Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Inspiratory Capacity”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 595 records · Page 33Linked to original sources

Ventilatory failure during resistive loaded breathing in the newborn primate.

Previous investigations have shown that ventilatory failure during severe inspiratory resistive loading (IRL) in the 21-day-old infant primate occurs secondary to a decrease in respiratory frequency, that is, central failure. To examine the response of the more immature newborn to IRL, minute ventilation (V'E), arterial blood gases and pH, minute diaphragmatic electromyogram (EMG) activity, peak inspiratory airway pressure, and the centroid frequency (Fc) of the diaphragmatic EMG power spectrum were measured in four unanesthetized tracheotomized 2-day-old monkeys during various levels of IRL, until either 1) ventilatory failure occurred (ventilatory failure run) or 2) normocapnia was sustained for 1 hr (successful trial). During successful trials, minute ventilation, breathing frequency, tidal volume, Fc, and PaCO2 were sustained at baseline levels and an increase in minute EMG activity and peak inspiratory airway pressure were observed. In contrast, during ventilatory failure runs, minute ventilation and tidal volume fell and PaCO2 rose compared to their respective baseline values. Respiratory frequency did not change. The decline in tidal volume occurred despite significant increases in minute diaphragmatic EMG activity and peak inspiratory airway pressure. No shifts in Fc were noted, suggesting that peripheral diaphragmatic fatigue did not occur. We conclude that ventilatory failure during IRL in the 2-day-old monkey is due to the animal's inability to defend tidal volume as opposed to central failure.

Airway Resistance↗

Influence of jacket placement on respiratory compliance during raised lung volume measurements in infants.

SUMMARY. Recent introduction of the raised lung volume rapid thoraco-abdominal compression (RVRTC) technique for measuring forced expiratory maneuvers in infants provides the potential opportunity to assess respiratory mechanics simultaneously by using multiple linear regression (MLR) of the relaxed breaths preceding jacket inflation to force expiration. This study was undertaken to investigate whether data obtained from raised lung volume are influenced by placement of the rapid thoraco-abdominal compression (RTC) squeeze jacket. Paired measurements of tidal volume (V(T)) and respiratory rate (RR) during tidal breathing, and of inflation volume (V(inf)), respiratory system compliance (C(rs)), and resistance (R(rs)) during passive lung inflations were made in 60 (30 male) healthy term infants with and without a fastened, but uninflated RTC jacket in place. Jacket placement was associated with a significant reduction (P < 0.0001) in weight-corrected V(inf) [-1.86 (95% confidence interval, -2.46, -1.27) mL.kg(-1)] and C(rs) [-0.77 (-1.04, -0.49) mL.kPa(-1).kg(-1)]. This represented a reduction in weight-corrected C(rs) from 9.00 to 8.24 mL.kPa(-1).kg(-1), with the fall being >10% in 42% of infants studied. There was no significant change in R(rs) or weight-corrected V(T). If passive respiratory mechanics are to be measured during raised lung volume maneuvers, they should be performed prior to the jacket being fastened, unless considerable care is taken with each infant to ensure that the jacket does not restrict chest wall movement during maximum inflation.

Airway Resistance↗

A study of the effect of a resistive heat moisture exchanger (Trachinaze) on pulmonary function and blood gas tensions in patients who have undergone a laryngectomy: a randomized control trial of 50 patients studied over a 6-month period.

BACKGROUND: Previous work from this department has shown that resistive tracheostomy filters increase the partial pressure of oxygen in capillary blood and also provide a significant amount of heat/moisture exchange. Until now it has not been shown whether there is any long-term beneficial effect and in particular whether raised tissue oxygenation is maintained using a practical filter device. METHODS: We carried out a 6-month randomized control trial including 50 laryngectomees. Twenty-five patients were treated with the Liverpool Heat Moisture Exchange device incorporating an airway resistor (Trachinaze). Another 25 patients were treated with a placebo device. Relevant subjective and objective data were collected before and at the end of the study. The objective measurements were capillary oxygen tension (which parallels blood arterial tension), carbon dioxide tension, FEV(1), FVC, and PIF. Patients were reviewed at intervals throughout the study. Data were analyzed using the Mann-Whitney U test and the paired t test to test the difference between the active device and placebo at 6 months. RESULTS: Subjective lower airway parameters, including cough, number of chest infections, mucus production, and shortness of breath at rest, were significantly improved in the active group compared with the placebo group. The objective parameters FEV(1), FVC, and PIF were not significantly different. Capillary oxygen tension, however, was highly significantly raised in the active group at 6 months. CONCLUSIONS: Trachinaze is highly superior to placebo at improving subjective pulmonary parameters, including shortness of breath. It is also superior in its ability to maintain an increased peripheral tissue oxygen tension over a 6-month period.

