Inspiratory Volume Research Articles

Predictors of outcome of prematurely born infants with pulmonary interstitial emphysema.

To determine how oxygenation, ventilation efficiency and tidal volume requirements changed with the development of pulmonary interstitial emphysema (PIE) and whether in affected patients a composite gas exchange index predicted death or bronchopulmonary dysplasia (BPD). Infants who developed PIE from 2010 to 2016 were identified. The oxygenation index (OI), ventilation efficiency index (VEI), ventilation to perfusion ratio and inspiratory tidal volume were calculated before radiological evidence of PIE (pre-PIE) and at the worst PIE radiographic appearance (PIE-worst). Thirty infants, median (IQR) gestational age of 24.6 (24.3-26.7) weeks were assessed. Their age at pre-PIE was 11 (6-19) days and 23 (13-42) days at PIE-worst. Compared to pre-PIE, at PIE-worst, the OI was higher [14.5 (10.7-19.2) vs 4.8 (3.1-6.1), respectively, p < 0.001], VEI was lower [0.01 (0.01-0.11) vs 0.16 (0.13-0.19), respectively, p < 0.001], ventilation to perfusion ratio was lower [0.15 (0.11-0.40) vs 0.26 (0.20-0.37), p = 0.033] and tidal volume was higher [9.9 (7.2-13.1) vs 6.4 (5.5-6.8) mL/kg, p = 0.007]. An OI >11.4 at PIE-worst predicted death or BPD with 80% sensitivity and 100% specificity. Development of PIE was associated with poorer oxygenation and ventilation efficiency despite increased tidal volumes. The OI at PIE-worst predicted death or BPD.

Comparative evaluation of effects of intrapleural block with adjuvants on analgesia and pulmonary function after intercostal drainage: A pilot study

BackgroundInter-costal chest drain (ICD) used for varied thoracic pathologies causes continuous pain and irritation of the pleura, which limits respiratory efforts and impairs ventilatory function. Intrapleural block deposits local anaesthetic between the layers of pleura and may improve ventilatory function especially in non surgical patients. MethodsTwenty eight ASA I-III patients treated with ICD, who could perform incentive spirometry, were included for study. They were randomized to ‘Group C’ (control group); ‘Group B’ (Bupivacaine); ‘Group M’ (Bupivacaine+Morphine) and ‘Group D’ (Bupivacaine+Dexmedetomidine). The drugs were administered via the ICD itself and clamped thereafter for 15min. The success of the block was assessed by time for first analgesic demand, maximum inspiratory volume generated and Numerical Rating Scale score for pain; by patients. ResultsEffective analgesia was observed in Group B, M and D. Addition of an adjuvant significantly prolonged time for rescue analgesic demand. Patients who received local anaesthetic alone or with an adjuvant had significantly improved maximal inspiratory volume and required lesser rescue analgesics. No significant complications were observed in any group. Pain relief in post-surgical patients using intraplural block is masked by systemic analgesics. However its application in patients with ICD for non surgical indications was explored in this study and was found to improve patient comfort and ventilation. ConclusionIntra-pleural blockade is safe and effective in relieving the constant pleural irritation and pain of ICD, thus enabling the patient to improve ventilatory effort and faster recovery of respiratory function.

Hemodynamic effects of incremental lung hyperinflation.

