| Inspiratory lung impedance in COPD: effects of PEEP and immediate impact of lung volume reduction surgery. | |
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MedLine Citation:
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PMID: 11299274 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Frequency-dependent characteristics of lung resistance (RL) and elastance (EL) are sensitive to different patterns of airway obstruction. We used an enhanced ventilator waveform (EVW) to measure inspiratory RL and EL spectra in ventilated patients during thoracic surgery. The EVW delivers an inspiratory flow waveform with enhanced spectral excitation from 0.156 to 8.1 Hz. Estimates of the coefficients in a trigonometric approximation of the EVW flow and transpulmonary pressure inspirations yielded inspiratory RL and EL spectra. We applied the EVW in a group with mild obstruction undergoing various thoracoscopic procedures (n = 6), and another group with severe chronic obstructive pulmonary disease undergoing lung volume reduction surgery (n = 8). Measurements were made at positive end-expiratory pressure (PEEP) of 0, 3, and 6 cmH(2)O. Inspiratory RL was similar in both groups despite marked differences in spirometry. The chronic obstructive pulmonary disease patients demonstrated a pronounced frequency-dependent increase in inspiratory EL consistent with severe heterogeneous peripheral airway obstruction. PEEP appears to have beneficial effects by reducing peripheral airway resistance. Lung volume reduction surgery resulted in increased inspiratory RL and EL at all frequencies and PEEPs, possibly due to loss of diseased lung tissue, pulmonary edema, increased mechanical heterogeneity, and/or an improvement in airway tethering. |
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Authors:
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D W Kaczka; E P Ingenito; S C Body; S E Duffy; S J Mentzer; M M DeCamp; K R Lutchen |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of applied physiology (Bethesda, Md. : 1985) Volume: 90 ISSN: 8750-7587 ISO Abbreviation: J. Appl. Physiol. Publication Date: 2001 May |
Date Detail:
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Created Date: 2001-04-12 Completed Date: 2001-07-05 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8502536 Medline TA: J Appl Physiol Country: United States |
Other Details:
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Languages: eng Pagination: 1833-41 Citation Subset: IM |
Affiliation:
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Department of Biomedical Engineering, Boston University, MA 02215, USA. dk@bu.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Female Humans Lung / surgery* Lung Diseases, Obstructive / physiopathology*, surgery, therapy* Male Middle Aged Positive-Pressure Respiration* Respiratory Mechanics Thoracoscopy |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL-622969-02/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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