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Pulmonary function with expiratory resistive loading in healthy volunteers
Expiratory flow limitation is a key characteristic in obstructive pulmonary diseases. To study abnormal lung mechanics isolated from heterogeneities of obstructive disease, we measured pulmonary function in healthy adults with expiratory loading. Thirty-seven volunteers (25±5 yr) completed spirometr...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195373/ https://www.ncbi.nlm.nih.gov/pubmed/34115812 http://dx.doi.org/10.1371/journal.pone.0252916 |
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author | Erram, Jyotika Bari, Monica Domingo, Antoinette Cannon, Daniel T. |
author_facet | Erram, Jyotika Bari, Monica Domingo, Antoinette Cannon, Daniel T. |
author_sort | Erram, Jyotika |
collection | PubMed |
description | Expiratory flow limitation is a key characteristic in obstructive pulmonary diseases. To study abnormal lung mechanics isolated from heterogeneities of obstructive disease, we measured pulmonary function in healthy adults with expiratory loading. Thirty-seven volunteers (25±5 yr) completed spirometry and body plethysmography under control and threshold expiratory loading of 7, 11 cmH(2)O, and a subset at 20 cmH(2)O (n = 11). We analyzed the shape of the flow-volume relationship with rectangular area ratio (RAR; Ma et al., Respir Med 2010). Airway resistance was increased (p<0.0001) with 7 and 11 cmH(2)O loading vs control (9.20±1.02 and 11.76±1.68 vs. 2.53± 0.80 cmH(2)O/L/s). RAR was reduced (p = 0.0319) in loading vs control (0.45±0.07 and 0.47±0.09L vs. 0.48±0.08). FEV(1) was reduced (p<0.0001) in loading vs control (3.24±0.81 and 3.23±0.80 vs. 4.04±1.05 L). FVC was reduced (p<0.0001) in loading vs control (4.11±1.01 and 4.14±1.03 vs. 5.03±1.34 L). Peak expiratory flow (PEF) was reduced (p<0.0001) in loading vs control (6.03±1.67 and 6.02±1.84 vs. 8.50±2.81 L/s). FEV(1)/FVC (p<0.0068) was not clinically significant and FRC (p = 0.4) was not different in loading vs control. Supra-physiologic loading at 20 cmH(2)O did not result in further limitation. Expiratory loading reduced FEV(1), FVC, PEF, but there were no clinically meaningful differences in FEV(1)/FVC, FRC, or RAR. Imposed expiratory loading likely leads to high airway pressures that resist dynamic airway compression. Thus, a concave expiratory flow-volume relationship was consistently absent–a key limitation for model comparison with pulmonary function in COPD. Threshold loading may be a useful strategy to increase work of breathing or induce dynamic hyperinflation. |
format | Online Article Text |
id | pubmed-8195373 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-81953732021-06-21 Pulmonary function with expiratory resistive loading in healthy volunteers Erram, Jyotika Bari, Monica Domingo, Antoinette Cannon, Daniel T. PLoS One Research Article Expiratory flow limitation is a key characteristic in obstructive pulmonary diseases. To study abnormal lung mechanics isolated from heterogeneities of obstructive disease, we measured pulmonary function in healthy adults with expiratory loading. Thirty-seven volunteers (25±5 yr) completed spirometry and body plethysmography under control and threshold expiratory loading of 7, 11 cmH(2)O, and a subset at 20 cmH(2)O (n = 11). We analyzed the shape of the flow-volume relationship with rectangular area ratio (RAR; Ma et al., Respir Med 2010). Airway resistance was increased (p<0.0001) with 7 and 11 cmH(2)O loading vs control (9.20±1.02 and 11.76±1.68 vs. 2.53± 0.80 cmH(2)O/L/s). RAR was reduced (p = 0.0319) in loading vs control (0.45±0.07 and 0.47±0.09L vs. 0.48±0.08). FEV(1) was reduced (p<0.0001) in loading vs control (3.24±0.81 and 3.23±0.80 vs. 4.04±1.05 L). FVC was reduced (p<0.0001) in loading vs control (4.11±1.01 and 4.14±1.03 vs. 5.03±1.34 L). Peak expiratory flow (PEF) was reduced (p<0.0001) in loading vs control (6.03±1.67 and 6.02±1.84 vs. 8.50±2.81 L/s). FEV(1)/FVC (p<0.0068) was not clinically significant and FRC (p = 0.4) was not different in loading vs control. Supra-physiologic loading at 20 cmH(2)O did not result in further limitation. Expiratory loading reduced FEV(1), FVC, PEF, but there were no clinically meaningful differences in FEV(1)/FVC, FRC, or RAR. Imposed expiratory loading likely leads to high airway pressures that resist dynamic airway compression. Thus, a concave expiratory flow-volume relationship was consistently absent–a key limitation for model comparison with pulmonary function in COPD. Threshold loading may be a useful strategy to increase work of breathing or induce dynamic hyperinflation. Public Library of Science 2021-06-11 /pmc/articles/PMC8195373/ /pubmed/34115812 http://dx.doi.org/10.1371/journal.pone.0252916 Text en © 2021 Erram et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Erram, Jyotika Bari, Monica Domingo, Antoinette Cannon, Daniel T. Pulmonary function with expiratory resistive loading in healthy volunteers |
title | Pulmonary function with expiratory resistive loading in healthy volunteers |
title_full | Pulmonary function with expiratory resistive loading in healthy volunteers |
title_fullStr | Pulmonary function with expiratory resistive loading in healthy volunteers |
title_full_unstemmed | Pulmonary function with expiratory resistive loading in healthy volunteers |
title_short | Pulmonary function with expiratory resistive loading in healthy volunteers |
title_sort | pulmonary function with expiratory resistive loading in healthy volunteers |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195373/ https://www.ncbi.nlm.nih.gov/pubmed/34115812 http://dx.doi.org/10.1371/journal.pone.0252916 |
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