Dynamic hyperinflation (DH) is common in chronic obstructive pulmonary disease and is associated with dyspnea and exercise intolerance. DH also has adverse cardiac effects, although the magnitude of DH and the mechanisms responsible for the hemodynamic impairment remain unclear. We hypothesized that incrementally increasing DH would systematically reduce left ventricular (LV) end-diastolic volume (LVEDV) and LV stroke volume (LVSV) because of direct ventricular interaction. Twenty-three healthy subjects (22 ± 2 yr) were exposed to varying degrees of expiratory loading to induce DH such that inspiratory capacity was decreased by 25%, 50%, 75%, and 100% (100% DH = inspiratory capacity of resting tidal volume plus inspiratory reserve volume ≈ 0.5 l). LV volumes, LV geometry, inferior vena cava collapsibility, and LV end-systolic wall stress were assessed by triplane echocardiography. 25% DH reduced LVEDV (-6 ± 5%) and LVSV (-9 ± 8%). 50% DH elicited a similar response in LVEDV (-6 ± 7%) and LVSV (-11 ± 10%) and was associated with significant septal flattening [31 ± 32% increase in the radius of septal curvature at end diastole (RSC-ED)]. 75% DH caused a larger reduction in LVEDV and LVSV (-9 ± 7% and -16 ± 10%, respectively) and RSC-ED (49 ± 70%). 100% DH caused the largest reduction in LVEDV and LVSV (-13 ± 9% and -18 ± 9%) and an increase in RSC-ED (56 ± 63%). Inferior vena cava collapsibility and LV afterload (LV end-systolic wall stress) were unchanged at all levels of DH. Modest DH (-0.6 ± 0.2 l inspiratory reserve volume) reduced LVSV because of reduced LVEDV, likely because of increased pulmonary vascular resistance. At higher levels of DH, direct ventricular interaction may be the primary cause of attenuated LVSV, as indicated by septal flattening because of a greater relative increase in right ventricular pressure and/or mediastinal constraint. NEW & NOTEWORTHY By systematically reducing inspiratory capacity during spontaneous breathing, we demonstrate that dynamic hyperinflation (DH) progressively reduces left ventricular (LV) end diastolic volume and LV stroke volume. Evidence of significant septal flattening suggests that direct ventricular interaction may be primarily responsible for the reduced LV stroke volume during DH. Hemodynamic impairment appears to occur at relatively lower levels of DH and may have important clinical implications for patients with chronic obstructive pulmonary disease.

Maximal Respiratory Pressures, their Association with Spirometric Parameters, Swimming Skills and Changes Due to Immersion in Water

Research background and hypothesis. We checked hypothesis that swimming skill improvement is more dependent on inspiratory muscle strength than endurance volume to be ventilated.Research aim was to determine associations between maximal static inspiratory (MIP) and expiratory (MEP) pressures, swimming skills, parameters of forced spirometry. Research methods. Investigation involved 62 female students (age 22.13 ± 1.3 years, height 168.4 ± 6.6 cm, and weight 61.3 ± 7.0 kg) of the Latvian Academy of Sports Education. All of them were non-smokers. Swimming skills in four strokes were evaluated by a swimming coach. MIP and MEP were measured at the mouth level outside the swimming pool and repeated in the swimming pool while the subject was immersed up to the neck level. Forced spirometry was performed according ATS guidelines outside the water. Research results. Average value for MIP outside the water was 109 ± 30 cm H 2 0 and for MEP it was 147 ± 33 cm H 2 0. There was positive correlation between peak expiratory flow and MIP, MEP, and the rate of increase of both pressures (p &lt; 0.05). Forced vital capacity was not related to maximal pressures. Faster rate of inspiratory pressure increase was positively related to forced inspiratory volume in one second (p &lt; 0.05). There was a significant decrease of MIP and the rate of increase of inspiratory pressure in the immersion state while no changes of expiratory parameters were observed. Discussion and conclusions. Swimming skill improvement is more dependent on inspiratory muscle strength than volume to be ventilated. Students with higher PEF have higher respiratory pressure parameters. Immersion in water decreases MIP, IMRPD and increases IMMRR. Changes of these parameters due to immersion are not related to swimming skills.Keywords: maximal inspiratory pressure, maximal expiratory pressure, swimming education, immersion in water.

Yoga Practice Has Minor Influence on Respiratory Function at Rest in Men and Women

