
David J. Zajac ◽  
A. H. Rochet
Keyword(s):  
Airway Resistance ◽  
Upper Airway ◽  
Breathing Rate ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Nasal Breathing ◽  
Oral Breathing ◽  
A Value ◽  
Normal Breathing ◽  
Study Support

Nasal resistance (NRZ) values for healthy adults range from 1.0 to 3.5 cm H2O/L/sec. Some oral breathing tends to occur at values above 3.5. The purpose of the present study was to determine at what level of NRZ individuals sense that nasal breathing is difficult. A diaphragm was used to add four different resistance loads in random to 15 adult subjects. These loads were 5, 8, and 15 cm H2O/L/sec and a value 40% above the individual's normal NRZ. Loads were added under four conditions: normal breathing, fixed flow rate, fixed breathing rate, and fixed flow and breathing rate. The pressure-flow technique was used to measure NRZ under all conditions. The study revealed that the sensation of breathing difficulty occurred at a median resistance of 5 cm H2O/L/sec and, as subjects were constrained to maintain fixed flow and breathing rates, the magnitude of RZ, at which the sensation of dyspnea was noted, decreased. The values observed in this study support previous findings suggesting that individuals switch to some oral breathing to maintain an adequate level of upper airway resistance at values between 3.5 and 4.5 cm H2/L/sec. The findings also show that individuals attempt to minimize increases in airway resistance by modifying breathing behaviors.

Total nasal airway resistance while sitting predicts airway collapse when lying down

2020 ◽  
Vol 134 (10) ◽  
pp. 917-924
Author(s):  
A Karlsson ◽  
M Persson ◽  
A-C Mjörnheim ◽  
G Gudnadottir ◽  
J Hellgren
Keyword(s):  
Nasal Obstruction ◽  
Supine Position ◽  
Airway Resistance ◽  
Upper Airway ◽  
Nasal Airway ◽  
Nasal Breathing ◽  
Nasal Airway Resistance ◽  
Airway Collapse ◽  
Before And After ◽  
Lying Down

AbstractBackgroundNasal obstruction when lying down is a common complaint in patients with chronic nasal obstruction, but rhinomanometry is typically performed in the sitting position. This study aimed to analyse whether adding rhinomanometry in a supine position is a useful examination.MethodA total of 41 patients with chronic nasal obstruction underwent rhinomanometry and acoustic rhinometry, sitting and supine, before and after decongestion, as well as an over-night polygraphy.ResultsTotal airway resistance was measurable in a supine position in 48 per cent (14 of 29) of the patients with total airway resistance of equal to or less than 0.3 Pa/cm3/second when sitting and in none (0 of 12) of the patients with total nasal airway resistance of more than 0.3 Pa/cm3/second when sitting. After decongestion, this increased to 83 per cent and 58 per cent, respectively.ConclusionIncreased nasal resistance when sitting predicts nasal breathing problems when supine. Rhinomanometry in a supine position should be performed to diagnose upper airway collapse when supine.

Objective assessment of nasal resistance among electronic cigarette users

2021 ◽  
pp. 1-4
Author(s):  
S W Lim ◽  
AB Zulkiflee
Keyword(s):  
Tobacco Smoking ◽  
Repeated Measures ◽  
Airway Resistance ◽  
Electronic Cigarettes ◽  
Objective Assessment ◽  
Control Group ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Short Term ◽  
Nasal Airway Resistance

Abstract Background Electronic cigarettes have been a popular alternative to tobacco smoking. The effect of tobacco smoking on nasal airway resistance has been investigated before; however, the effect of the aerosol generated by electronic cigarettes is still unknown. This study aimed to evaluate the short-term effects of e-cigarettes on nasal airway resistance. Methods Sixty-one participants were recruited into a vapers group and a control group. The vapers group was instructed to smoke for 5 minutes, and their nasal resistance was measured pre-procedure and at 1 and 5 minutes post-procedure. The results were compared between both groups. Results Repeated measures analysis of variance demonstrated that vaping has no statistically significant effect on total nasal airway resistance. Conclusion Although the differences between both groups were not statistically significant overall, the vapers group showed a reduction in nasal airway resistance in the short term.