Airway Resistance↗

Assessment of inspiratory flow limitation in children with sleep-disordered breathing by a nasal cannula pressure transducer system.

A nasal cannula pressure transducer system identifies inspiratory flow limitation and increased upper airway resistance in adults with sleep-disordered breathing (SDB). The purpose of this study was to evaluate whether nasal cannula pressure (NCP) detects apneas and hypopneas as well as additional flow-limited events associated with increased airway resistance in children. We studied NCP in 47 patients (ages 2-14 years) referred for SDB to a university-based sleep disorders program during nocturnal polysomnography (NPSG). During NPSG, airflow was assessed simultaneously by thermistor and NCP. There was a high correlation between apneas assessed by thermistor (T) and NCP (r = 0.90, P < 0.0001), and for hypopneas using these two methods (r = 0.94, P = 0.0001). Respiratory driving pressure was indirectly measured with an esophageal pressure catheter. Flow-limited (flattened) NCP waves were associated with significantly higher driving pressure, indicating elevated upper airway resistance, compared to nonflow-limited (rounded) waves during nonrapid eye movement (NREM) (P = 0.05) and rapid eye movement (REM) (P = 0.01) sleep. Patients were classified as either having obstructive sleep apnea syndrome (OSAS) or primary snoring, based on standard NPSG criteria. NCP identified additional respiratory events with a flattened contour (FC) not detected by thermistor. NCP is a noninvasive device that identifies obstructive apneas and hypopneas as well as additional respiratory events associated with flow limitation in children.

Adolescent↗

Within- and between-day variability of respiratory impedance, using impulse oscillometry in adolescent asthmatics.

The objectives of the present study were to: 1) assess spirometric indices and respiratory impedance with forced oscillation (FO), using impulse oscillometry (IOS) in clinically stable asthmatic children over 3 consecutive days; 2) assess FO reactance (X), using an integrated index and resistance (R) separately during inspiration and expiration; and 3) assess effects on FO of hand support of cheeks vs. no hand support. Our hypotheses were: 1) because of increased sensitivity, IOS manifests day-to-day variability not demonstrable by spirometry; 2) IOS R during expiration exceeds that during inspiration; and 3) hand support of cheeks affects IOS R and X only minimally. We obtained triplicate twice-daily measures of IOS R and X in asthmatic adolescents at summer camp, in a convenience sample of children willing, with parental permission, to undergo repeated testing on consecutive days. Subjects received all medications between 6:30-7:30 AM, and were bronchodilated at time of testing. Subjects underwent IOS tests without hand support of cheeks, followed by tests with both hands supporting cheeks. ANOVA and regression analyses were used to discern technique differences.Significant differences in IOS inspiratory R5, R5 - R15 (frequency dependence of R), and low frequency reactance area (AX) occurred across 3 days, but spirometric indices were unchanged. Inspiratory R at 5 Hz (R5) was significantly smaller than expiratory R5 (P < 0.0001). ANOVA revealed no significant differences between hand and facial muscle cheek support for IOS R and X below 15 Hz, but significant differences occurred above 15 Hz. In conclusion, inspiratory R5, R5 - R15, and AX are sensitive measures for detecting changes in bronchomotor tone in adolescent asthmatic subjects, while expiratory R5 may be influenced by additional factors. Manual support of cheeks does not appear to affect IOS indices of peripheral airway obstruction in adolescent asthmatics. IOS is a practical method for quantifying respiratory mechanics, and its potential role in disease management warrants further study.

Adolescent↗

Maximal static respiratory pressures in children and adolescents.