Research background and hypothesis. Hatha yoga breathing has the potential of training the respiratory system in such a way that it helps an individual to cope with the respiratory demand (Ray et al., 2011).Research aim was to compare pulmonary function variables between physically inactive subjects and the ones practicing hatha yoga and to evaluate changes after 6 months of yoga practice in the latter group. Research methods. Pulmonary function was measured by means of the gas analyser “Oxycon Mobile” (Germany) before and after 6 months of yoga training in men (n = 11) (age – 30.8 (7.06), BMI – 25.6 (2.6)) and women (n = 11) (age – 28.9 (6.86), BMI – 22.5 (2.3)) practicing yoga and control subjects (n = 22) of similar age. Measurements included forced vital capacity (FVC), forced expiration volume in one second (FEV(1)), forced inspiratory volume in one second FIV1, vital capacity (VC), peak expiratory flow (PEF), forced expiratory flow rate (FEF (25–75)%), forced inspiratory flow at 50% of the vital capacity (FIF50%), maximum voluntary ventilation (MVV), vital capacity (VC MAX), peak inspiratory flow (PIF), etc.Research results. Pulmonary function measures FEF 75/85 (L/s) (p = 0.036), total volume inspired FVC IN (L) (p = 0.014), FIV1 (L) (p = 0.045) were significantly higher in the group practicing yoga than in the control group of women, and VC MAX (%) (p = 0.018), FEV 1 (%) (p = 0.041), FEF 25 (L/s) (p = 0.017), FVC IN (L) (p = 0.002) in men practicing yoga, than in men not practicing yoga. They also demonstrated higher values of MVV (L/min) (p = 0.068) and FVC (L) (p = 0.050). After 6 months of practicing yoga we found higher FEF 50 (L/s) (p = 0.003), FEF 50% (L/s) (p = 0.003) in women’s group and VCMAX (%) (p = 0.028) in men’s group. We also found a tendency of the increase of VCMAX (L) (p = 0.053), PIF (L/s) (p = 0.051), FVC IN (L) (p = 0.061), FIVI (L) (p = 0.064) indexes in men and PIF (L/s) (p = 0.072), FVC IN (L) (p = 0.076) in women.Discussion and conclusions. Yoga practice appeared to have minor influence on respiratory function at rest in men and women of middle age. Additional studies examining various yoga practices are warranted to gain a more comprehensive understanding of the effects of yoga techniques on pulmonary functions.Keywords: pulmonary function at rest, yoga training, yoga breathing.

Resistive and elastic work of breathing in older and younger adults during exercise.

It is unknown whether the greater total work of breathing (WOB) with aging is due to greater elastic and/or resistive WOB. We hypothesized that older compared with younger adults would exhibit a greater total WOB at matched ventilations (V̇e) during graded exercise, secondary to greater inspiratory resistive and elastic as well as expiratory resistive WOB. Older (OA: 60 ± 8 yr; n = 9) and younger (YA: 38 ± 7 yr; n = 9) adults performed an incremental cycling test to volitional fatigue. Esophageal pressure, inspiratory (IRV) and expiratory reserve volumes (ERV), expiratory flow limitation (EFL), and ventilatory variables were measured at matched V̇e (i.e., 25, 50, and 75 l/min) during exercise. The inspiratory resistive and elastic as well as expiratory resistive WOB were quantified using the Otis method. At V̇e of 75 l/min, older adults had greater %EFL and larger tidal volumes to inspiratory capacity but smaller relative IRV ( P ≤ 0.03) than younger adults. Older compared with younger adults had greater total WOB at V̇E of 50 and 75 l/min (OA: 90 ± 43 vs. YA: 49 ± 21 J/min; P < 0.04 for both). At V̇e of 75 l/min, older adults had greater inspiratory elastic and resistive WOB (OA: 44 ± 27 vs. YA: 24 ± 22 and OA: 23 ± 15 vs. YA: 11 ± 3 J/min, respectively, P < 0.03 for both) and expiratory resistive WOB (OA: 23 ± 19 vs. YA: 14 ± 9 J/min, P = 0.02) than younger adults. These data demonstrate that aging-induced pulmonary alterations result in greater inspiratory elastic and resistive as well as expiratory resistive WOB, which may have implications for the integrated response during exercise. NEW & NOTEWORTHY Aging-induced changes to the pulmonary system result in increased work of breathing (WOB) during exercise. However, it is not known whether this higher WOB with aging is due to differences in elastic and/or resistive WOB. Herein, we demonstrate that older adults exhibited greater inspiratory elastic and resistive as well as expiratory resistive WOB during exercise.

