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1.
Respirology ; 28(12): 1154-1165, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37587874

RESUMO

BACKGROUND AND OBJECTIVE: Indoor air pollution (IAP) and tobacco smoke exposure (ETS) are global health concerns contributing to the burden of childhood respiratory disease. Studies assessing the effects of IAP and ETS in preschool children are limited. We assessed the impact of antenatal and postnatal IAP and ETS exposure on lung function in a South African birth cohort, the Drakenstein Child Health Study. METHODS: Antenatally enrolled mother-child pairs were followed from birth. Lung function measurements (oscillometry, multiple breath washout and tidal breathing) were performed at 6 weeks and 3 years. Quantitative antenatal and postnatal IAP (particulate matter [PM10 ], volatile organic compounds [VOC]) and ETS exposures were measured. Linear regression models explored the effects of antenatal and postnatal exposures on lung function at 3 years. RESULTS: Five hundred eighty-four children had successful lung function testing, mean (SD) age of 37.3 (0.7) months. Exposure to antenatal PM10 was associated with a decreased lung clearance index (p < 0.01) and postnatally an increase in the difference between resistance at end expiration (ReE) and inspiration (p = 0.05) and decrease in tidal volume (p = 0.06). Exposure to antenatal VOC was associated with an increase in functional residual capacity (p = 0.04) and a decrease in time of expiration over total breath time (tE /tTOT ) (p = 0.03) and postnatally an increase in respiratory rate (p = 0.05). High ETS exposure postnatally was associated with an increase in ReE (p = 0.03). CONCLUSION: Antenatal and postnatal IAP and ETS exposures were associated with impairment in lung function at 3 years. Strengthened efforts to reduce IAP and ETS exposure are needed.


Assuntos
Poluição do Ar em Ambientes Fechados , Poluição do Ar , Poluição por Fumaça de Tabaco , Compostos Orgânicos Voláteis , Pré-Escolar , Humanos , Feminino , Gravidez , Poluição do Ar em Ambientes Fechados/efeitos adversos , Poluição por Fumaça de Tabaco/efeitos adversos , Coorte de Nascimento , Compostos Orgânicos Voláteis/efeitos adversos , Compostos Orgânicos Voláteis/análise , Pulmão , Exposição Ambiental/efeitos adversos
2.
Respir Physiol Neurobiol ; 215: 13-9, 2015 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-25896285

RESUMO

Structural and functional longitudinal alterations of the lungs were followed in an emphysema model. Rats were treated with porcine pancreatic elastase (PPE, n=21) or saline (controls, C, n=19). Before the treatment and 3, 10, 21 and 105 days thereafter, absolute lung volumes (FRC, TLC and RV) and tissue mechanical parameters (elastance: H; damping: G) were determined. At 3, 21 and 105 days the lungs were fixed in subgroups of rats. From histological samples the equivalent diameter of airspaces (Dalv), elastin (Mec) and collagen densities were assessed. In the PPE group, FRC and RV were higher from 3 days after treatment compared to controls (p<0.001), while TLC exhibited a delayed increase. H and G decreased in the PPE group throughout the study (p<0.001). Higher Mec (p<0.001) and late-phase inflammation were observed at 105 days. We conclude that during the progression of emphysema, septal failures increase Dalv which decreases H; this reveals a strong structure-function relationship.


Assuntos
Enfisema/tratamento farmacológico , Pulmão , Elastase Pancreática/uso terapêutico , Respiração/efeitos dos fármacos , Análise de Variância , Animais , Peso Corporal/efeitos dos fármacos , Enfisema/patologia , Volume de Reserva Expiratória/efeitos dos fármacos , Seguimentos , Pulmão/efeitos dos fármacos , Pulmão/patologia , Pulmão/fisiopatologia , Pletismografia , Ratos , Ratos Sprague-Dawley , Estatísticas não Paramétricas , Fatores de Tempo , Capacidade Pulmonar Total/efeitos dos fármacos
3.
Acta Physiol Hung ; 99(3): 289-301, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22982717

RESUMO

During intestinal ischaemia-reperfusion, endotoxin can be translocated. Pretreatment with sublethal doses of endotoxin develops tolerance to ischaemia-reperfusion in different organs; however, the tolerance to intestinal ischaemia-reperfusion in the lung has rarely been investigated. Our aim was to study the role of endotoxin pretreatment in the mechanical responses and inflammatory activation induced by intestinal ischaemia-reperfusion in the lung. Wistar rats were preconditioned with a sublethal dose of endotoxin on day -3 or -1. On day 0, anesthetized, paralyzed and mechanically ventilated rats were subjected to a 60-min occlusion of the superior mesenteric artery and a subsequent 240-min reperfusion. The low-frequency forced oscillation technique was employed to characterize the separate mechanical responses of the airways and respiratory tissues. Intestinal ischaemia-reperfusion caused a significant decrease in airway resistance and increases in tissue resistance and elastance, nitric oxide synthase and myeloperoxidase activities. Pretreatment with endotoxin modified both the pulmonary mechanical responses and the inflammatory markers in the lung during intestinal ischaemia-reperfusion. We conclude that endotoxin or the endotoxin-induced processes (and humoral mediators) have significant roles in the pathomechanism of the remote pulmonary effect of intestinal ischaemia-reperfusion.