Effect of Ammonia on Nasal Resistance in Atopic and Nonatopic Subjects

1979 ◽  
Vol 88 (2) ◽  
pp. 228-234 ◽  
Author(s):  
J. A. McLean ◽  
K. P. Mathews ◽  
W. R. Solomon ◽  
P. R. Brayton ◽  
N. K. Bayne
Keyword(s):  
Progressive Increase ◽  
Compressed Air ◽  
Nasal Airway ◽  
Nasal Breathing ◽  
Short Term ◽  
Flow Curves ◽  
Simple Method ◽  
Significant Difference ◽  
The Mean ◽  
Small Change

Nasal airway resistance (NAR) was assessed from the slope of pressure-flow curves obtained during normal nasal breathing. Volunteers were classified as atopic or nonatopic according to strict criteria. 100 ppm NH3 was introduced into each nostril for periods ranging from 5 to 30 seconds with frequent NAR monitoring. A progressive increase in NAR responses was obtained with incremental NH3 exposures, but no significant difference was noted between the mean response of atopic and nonatopic subjects. Control exposures to compressed air under the same pressure generally produced only a small change in NAR, while aerosolized buffered saline increased NAR more than compressed air. The nasal response to NH3 was effectively inhibited by intranasal atropine administration but not by chlorpheniramine. The described procedure provides a safe and simple method for studying semiquantitatively the short-term effects of inhaled irritants on the nose.

Treatment of Rhinitis Medicamentosa

1996 ◽  
Vol 10 (5) ◽  
pp. 323-326 ◽  
Author(s):  
Mats Bende
Keyword(s):  
Physical Exercise ◽  
Treatment Period ◽  
Blood Volume ◽  
Exercise Test ◽  
Airway Resistance ◽  
Nasal Airway ◽  
Nasal Decongestants ◽  
Sustained Use ◽  
Before And After ◽  
Rhinitis Medicamentosa

Eleven patients with rhinitis medicamentosa were treated with twice the recommended dose of a topical nasal corticosteroid for 2 months. Nasal airway resistance (NAR) was measured at rest and after a physical exercise test, before and after the treatment period. NAR at rest was reduced after the treatment because of diminished blood volume in the nasal mucosa. Treatment with topical corticosteroids for short periods may help patients with rhinitis medicamentosa to refrain from using nasal decongestants. Topical nasal decongestants are not recommended for sustained use.

Objective Assessment of the Breathe-Right Device during Exercise in Adult Males

1997 ◽  
Vol 11 (5) ◽  
pp. 393-398 ◽  
Author(s):  
Louis G. Portugal ◽  
Rajeev H. Mehta ◽  
Bonnie E. Smith ◽  
Jaishiri B. Sabnani ◽  
Matthew J. Matava
Keyword(s):  
African American ◽  
Objective Assessment ◽  
Acoustic Rhinometry ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Adult Males ◽  
Nasal Breathing ◽  
Cross Sectional ◽  
American Group ◽  
Paradoxical Worsening

In order to improve nasal breathing during competition, many athletes recently have been wearing a spring-loaded, external nasal dilator referred to as the Breathe-Right device (BRD). Although there are many subjective claims that this device improves breathing during exercise, there are currently no controlled studies documenting its efficacy. To determine objectively whether the device improves the nasal airway, 20 subjects (10 Caucasian and 10 African-American) were studied during rest and after 15 minutes of exercise using anterior rhinomanometry and acoustic rhinometry to measure changes in airway resistance and minimal cross-sectional area, respectively. We found that the BRD exerts its main effect in the region of the nasal valve improving the airway an overall 21% in our group of subjects. This anatomic improvement in nasal airway resulted in an overall 27% reduction in nasal resistance in the Caucasian group. However, in the African-American group, a wider range of resistance changes was observed with application of the BRD with significant improvement in nasal resistance in some subjects but paradoxical worsening in others. In the African-American group as a whole, no significant change in nasal resistance occured with application of the BRD. These measured differences are likely due to variations in nasal anatomy that exist not only between races but also between individuals within a given race. In addition, this study confirms the well known decongestant effects of exercise providing anatomic data with acoustic rhinometry not previously documented in the literature. Overall improvement in nasal airway seen with application of the BRD occured independent of these exercise-related decongestant effects.

