Document Detail


Oxygen cost of increasing tidal volume and diaphragm flattening in obstructive pulmonary disease.
MedLine Citation:
PMID:  8365977     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypercapnia is associated with a shallow breathing pattern in patients with severe chronic obstructive pulmonary disease (COPD). We sought to determine the oxygen cost of increasing tidal volume and to relate this to hypercapnia [arterial PCO2 (PaCO2) > or = 45 Torr] and diaphragm flattening. We studied 3 normal subjects and 12 patients with stable but comparably severe COPD (forced expired volume in 1 s 1.01 +/- 0.09 liters) who had baseline PaCO2 ranging from 36 to 56 Torr. Oxygen consumption was measured during the subject's native breathing pattern and then while tidal volume was increased by 20%; minute ventilation was held constant by proportionately slowing frequency. There was a significant oxygen cost of increasing tidal volume for hypercapnic patients (235 +/- 23 to 260 +/- 25 ml O2/min; P = 0.002); no significant oxygen cost was observed in normal or eucapnic patients. This oxygen cost was positively correlated to baseline PaCO2 (r2 = 0.88, P < 0.001) and degree of diaphragm flattening assessed from chest radiographs (r2 = 0.74, P < 0.05). Although others have shown that force generation is preserved during chronic hyperinflation (G. A. Farkas and C. Roussos. J. Appl. Physiol. 54: 1635-1640, 1983; T. Similowski et al. N. Engl. J. Med. 325: 917-923, 1991), we conclude that diaphragm flattening produces mechanical inefficiency that may contribute to limiting the effective operating range of the respiratory muscles during tidal breathing.
Authors:
W D Pitcher; H S Cunningham
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  74     ISSN:  8750-7587     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-10-01     Completed Date:  1993-10-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2750-6     Citation Subset:  IM    
Affiliation:
Pulmonary and Critical Care Medicine Division, University of Texas, Southwestern Medical Center, Dallas 75216.
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MeSH Terms
Descriptor/Qualifier:
Aged
Diaphragm / physiopathology*
Humans
Hypercapnia / physiopathology
Lung Diseases, Obstructive / physiopathology*
Male
Middle Aged
Oxygen Consumption / physiology*
Respiratory Mechanics / physiology
Tidal Volume / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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