This study was designed to establish reference values of maximal static respiratory pressures in children and adolescents in our community, and compare them with previous studies. Participants were recruited from three schools (randomly chosen from those located in the metropolitan area of the city of Valencia) after appropriate consent. None of the participants had a previous history of pulmonary, cardiac, and/or skeletal abnormalities, and all of them had normal spirometry. Forced spirometry (Spirotrac III, Vitalograph) and maximal inspiratory (P(ImaxRV)) and expiratory (P(EmaxTLC)) pressure values (Sibelmed 163) were obtained by the same investigator, following national guidelines (SEPAR 1990).We studied 392 subjects (185 males, 207 females) whose ages ranged from 8-17 years. The reproducibility of measurements was investigated in a subgroup of 88 participants (randomly selected from the total sample, and stratified for age and gender) by means of the intraclass correlation coefficient (P(EmaxTLC), 0.98; P(ImaxRV), 0.95). P(EmaxTLC) and P(ImaxRV) values were significantly different between males and females (P < 0.0001) and were normally distributed. A stepwise, linear multiple regression model was built in each gender group (male/female) for the prediction of P(ImaxRV) and P(EmaxTLC) values. Independent variables (weight, height, and age) and their potential interactions were forced to enter the model in order to maximize the square of the multiple correlation coefficient of the resultant equation. This model turned out to be applicable (homoscedasticity, independence, and normality requirements) for P(ImaxRV) (in males and females) and for P(EmaxTLC) (in males but not in females). Variables included in the model were age and the product of weight and height. Their predictive power ranged between 0.21-0.51. In conclusion, P(ImaxRV) and P(EmaxTLC) values increase with age from 8 until 17 years. In all age groups, values were higher in males than in females. Weight, height, and age are included in the predictive equations for P(ImaxRV) (in males and females) and P(EmaxTLC) (in males). Their predictive value is similar to that reported by other authors and ranges between 0.21-0.51. This model is not suitable for the prediction of P(EmaxTLC) in females; the observed mean and range should be used instead.

Adolescent↗

Variation of peak inspiratory flow through dry powder inhalers in children with stable and unstable asthma.

Drug release from dry powder inhalers depends for a large part on a sufficiently high peak inspiratory flow (PIF). We determined the variation of PIF through two commonly prescribed dry powder inhalers in children with asthma. We analyzed the effect of inhaler device, age, and severity of asthma symptoms on variation of PIF. Fifty-eight children with asthma (4-15 years old) recorded PIF values together with asthma symptoms in a diary twice daily for 4 weeks. PIF was measured with a portable PIF-meter (In-Check) equipped with adapters to simulate flow resistance through the Accuhaler and Turbohaler inhalers. Children generated higher PIF values through an Accuhaler adapter than through a Turbohaler adapter (95% CI for difference, 25.7-31.7). Mean PIF values increased with age, independent of type of inhaler. The mean (SD) variation of PIF (low%high) was 72.3 (8.1)% for patients using the Accuhaler adapter, and 67.0 (14.5)% for patients using the Turbohaler adapter (mean difference, 5.2%; 95% CI, -0.9 to 11.4). Children < or =7 years of age had a significantly greater variation of PIF in addition to a lower mean PIF (P = 0.0003). PIF decreased significantly when symptoms of asthma increased (mean maximal decrease 11 l/min; P < 0.01), but the correlation between PIF and morning and evening symptoms was weak (r = -0.18 and r = -0.16, respectively). Patients who reported moderate or severe symptoms during the study period had a significantly greater variation of PIF compared to patients who remained free of symptoms or reported mild symptoms. The majority of patients generated PIF >30 l/min during the study, even when they experienced symptoms of asthma. The variation of PIF through the Accuhaler and Turbohaler adapter was significantly greater for children < or =7 years of age and for patients experiencing moderate or severe symptoms of asthma.

Adolescent↗

Recruitment of intercostal muscle activity during hypercapnia in kittens.

Little is known about the respiratory behavior of the intercostal muscles within a neonatal and developmental context. We, therefore, examined intercostal muscle electromyographic (EMG) activity in kittens (1 month old, n = 8; 2 months old, n = 7) during eupnea and heightened respiratory drive induced by hypercapnia. The kittens were anesthetized with halothane (1.25-1.50%) at comparable minimum alveolar concentrations and were studied in the prone position during an acute exposure to hyperoxic hypercapnia (8% CO2, 50% O2, balance N2) for 7 min. We recorded EMG activities from bipolar electrodes embedded in the intercostal (dorsolateral thorax, 4th-5th interspace) (EMGic) and costal diaphragm (EMGdi) muscles. Peak moving time average EMG measurements served as our index of muscle activity. Phasic inspiratory EMGic activity was present during eupnea in all animals. EMGic and EMGdi increased significantly above baseline levels during hypercapnic exposure with the increase in EMGic (133 +/- 27%) being comparable to that observed in EMGdi (141 +/- 28%) (P = 0.40). No differences in EMGic (P = 0.64) or EMGdi (P = 0.88) recruitment were noted between age groups. These data indicate that hypercapnia augments intercostal muscle EMG activity in kittens and suggest that such activity parallels costal diaphragmatic EMG recruitment. We conclude that EMGic recruitment is a frequent respiratory phenomenon associated with hypercapnically stimulated diaphragmatic muscle activity in kittens. We speculate that intercostal muscle recruitment stabilizes the compliant chest wall of the newborn and helps sustain inspiratory force generation during stimulated breathing.