scholarly journals Computational Fluid Dynamics Analysis of Nasal Airway Changes after Treatment with C-Expander

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Wang Xiao ◽  
Siling Liu ◽  
Yanqin Lu ◽  
Lei Lei ◽  
Ning Liu ◽  
...  
Keyword(s):  
Maximum Velocity ◽  
Study Data ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Effective Treatment Modality ◽  
Computational Fluid Dynamics Analysis ◽  
Before And After ◽  
Reduce Life Expectancy ◽  
Nasal Pressure ◽  
Age Range

The use of the C-expander is an effective treatment modality for maxillary skeletal deficiencies which can cause ailments and significantly reduce life expectancy in late adolescents and young adults. However, the morphological and dynamic effects on the nasal airway have not been reported. The main goal of this study was to evaluate the nasal airway changes after the implementation of a C-expander. A sample of nine patients (8 females, 1 male, age range from 15 to 29 years) was included. The morphology parameters and nasal airway ventilation parameters of pretreatment and posttreatment were measured. All study data were normally distributed. A paired t -test was used to evaluate the changes before and after treatment. After expansion, the mean and standard deviation values of intercanine maxillary width (CMW) and intermolar maxillary width (MMW) increased from 35.75 ± 2.48  mm and 54.20 ± 3.17  mm to 37.87 ± 2.26  mm ( P < 0.05 ) and 56.65 ± 3.10  mm ( P < 0.05 ), respectively. The nasal cavity volume increased from 20320.00 ± 3468.25  mm3 to 23134.70 ± 3918.84  mm3 ( P < 0.05 ). The nasal pressure drop decreased from 36.34 ± 3.99  Pa to 30.70 ± 3.17  Pa ( P < 0.05 ), while the value of the maximum velocity decreased from 6.50 ± 0.31  m/s to 5.85 ± 0.37  m/s ( P < 0.05 ). Nasal resistance dropped remarkably from 0.16 ± 0.14  Pa/ml/s to 0.08 ± 0.06  Pa/ml/s ( P < 0.05 ). The use of C-expander can effectively broaden the area and volume of the nasal airway, having a positive effect in the reduction of nasal resistance and improvement of nasal airway ventilation. For patients suffering from maxillary width deficiency and respiratory disorders, a C-expander may be an alternative method to treat the disease.

scholarly journals Efferent therapy in the first-line drug treatment of metastatic colorectal cancer

2018 ◽  
pp. 172-175
Author(s):  
Z. S. Kotova ◽  
T. Yu. Semiglazova ◽  
I. A. Baldueva ◽  
D. H. Latipova ◽  
D. O. Yurlov ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Drug Treatment ◽  
Metastatic Colorectal Cancer ◽  
Objective Response ◽  
First Line ◽  
Genetic Characteristics ◽  
Significant Difference ◽  
Before And After ◽  
Line Drug