Respiratory load compensation and perception during 10‐breath sustained inspiratory resistive loading in normal subjects

Increased load on the respiratory system is a key feature in various respiratory diseases, accompanied by ventilatory compensatory behavior and breathlessness. This increased inspiratory load is often prolonged, ranging from minutes to days, and requires the individual to adjust their breathing pattern to sustain alveolar ventilation and minimize the work of breathing, i.e. load compensation. Experimentally, this is often studied by breathing through resistive (R) loads. Most prior load compensation studies have used single breath loads within a range of adaptability for most individuals (0–40 cmH2O/l/s) to determine the load compensation mechanisms. However, during exacerbations of lung diseases, the individual must load compensate for multiple breaths against increasing load magnitudes that may exceed their ability to sustain alveolar ventilation. The aim of this study was to investigate load compensation in normal subjects when breathing for multiple breaths (10) through loads of increasing magnitudes greater than their expected ability to sustain alveolar ventilation. A threshold for load decompensation was hypothesized. Healthy participants were tested while breathing through a circuit with inspiratory flow‐resistive loads (R's: 0–100 cmH20/L/s). The loads were presented in random block order, each for 10 consecutive breaths and separated by unloaded breathing periods. The loads were presented in 2 trials, 2 times each per trial. Subjects estimated their perceived load intensity in one trial and unpleasantness in the other trial. A load compensation index (LCI) was calculated using breath phase duration and airflow. For R=0–25 cmH2O/L/s, respiratory load pattern was a load magnitude dependent increased maximum inspiratory pressure, decreased airflow, increased inspiratory duration and decreased expiratory duration. This resulted in a relatively constant total breath time, inspiratory volume, minute ventilation, PCO2, PO2 and LCI. However, decompensation was observed for R50 and R100 leading to declining minute ventilation and LCI. The results suggest, however, that increasing the duration of the R=50–100 load presentations would likely lead to hypoventilation and respiratory failure. The perception of inspiratory R load intensity and unpleasantness increased with load magnitude. The results suggest that high magnitude loads and/or long durations of loaded breathing result in increased affective response and decompensating respiratory pattern indicating that the individual is no longer able to sustain ventilation under these conditions.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Inspiratory Resistive (R) Load Endurance Testing in Normal Healthy Adults: Load compensation, effort sensation and affective perception.

Increased respiratory load is a key feature in various respiratory diseases, accompanied by ventilatory compensation, cognitive awareness and affective perception. Loaded breathing can occur from minutes to days requiring the individual to modulate their breathing pattern to maintain alveolar ventilation, minimize work of breathing and minimize aversive load sensations. Increased inspiratory load is associated with cognitive sensation of the load magnitude and affective escape behavior to reduce the aversive perception of loaded breathing. During exacerbations of lung diseases, an individual often must compensate for increased loads that exceed their ability to sustain alveolar ventilation. Yet it is difficult to assess the capacity of an individual to adapt to an increased respiratory load. The aim of this study was to determine the ventilatory and perceptual endurance response to a high magnitude inspiratory R load applied for 10 minutes. It was hypothesized that some individuals would be able to complete the task and other individuals would terminate the task early. It was further hypothesized that early termination of the task would be due to increased aversive affective awareness. Healthy participants were tested while breathing through a non‐rebreathing circuit with an inspiratory load R=50 cmH20/L/s. The individual respired with no‐load for 1 minute, then the load was applied for 10 minutes, followed by 1 minute of no‐load breathing. The subject was instructed that they could terminate the task at any time by removing the mouthpiece. Subjects estimated their perceived load intensity (MEInt) and unpleasantness (MEUn) every minute. Fear (MEF) was estimated before and after the load trial. Two of six subjects terminated the trial early. The ventilatory load pattern for all subjects was a load dependent increased maximum inspiratory pressure, decreased airflow, increased inspiratory duration and unchanged expiratory duration, increased total breath time, increased inspiratory volume, unchanged minute ventilation, PCO2 and PO2. The MEInt increased with the onset of the load, was constant throughout the task and was the same for individuals that completed and stopped the task. MEUn increased with the load onset with greater MEUn for subjects that stopped early. The individuals that stopped early had equal MEF at task onset but much greater MEF when the task stopped. The results suggest that inspiratory R50 endurance capacity is decreased in individuals with greater negative affective responses to high magnitude loaded breathing.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Immediate and delayed effect of Ramadan fasting on spirometry parameters