Animals↗

Noninvasive breathing analysis: repetitive chloral hydrate in neonatal guinea pigs.

A noninvasive method was used to record neonatal breathing, heart rate (HR), and the electroencephalogram (EEG) in guinea pig pups. Neonates were randomly assigned at birth to chloral hydrate (CH) or placebo (PLA) treatment. Treatments were administered 30 min before each study on days 1, 3, 5, 7, 14, and 21 after birth. Animals were studied while they breathed room air followed by air with 5% CO2 and 30% O2. CH decreased breathing frequency (f) and inspiratory minute volume (VI), but not tidal volume (VT) during the first week (P less than 0.05), and reduced the rate of growth throughout the study (P less than 0.01), whereas breathing of CO2 increased f, VT, VI, HR, and the relative power in the delta frequency band of the EEG. The percent change in VI induced by CO2, however, was not affected by drug treatment. There was a significant day of life effect on all breathing parameters and HR. CH has cumulative effects on breathing and growth that should be considered when it is used as a sedative for repeated neonatal studies in guinea pigs.

Animals↗

Reference values for forced inspiratory flows in children aged 7-15 years.

In order to construct reference equations, we attempted to measure forced inspiratory flows, i.e., peak inspiratory flow (PIF) and maximal inspiratory flow at 50% of FVC (MIF50%FVC) in 332 healthy schoolchildren aged 7-15 years during flow-volume loop measurements, using an electronic spirometer. In 255 children (122 boys and 133 girls), the results were satisfactory. Statistical analysis revealed that the only predictive variables were sex and height. The best fit of the data was obtained with the power model (Y = A * H(B)); the coefficients of correlation between flows and height ranged from 0.66-0.77, and were slightly greater for boys. Forced inspiratory flows in children increase with height, and the variability is higher than for forced expiratory flows. Reference values for forced inspiratory flows can be useful in assessing the ability of children to generate affective inspiratory flows for choosing an inhalation device, or in resolving diagnostic problems, e.g., extrathoracic obstruction.

Adolescent↗

Measurement of inspiratory flow in children with acute asthma.

Dry-powder inhalers (DPIs) have been proposed for treatment of acute asthma. Different DPIs vary in their inspiratory resistance and have different recommended optimal peak inspiratory flows (PIFs). Reduced PIF during acute asthma may result in inadequate drug delivery to the lungs. Our aim was to measure the inspiratory flow in relation to inspiratory resistance during acute asthma in children presenting to the emergency room. School-age (range, 6-18 years) children were referred to the emergency room for acute asthma. PIF measurements were performed by In-Check Dial trade mark device with simulated airflow resistances equivalent to Turbuhaler, Diskus, and free flow. Percent change in PIF between remission and acute asthma (%Delta) was correlated with percent change in clinical score (CS) and percent change in spirometry in children <9 and >9 years old. Thirty-three children (21 males) participated. PIF with simulated Turbuhaler resistance was significantly lower than with simulated Diskus resistance in both acute and remission states (P < 0.0001). PIF with simulated Turbuhaler resistance increased from 62.1 +/- 15.3 (acute) to 74.4 +/- 16.5 l/min (remission, P < 0.0001), while with Diskus it rose from 72.6 +/- 20.5 to 91.1 +/- 18.9 l/min (P < 0.0001). Turbuhaler %Delta PIF correlated with %Delta FEV(1) (P = 0.01) and with %Delta CS (P = 0.0001). A lesser degree of correlation was observed while using Diskus resistance and in children above 9 years old. During acute asthmatic attacks, PIF is reduced; this reduction is particularly prominent in young children who use a high-resistance device. However, the PIF generated is generally within the values considered compatible with adequate lung deposition with both Diskus and Turbuhaler.