The aim of this study is to analyse the efficacy of efferent therapy (hemosorption) as part of drug treatment in patients with metastatic colorectal cancer (mCRC) based on the use of standard first-line chemotherapy combined with the bevacizumab biosimilar. The study included 54 patients with histologically verified mCRC who received the first-line FOLFOX + bevacizumab therapy in combination with and without hemosorption. All patients of the FOLFOX + bevacizumab (+) hemosorption group (n = 32) received the hemosorption using Hemophoenix apparatus on Day 4 of the cycle during the first 6 cycles. A total of 182 hemosorption procedures were performed. The control group included 22 patients receiving the FOLFOX + bevacizumab regimen without hemosorption. The bevacizumab biosimilar was introduced in both groups throughout the treatment at standard doses once every 2 weeks. There was no statistically significant difference between the study groups in the main clinical, pathomorphological, molecular genetic characteristics (sex, age, ECOG status, localization of primary tumor, tumor differentiation, RAS, BRAF mutations, microsatellite instability, etc.).Blood sampling to evaluate the effect of hemosorption on the pharmacokinetics (PK) of bevacizumab biosimilar was performed during the 2nd cycle before (PK1) and after (PK2) hemosorption procedures. The bevacizumab biosimilar concentration in the blood of patients before and after hemosorption showed no statistically significant difference (p = 0,423).The use of pharmaceutical treatment in the FOLFOX + bevacizumab (+) hemosorption group contributed to the achievement of an objective response (OR) in 62% of patients (p = 0.001). Median progression-free survival (PFS) was 10 ± 0.9 months [95% CI 8.3-11.7] in the FOLFOX + bevacizumab (+) hemosorption group, and 7 ± 0.5 months [95% CI 4.4-11.6] in the FOLFOX + bevacizumab (-) hemosorption group. There was no significant difference in PFS between the groups of patients treated with FOLFOX + bevacizumab regimen with and without hemosorption (p = 0.445).There were statistically significant differences in the frequency of nausea, diarrhoea and asthenia in the FOLFOX + bevacizumab (+) hemosorption group. The analysis of the dynamics of the quality of life (QoL) level before and after treatment showed that QoL level related to health (p = 0.0001) as well as the emotional (p = 0.0001) and social (p = 0,04) functioning increased in patients receiving the FOLFOX + bevacizumab regimen in combination with hemosorption, 0,039).Thus, the addition of hemosorption to the first-line drug treatment according to the FOLFOX + bevacizumab regimen does not affect bevacizumab pharmacokinetics, increases the frequency of objective response, reduces toxicity of the therapy and improves the quality of patients’ life indicators.

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.

Nasal resistance asymmetry as a predictor of satisfaction following nasal airway obstruction surgeries

2017 ◽  
Vol 6 (4) ◽  
pp. 1-9
Author(s):  
Monika Prus ◽  
Jarosław Wysocki ◽  
Marta Krasny ◽  
Kazimierz Niemczyk
Keyword(s):  
Airway Obstruction ◽  
Subjective Assessment ◽  
Subjective Perception ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Nasal Patency ◽  
Self Evaluation ◽  
Before And After ◽  
The Right ◽  
Medical University

Patients’ subjective assessment of nasal patency often does not correspond to the objective results of functional and imaging examinations. The objective of this study was to identify the rhinometry (AR) and rhinomanometry (RMM) parameters that were best correlated to patients’ self-evaluation of nasal patency before and after nasal airway obstruction surgery. The study material consisted of RMM and AR results as well as SNOT-20 self-evaluation questionnaires completed by 233 patients presenting with rhinological problems and routinely diagnosed at the RMM Lab of the Department and Clinic of Otolaryngology of the Medical University of Warsaw. Data were collected from 70 females (31.4%) aged 18 through 81 years and 153 males (68.6%) aged 16 through 81 years. The results were subjected to statistical analysis by a licensed statistician using the Statistica 10 software package. A statistically significant relationship was demonstrated between the subjective perception of nasal patency and RMM results. The higher the asymmetry of air flow within the left and the right nasal cavity, the higher the perceived restriction of nasal patency. Significant differences were observed between patients reporting maximum discomfort regarding impaired nasal patency and the remaining patients: the former were characterized by nasal resistance values being several-fold higher than that observed in the latter while nearly always improving after nasal airway obstruction surgeries. No significant reflection of patients’ self-evaluation of nasal patency was found in the acoustic rhinometry measurements.

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