Fasting in the month of Ramadan is an obligatory duty for muslims. Researchers have investigated health benefits of fasting and reported conflicting results. The purpose of this study was to determine the immediate and delayed effects of Ramadan fasting on spirometric parameters. 50 apparently healthy young adults aged between 17-27 years, belonging to both genders who fast during the month of Ramadan were enrolled for the study. Spirometric recordings were done at three different time points. First: 5-10 days before the start of Ramadan (Pre-Ramadan); second: within 10 days of the beginning of Ramadan fasting (Ramadan); third: within 7 days of the end of Ramadan (Post-Ramadan). There were no statistically significant differences between the three phases with respect to tidal volume (TV), inspiratory reserve volume (IRV), expiratory reserve volume (ERV), forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), FEV1/FVC, peak expiratory flow rate (PEFR) and forced expiratory flow 25% to 75% (FEF25-27). To conclude, Ramadan fasting does not have any significant effect on pulmonary function tests as assessed by spirometry. Hence, the diagnosis and prognosis of a respiratory disorder made on spirometry findings are reliable and need no error correction if an individual is fasting.

Reference values of inspiratory spirometry for Finnish adults

Inspiratory spirometry is used in evaluation of upper airway disorders e.g. fixed or variable obstruction. There are, however, very few published data on normal values for inspiratory spirometry. The main aim of this study was to produce reference values for inspiratory spirometry for healthy Finnish adults.Inspiratory spirometry was preplanned to a sample of the Finnish spirometry reference values sample. Data was successfully retrieved from 368 healthy nonsmoking adults (132 males) between 19 and 83 years of age. Reference equations were produced for forced inspiratory vital capacity (FIVC), forced inspiratory volume in one second (FIV1), FIV1/FIVC, peak inspiratory flow (PIF) and the ratios of FIV1/forced expiratory volume in one second and PIF/peak expiratory flow. The present values were compared to PIF values from previously used Finnish study of Viljanen et al. (1982) reference values and Norwegian values for FIV1, FIVC and FIV1/FIVC presented by Gulsvik et al. (2001). The predicted values from the Gulsvik et al. (2001), provided a good fit for FIVC, but smaller values for FIV1 with mean 108.3 and 109.1% of predicted values for males and females, respectively. PIF values were 87.4 and 91.2% of Viljanen et al. (1982) predicted values in males and females, respectively. Differences in measurement methods and selection of results may contribute to the observed differences. Inspiratory spirometry is technically more demanding and needs repeatability criteria to improve validity. New reference values are suggested to clinical use in Finland when assessing inspiratory spirometry. Utility of inspiratory to expiratory values indices in assessment of airway collapse need further study.

Accuracy of near-patient vs. inbuilt spirometry for monitoring tidal volumes in an in-vitro paediatric lung model.

Spirometric monitoring provides precise measurement and delivery of tidal volumes within a narrow range, which is essential for lung-protective strategies that aim to reduce morbidity and mortality in mechanically-ventilated patients. Conventional anaesthesia ventilators include inbuilt spirometry to monitor inspiratory and expiratory tidal volumes. The GE Aisys CS2 anaesthesia ventilator allows additional near-patient spirometry via a sensor interposed between the proximal end of the tracheal tube and the respiratory tubing. Near-patient and inbuilt spirometry of two different GE Aisys CS2 anaesthesia ventilators were compared in an in-vitro study. Assessments were made of accuracy and variability in inspiratory and expiratory tidal volume measurements during ventilation of six simulated paediatric lung models using the ASL 5000 test lung. A total of 9240 breaths were recorded and analysed. Differences between inspiratory tidal volumes measured with near-patient and inbuilt spirometry were most significant in the newborn setting (p < 0.001), and became less significant with increasing age and weight. During expiration, tidal volume measurements with near-patient spirometry were consistently more accurate than with inbuilt spirometry for all lung models (p < 0.001). Overall, the variability in measured tidal volumes decreased with increasing tidal volumes, and was smaller with near-patient than with inbuilt spirometry. The variability in measured tidal volumes was higher during expiration, especially with inbuilt spirometry. In conclusion, the present in-vitro study shows that measurements with near-patient spirometry are more accurate and less variable than with inbuilt spirometry. Differences between measurement methods were most significant in the smallest patients. We therefore recommend near-patient spirometry, especially for neonatal and paediatric patients.

