The effects of lung volume recruitment on coughing and pulmonary function in patients with ALS

The aim of the present study was to determine whether lung volume recruitment (LVR) acutely increases respiratory system compliance (Crs) in individuals with severe respiratory muscle weakness (RMW).Individuals with RMW resulting from neuromuscular disease or quadriplegia (n=12) and healthy controls (n=12) underwent pulmonary function testing and the measurement ofCrsat baseline, immediately after, 1 h after and 2 h after a single standardised session of LVR. The LVR session involved 10 consecutive supramaximal lung inflations with a manual resuscitation bag to the highest tolerable mouth pressure or a maximum of 50 cmH2O. Each LVR inflation was followed by brief breath-hold and a maximal expiration to residual volume.At baseline, individuals with RMW had lowerCrsthan controls (37±5 cmH2Oversus109±10 mL·cmH2O−1, p<0.001). Immediately after LVR,Crsincreased by 39.5±9.8% to 50±7 mL·cmH2O−1in individuals with RMW (p<0.05), while no significant change occurred in controls (p=0.23). At 1 h and 2 h post-treatment, there were no within-group differences inCrscompared to baseline (all p>0.05). LVR had no significant effect on measures of pulmonary function at any time point in either group (all p>0.05). During inflations, mean arterial pressure decreased significantly relative to baseline by 10.4±2.8 mmHg and 17.3±3.0 mmHg in individuals with RMW and controls, respectively (both p<0.05).LVR acutely increasesCrsin individuals with RMW. However, the high airway pressures during inflations cause reductions in mean arterial pressure that should be considered when applying this technique.

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Lung Volume Recruitment Slows Pulmonary Function Decline in Duchenne Muscular Dystrophy

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2012.02.024 ◽

2012 ◽

Vol 93 (7) ◽

pp. 1117-1122 ◽

Cited By ~ 41

Author(s):

Douglas A. McKim ◽

Sherri L. Katz ◽

Nicholas Barrowman ◽

Andy Ni ◽

Carole LeBlanc

Keyword(s):

Duchenne Muscular Dystrophy ◽

Muscular Dystrophy ◽

Pulmonary Function ◽

Lung Volume ◽

Lung Volume Recruitment

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Faculty Opinions recommendation of CONFERENCE POSTER: Hemodynamic responses to lung volume recruitment maneuvers in post-operative cardiac surgery patients.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.11287957.12285055 ◽

2011 ◽

Author(s):

Heidi Dalton ◽

Jennifer Matchey

Keyword(s):

Cardiac Surgery ◽

Lung Volume ◽

Hemodynamic Responses ◽

Recruitment Maneuvers ◽

Lung Volume Recruitment

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Airway to Lung Volume Ratio on CT is Associated with Pulmonary Function Transition from Obstructive to Restrictive Pattern in Obesity

10.21203/rs.3.rs-1238490/v1 ◽

2022 ◽

Author(s):

Xin Yu ◽

Ming-Hui Zhang ◽

Yan-Hao Huang ◽

Yu Deng ◽

You-Zhen Feng ◽

...

Keyword(s):

Pulmonary Function ◽

Lung Volume ◽

Volume Ratio ◽

Lung Ventilation ◽

Forced Expiratory Volume ◽

Obese Adults ◽

Obese Adolescents ◽

Wall Area ◽

Adolescents And Adults ◽

Airway Tree

Abstract Background: Obesity is associated with excessive airway collapse and reduced lung volume; it is unknown whether it affects airway-lung interactions. We sought to compare the airway tree to lung volume ratio, assessed by CT, in obese individuals with and without ventilation disorders.Methods: Participants underwent inspiratory chest CT and pulmonary function. The percentage ratio of the whole airway tree to lung volume, automatically segmented via deep learning, was defined as CT airway volume percent (AWV%). Total airway count (TAC), airway wall area percent (WA%), and other CT indexes were also measured. Results: We evaluated 88 participants including adolescents(age: 14-18, n= 12) and adults (age: 19-25, n= 17; age: 26-35, n= 39; age> 35, n= 20). Obese adolescents had higher forced vital capacity (FVC) (P = 0.001) and lower AWV% (P = 0.008) than obese adults (age >35). Among obese adults, participants with restrictive disorders had larger AWV% (P < 0.001) and those with obstructive disorders showed smaller AWV% (P < 0.001) compared to participants with normal ventilation. AWV% was positively correlated with age and forced expiratory volume in 1 second (FEV1)/FVC and adversely related to FVC (P< 0.05 for all), and in multivariate models, AWV% independently predicted FEV1/FVC (R2 = 0.49, P < 0.001) and FVC (R2 = 0.60, P < 0.001).Conclusion: Transitions in lung function patterns between obese adolescents and adults are associated with airway to lung ratios. The obesity-induced disproportion between the airway tree and lung volume may adversely affect and complicate lung ventilation.

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Lung Volume Reduction Surgery in Patients with Heterogenous Emphysema: Selecting Perspective

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.841 ◽

2019 ◽

Vol 7 (24) ◽

pp. 4389-4392

Author(s):

Nguyen Truong Giang ◽

Trung Nguyen Ngoc ◽

Nguyen Van Nam ◽

Nguyen Viet Nhung ◽

Ta Ba Thang ◽

...

Keyword(s):

Pulmonary Function ◽

Lung Volume ◽

Pulmonary Function Tests ◽

Volume Reduction ◽

Military Hospital ◽

Lung Volume Reduction Surgery ◽

Lung Volume Reduction ◽

Function Tests ◽

Significant Difference ◽

Preoperative Factor

BACKGROUND: Lung volume reduction surgery (LVRS) was introduced to alleviate clinical conditions in selected patients with heterogenous emphysema. Clarifying the most suitable patients for LVRS remained unclear. AIM: This study was undertaken to specifically analyze the preoperative factor affecting to LVRS. METHODS: The prospective study was conducted at 103 Military Hospital between July 2014 and April 2016. Severe heterogenous emphysema patients were selected to participate in the study. The information, spirometry, and body plethysmographic pulmonary function tests in 31 patients who underwent LVRS were compared with postoperative outcomes (changing in FEV1 and CAT scale). RESULTS: Of the 31 patients, there was statistically significant difference in the outcome of functional capacity, lung function between two groups (FEV1 ≤ 50% and > 50%) (∆FEV1: 22.46 vs 18.32%; p = 0.042. ∆CAT: 6.85 vs 5.07; p = 0.048). Changes of the FEV1 and CAT scale were no statistically significant differences in three groups residual volume. Patients with total lung capacity < 140% had more improved than others (∆FEV1: 23.81 vs 15.1%; p = 0.031). CONCLUSION: Preoperative spirometry and body plethysmographic pulmonary function tests were useful measures to selected severe heterogenous emphysema patients for LVRS. Patients with FEV1 ≤ 50%, TLC in the range of 100-140% should be selected.

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