Acute Disease↗

Decelerating inspiratory flow waveform improves lung mechanics and gas exchange in patients on intermittent positive-pressure ventilation.

The effects of two inspiratory flow waveforms (WFs), decelerating and constant have been studied in 14 patients undergoing intermittent positive-pressure ventilation (IPPV). With tidal volume (VT), inspiratory time, inspiratory-expiratory (I/E) ratio and frequency being kept constant, the decelerating waveform produced statistically significant reduction of peak pressure, total respiratory resistance, work of inspiration, ratio of dead space to tidal volume (VD/VT) and alveolar-arterial gradient for oxygen (A-a)PO2. There was significant increase in total static and kinetic compliances and PaO2, with no significant changes in PaCO2, in cardiac output (CO) and in other haemodynamic measurements.

Adult↗

Intrinsic PEEP: a cause of inspiratory muscle ineffectivity.

Intrinsic PEEP has been described as an inspiratory threshold load to the inspiratory muscles that could increase the work of breathing. We report a patient who presented ineffective inspiratory efforts to trigger the ventilator; when we applied PEEP in similar amounts of measured intrinsic PEEP, his inspiratory efforts became able to trigger the ventilator, suggesting that the inspiratory load was alleviated.

Aged↗

Mouth occlusion pressure (P0.1) in acute respiratory failure.

We studied 20 unselected patients admitted to our Intensive Care Unit (ICU) suffering from acute respiratory failure (ARF), who needed mechanical ventilatory support. In all of them we followed a prospective protocol to investigate the value of mouth occlusion pressure (P0.1) as an indicator for weaning. Fifty-two tests were classified into three groups: a need to be reconnected to mechanical ventilation (MV), stable on intermittent mandatory ventilation (IMV), or spontaneous breathing on a T-tube (TT). The results showed that at increased values of P0.1 there were more difficulties in weaning patients from MV. Seventy-eight percent (78%) of the occasions where weaning was successful, values of P0.1 were less than or equal to 4.2 cm H2O, in chronic or non-chronic patients. Eighty-nine percent (89%) of the times when P0.1 values were higher than 4.2 cm H2O the same patients required ventilatory support, total (MV) or partial (IMV). These differences were statistically significant (p less than 0.01). We conclude that the P0.1 is an easily obtained non-invasive parameter, that can contribute along with other more conventional measurements to a superior indication for weaning.

Adult↗

Changes of ventilation and ventilatory response to hypoxia during the menstrual cycle.

The relationship between change in hypoxic sensitivity in respiration, defined as increment in ventilation per drop of arterial O2 saturation (delta VE/delta SaO2), with the phase change from follicular to luteal and those in resting pulmonary ventilation (VE), mean inspiratory flow (VT/TI), alveolar partial pressures of CO2 and O2 (PACO2 and PAO2, respectively) and body temperature was studied in 10 women. There was a significant relationship between % increase in hypoxic sensitivity and decrement of resting PACO2 that occurred in the luteal phase. However, no significant relationships were observed between change in hypoxic sensitivity and those in the remaining parameters studied. The intersubject variation in % increase in resting VE during the luteal phase was not associated with that in % increase in hypoxic sensitivity. The results indicate that the contribution of increased hypoxic sensitivity to increasing VE during the luteal phase is variable among subjects. Reasons for the increase in hypoxic sensitivity with hypocapnia are discussed.

Adult↗

Peak flow nasal patency indices in patients operated for nasal obstruction.

In 26 patients undergoing operation for nasal obstruction, nasal and oral peak expiratory and inspiratory flow rates were measured preoperatively and 1 month postoperatively. Peak expiratory and inspiratory flow nasal patency indices were calculated from the ratio between the nasal and oral peak flow rates. Postoperatively, these indices were significantly increased for the total nose and for the preoperatively worse nasal cavity. No significant change was observed for the oral peak flow rates. A significant preoperative difference in nasal patency between the two nasal cavities was eliminated by surgery, as the postoperative peak flow of each nasal cavity reached 80% of the peak flow of the total nose on expiration and close to 50% on inspiration. A good correspondence between the subjective improvement of nasal patency and the increase in peak expiratory and inspiratory flow nasal patency indices was observed for the total nose. These findings show that peak flow nasal patency indices give valuable information pre- and post-operatively in patients undergoing nasal surgery and that the method is simple and easy to perform.

Adolescent↗