Objective Assessment of Patient Inhaler User Technique Using an Audio-Based Classification Approach

Many patients make critical user technique errors when using pressurised metered dose inhalers (pMDIs) which reduce the clinical efficacy of respiratory medication. Such critical errors include poor actuation coordination (poor timing of medication release during inhalation) and inhaling too fast (peak inspiratory flow rate over 90 L/min). Here, we present a novel audio-based method that objectively assesses patient pMDI user technique. The Inhaler Compliance Assessment device was employed to record inhaler audio signals from 62 respiratory patients as they used a pMDI with an In-Check Flo-Tone device attached to the inhaler mouthpiece. Using a quadratic discriminant analysis approach, the audio-based method generated a total frame-by-frame accuracy of 88.2% in classifying sound events (actuation, inhalation and exhalation). The audio-based method estimated the peak inspiratory flow rate and volume of inhalations with an accuracy of 88.2% and 83.94% respectively. It was detected that 89% of patients made at least one critical user technique error even after tuition from an expert clinical reviewer. This method provides a more clinically accurate assessment of patient inhaler user technique than standard checklist methods.

Perspectives on Incentive Spirometry Utility and Patient Protocols.

Incentive spirometry (IS) is widely used to prevent postoperative pulmonary complications, despite limited clinical effectiveness data and a lack of standardized use protocols. We sought to evaluate health care professionals' perspectives on IS effectiveness and use procedures. An online survey was distributed via social media and newsletters to relevant national nursing and respiratory care societies. Attitudes concerning IS were compared between the American Association for Respiratory Care (AARC) and the nursing societies. A total of 1,681 responses (83.8% completion rate) were received. The clear majority of these respondents agreed that IS is essential to patient care (92.7%), improves pulmonary function (92.0%), improves inspiratory capacity (93.0%), helps to prevent (96.6%) and to reverse (90.0%) atelectasis, helps to prevent (92.5%) and to reverse (68.4%) pneumonia, and is as effective as early ambulation (74.0%), deep-breathing exercises (88.2%), and directed coughing (79.8%). Furthermore, most health care professionals believed that IS should be used routinely preoperatively (78.1%) and postoperatively (91.1%), used every hour (59.8%), used for an average of 9.6 (95% CI 9.3-9.9) breaths per session, used to achieve breath holds of 7.8 (95% CI 7.4-8.2) s, used to reach an initial target inspiratory volume of 1,288.5 (95% CI 1,253.8-1,323.2) mL, and used to achieve a daily inspiratory volume improvement of 525.6 (95% CI 489.8-561.4) mL. Of all respondents, 89.6% believed they received adequate IS education and training. Respondents from the AARC endorsed significantly less agreement relative to the nursing societies on most parameters for IS utility. There was a major discrepancy between health care professionals' beliefs and the published clinical effectiveness data supporting IS. Despite reported adequate education on IS, variability in what health care professionals believed to be appropriate use underscores the literature's lack of standardization and evidence for specific use procedures.

Does Regional Lung Strain Correlate With Regional Inflammation in Acute Respiratory Distress Syndrome During Nonprotective Ventilation? An Experimental Porcine Study.

It is known that ventilator-induced lung injury causes increased pulmonary inflammation. It has been suggested that one of the underlying mechanisms may be strain. The aim of this study was to investigate whether lung regional strain correlates with regional inflammation in a porcine model of acute respiratory distress syndrome. Retrospective analysis of CT images and positron emission tomography images using [F]fluoro-2-deoxy-D-glucose. University animal research laboratory. Seven piglets subjected to experimental acute respiratory distress syndrome and five ventilated controls. Acute respiratory distress syndrome was induced by repeated lung lavages, followed by 210 minutes of injurious mechanical ventilation using low positive end-expiratory pressures (mean, 4 cm H2O) and high inspiratory pressures (mean plateau pressure, 45 cm H2O). All animals were subsequently studied with CT scans acquired at end-expiration and end-inspiration, to obtain maps of volumetric strain (inspiratory volume - expiratory volume)/expiratory volume, and dynamic positron emission tomography imaging. Strain maps and positron emission tomography images were divided into 10 isogravitational horizontal regions-of-interest, from which spatial correlation was calculated for each animal. The acute respiratory distress syndrome model resulted in a decrease in respiratory system compliance (20.3 ± 3.4 to 14.0 ± 4.9 mL/cm H2O; p < 0.05) and oxygenation (PaO2/FIO2, 489 ± 80 to 92 ± 59; p < 0.05), whereas the control animals did not exhibit changes. In the acute respiratory distress syndrome group, strain maps showed a heterogeneous distribution with a greater concentration in the intermediate gravitational regions, which was similar to the distribution of [F]fluoro-2-deoxy-D-glucose uptake observed in the positron emission tomography images, resulting in a positive spatial correlation between both variables (median R = 0.71 [0.02-0.84]; p < 0.05 in five of seven animals), which was not observed in the control animals. In this porcine acute respiratory distress syndrome model, regional lung strain was spatially correlated with regional inflammation, supporting that strain is a relevant and prominent determinant of ventilator-induced lung injury.

Correlation between skeletal muscle mass index and parameters of respiratory function and muscle strength in young healthy adults according to gender

[Purpose] The purpose was to determine the correlation between the skeletal muscle mass index and parameters of respiratory function and muscle strength in young healthy adults as predictors of sarcopenia in association with aging and respiratory diseases. [Participants and Methods] Participants were 41 males and 37 females with a mean age of 19.5 ± 1.5 years. The following were measured: body composition (skeletal muscle mass index), respiratory function (vital capacity, inspiratory reserve volume, expiratory reserve volume, inspiratory capacity, forced vital capacity, one-second forced expiratory volume, peak expiratory flow rate), and respiratory muscle strength (maximum inspiratory pressure, maximum expiratory pressure). Correlations between the skeletal muscle mass index and parameters of respiratory function and respiratory muscle strength were assessed using Pearson’s coefficient. [Results] The total skeletal muscle mass index showed a positive correlation with all items. The male skeletal muscle mass index showed a positive correlation with respiratory function excluding inspiratory reserve volume, expiratory reserve volume, maximum inspiratory pressure, and maximum expiratory pressure. The female skeletal muscle mass index showed a positive correlation with all respiratory functions including inspiratory reserve volume and expiratory reserve volume, but was not associated with respiratory muscle strength. [Conclusion] The skeletal muscle mass index showed a positive correlation with respiratory function and respiratory muscle strength. Gender-based features were correlated with respiratory muscle strength in males and lung capacity in females.

The influence of the composition of inhaled gas mixture in the inspiratory tidal volume and airway pressure during mechanical ventilation with controlled volume and pressure (experimental study)

The aim of the study was to assess the effect of the composition of the inhaled gas mixture on the recorded indicators of inspiratory respiratory volume in ventilator with controlled volume, and inspiratory pressure in the Airways, in ventilator with controlled pressure. To carry out the ventilation with a mixture of helium and oxygen, the Hamilton G5 (Hamilton Medical, Switzerland) ventilator was used with a unit that provides the possibility of supplying this type of mixture. To simulate the lungs, we used TestChest Respiratory Flight Simulator (Organis GmbH, Switzerland) with settings reflecting the patientʼs respiratory system, both in normal and in pathological conditions. According to the results of the study, the composition of the inhaled gas mixture during lung ventilation with controlled volume does not affect the recorded inspiratory respiratory volume on the models of normal and pathological lungs. However, during artificial ventilation of lungs with a mixture of helium and oxygen with controlled pressure, statistically significant differences in the recorded inspiratory pressure in the Airways on the model of lungs were revealed in comparison with the mechanical ventilation oxygen-air mixture.

Correlation between Anthropometric, Physical Fitness Traits and Lung Capacities with Success of Iranian Elite Greco-Roman Wrestlers

The aim of present study was to evaluate the relation of anthropometric, physical fitness traits and lung capacities with success of Iranian elite Greco-Roman wrestlers. Twenty five Iranian elite Greco-Roman wrestlers (22 ± 4 years old) (both of light and heavy weights) participated in present study. Anthropometric characteristics, physical fitness traits and lung capacities were tested in the exercise physiology laboratory. Our results showed a significant and positive correlation between arm spam, as only anthropometric trait, and success of Iranian elite Greco-Roman wrestlers. Also, maximal oxygen consumption, dead lift, squat, bench press, agility, shoulder and-wrist elevation, sit and reach, reaction time-eye/left hand, reaction time-eye/foot, reaction time-ear/left hand, reaction time-ear/foot have positive correlation with their success. Furthermore, there were a significant and positive correlations between inspiratory reserve volume, tidal volume, forced vital capacity, forced expiratory volume (second), maximal voluntary ventilation and success. In contrast, we observed a negative and significant correlation between body fat (%) and success of Iranian elite Greco-Roman wrestlers. Physical fitness traits and lung capacities have greater potential than anthropometric characteristics in the prediction of Greco-Roman wrestler's success in championship levels.

Pulmonary Function Difference in Sasang Constitutional Types.

The purpose of this study was to determine the differences in pulmonary function among Sasang constitutional types in young adults. The Sasang Constitutional Analysis Tool (SCAT), pulmonary function tests (PFTs), and cardiopulmonary exercise tests were conducted in 417 participants from 2009 to 2015. Subjects with the Tae-Eum (TE) type had significantly higher inspiratory capacity (IC) and inspiratory reserve volume (IRV) values than those with the So-Yang (SY) and So-Eum (SE) types (P < 0.0001). The TE and SY types showed higher forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) values than the SE type (P < 0.0001). An increase in IRV and a decrease in expiratory reserve volume (ERV) in TE type males remained even after adjusting for covariate factors. These results indicate that young adults with the TE type have weaker lung function than those with the other constitutional types, suggesting its innate physiological pulmonary features.

A multivariate analysis of cardiopulmonary parameters in archery performance

PurposeThe aim of this investigation was to determine the most significant cardiopulmonary parameters bound with high archery scores and to assess their relationship with successful performance in archery.MethodsThe total of 32 archers with mean age of 17 ± 0.56 years were gathered from dissimilar archery programmes. Cardiopulmonary parameters were measured prior to shooting tests. Multivariate techniques of principal component analysis (PCA), hierarchical agglomerative cluster analysis (HACA), and discriminant analysis (DA) were used to analyse the data collected.ResultsThe initial PCA identified 4 parameters with a higher eigenvalue (&gt; 1). However, PCA after varimax rotation indicated 4 varifactors with high positive loadings, containing 3 respiratory parameters: forced vital capacity (FVC; 0.83), maximum voluntary ventilation (MVV; 0.83), and peak expiratory flow rate (PEFR; 0.87); 2 pressure parameters: resting diastolic blood pressure (RDBP; 0.78) and resting systolic blood pressure (RSBP; 0.88); 1 volume parameter: inspiratory reserve volume (IRV; 0.86); and 1 rate parameter: resting respiratory rate (RRR; 0.87). HACA divided the archers into 2 categories on the basis of their performance on the most needed parameters; these were high-optimum pulmonary capacity archers (HOCA) and low-optimum pulmonary capacity archers (LOCA). Standard, backward stepwise, and forward stepwise DA discriminated the classes from the 7 parameters with remarkable accuracy (90.63%, 93.75%, and 96.88%, respectively) for each method, confirming the classification provided by HACA.ConclusionsIt is obvious from the current outcomes that such cardiopulmonary parameters as good FVC, MVV, PEFR, IRV, RRR, and optimal RSBP and RDBP are necessary for better archery performance.

Impact of gas emboli and hyperbaric treatment on respiratory function of loggerhead sea turtles (Caretta caretta).

Fisheries interactions are the most serious threats for sea turtle populations. Despite the existence of some rescue centres providing post-traumatic care and rehabilitation, adequate treatment is hampered by the lack of understanding of the problems incurred while turtles remain entrapped in fishing gears. Recently it was shown that bycaught loggerhead sea turtles (Caretta caretta) could experience formation of gas emboli (GE) and develop decompression sickness (DCS) after trawl and gillnet interaction. This condition could be reversed by hyperbaric O2 treatment (HBOT). The goal of this study was to assess how GE alters respiratory function in bycaught turtles before recompression therapy and measure the improvement after this treatment. Specifically, we assessed the effect of DCS on breath duration, expiratory and inspiratory flow and tidal volume (VT), and the effectiveness of HBOT to improve these parameters. HBOT significantly increased respiratory flows by 32-45% while VT increased by 33-35% immediately after HBOT. Repeated lung function testing indicated a temporal increase in both respiratory flow and VT for all bycaught turtles, but the changes were smaller than those seen immediately following HBOT. The current study suggests that respiratory function is significantly compromised in bycaught turtles with GE and that HBOT effectively restores lung function. Lung function testing may provide a novel means to help diagnose the presence of GE, be used to assess treatment efficacy, and contribute to sea turtle conservation efforts.