Assuntos
Endotoxinas/farmacologia , Intestinos/irrigação sanguínea , Precondicionamento Isquêmico/métodos , Traumatismo por Reperfusão/tratamento farmacológico , Traumatismo por Reperfusão/fisiopatologia , Mecânica Respiratória/fisiologia , Resistência das Vias Respiratórias/fisiologia , Animais , Pressão Sanguínea/fisiologia , Modelos Animais de Doenças , Intestinos/fisiologia , Pulmão/fisiologia , Masculino , Artéria Mesentérica Superior/fisiologia , Óxido Nítrico Sintase Tipo II/fisiologia , Óxido Nítrico Sintase Tipo III/fisiologia , Ratos , Ratos Wistar
4.
Am J Physiol Lung Cell Mol Physiol ; 303(7): L567-74, 2012 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-22865550

RESUMO

The relation between the progression of chronic obstructive pulmonary disease (COPD) and exacerbations is unclear. Currently, no animal model of acute exacerbation of COPD (AECOPD) exists. The objectives of this study were to evaluate the effects of mechanical forces induced by deep inspirations (DIs) on short-term deterioration of lung structure and function to mimic AECOPD. At 2, 7, or 21 days after treatment with elastase, mice were ventilated with or without DIs (35 cmH(2)O airway pressure for 3 s, 2 times/min) for 1 h. Functional residual capacity (FRC) was measured with body plethysmography, and respiratory compliance, resistance, and hysteresivity were obtained via forced oscillations. From hematoxylin and eosin-stained sections, equivalent airspace diameters (D), alveolar wall thickness (W(t)), number of septal ruptures (N(sr)), and attachment density (A(d)) around airways were determined. FRC, compliance, and hysteresivity statistically significantly increased with time, and both increased due to DIs. Interestingly, DIs also had an effect on FRC, compliance, resistance, and hysteresivity in control mice. The development of emphysema statistically significantly increased D and W(t) in time, and the DIs caused subtle differences in D. At 21 days, the application of DIs changed the distribution of D, increased W(t) and N(sr), and decreased A(d). These results suggest that once a critical remodeling of the parenchyma has been reached, acute mechanical forces lead to irreversible changes in structure and function, mimicking COPD exacerbations. Thus, the acute application of DIs in mice with emphysema may serve as a useful model of AECOPD.


Assuntos
Doença Pulmonar Obstrutiva Crônica/patologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Enfisema Pulmonar/patologia , Enfisema Pulmonar/fisiopatologia , Resistência das Vias Respiratórias/efeitos dos fármacos , Animais , Modelos Animais de Doenças , Progressão da Doença , Complacência Pulmonar/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Elastase Pancreática/farmacologia , Doença Pulmonar Obstrutiva Crônica/induzido quimicamente , Enfisema Pulmonar/induzido quimicamente , Testes de Função Respiratória
5.
J Appl Physiol (1985) ; 112(11): 1932-9, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22442024

RESUMO

The aim of this study was to evaluate airway structure-function relations in elastase-induced emphysema in rats. Sprague-Dawley rats were treated intratracheally with 50 IU porcine pancreatic elastase (PPE, n = 8) or saline (controls, n = 6). Six weeks later, lung volumes [functional residual capacity (FRC), residual volume (RV), and total lung capacity (TLC)] and low-frequency impedance parameters (Newtonian resistance, R(N); tissue damping; tissue elastance, H) were measured, and tracheal sounds were recorded during slow inflation to TLC following in vivo degassing. The lungs were fixed and stained for standard morphometry, elastin, and collagen. In the PPE group, FRC and RV were higher [4.53 ± 0.7 (SD) vs. 3.28 ± 0.45 ml; P = 0.003 and 1.06 ± 0.35 vs. 0.69 ± 0.18 ml; P = 0.036, respectively], and H was smaller in the PPE-treated rats than in the controls (1,344 ± 216 vs. 2,178 ± 305 cmH(2)O/l; P < 0.001), whereas there was no difference in R(N). The average number of crackles per inflation was similar in the two groups; however, the crackle size distributions were different and the lower knee of the pressure-volume curves was higher in the PPE group. Microscopic images revealed different alveolar size distributions but similar bronchial diameters in the two groups. The treatment caused a slight but significant decrease in the numbers of alveolar attachments, no difference in elastin and slightly increased mean level and heterogeneity of collagen in the bronchial walls. These results suggest that tissue destruction did not affect the conventionally assessed airway resistance in this emphysema model, whereas the alterations in the recruitment dynamics can be an early manifestation of impaired airway function.


Assuntos
Modelos Animais de Doenças , Pulmão/patologia , Pulmão/fisiopatologia , Enfisema Pulmonar/patologia , Enfisema Pulmonar/fisiopatologia , Animais , Masculino , Ratos , Ratos Sprague-Dawley , Fatores de Tempo
6.
J Appl Physiol (1985) ; 105(6): 1864-72, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18845778

RESUMO

Absolute lung volumes such as functional residual capacity, residual volume (RV), and total lung capacity (TLC) are used to characterize emphysema in patients, whereas in animal models of emphysema, the mechanical parameters are invariably obtained as a function of transrespiratory pressure (Prs). The aim of the present study was to establish a link between the mechanical parameters including tissue elastance (H) and airway resistance (Raw), and thoracic gas volume (TGV) in addition to Prs in a mouse model of emphysema. Using low-frequency forced oscillations during slow deep inflation, we tracked H and Raw as functions of TGV and Prs in normal mice and mice treated with porcine pancreatic elastase. The presence of emphysema was confirmed by morphometric analysis of histological slices. The treatment resulted in an increase in TGV by 51 and 44% and a decrease in H by 57 and 27%, respectively, at 0 and 20 cmH(2)O of Prs. The Raw did not differ between the groups at any value of Prs, but it was significantly higher in the treated mice at comparable TGV values. In further groups of mice, tracheal sounds were recorded during inflations from RV to TLC. All lung volumes but RV were significantly elevated in the treated mice, whereas the numbers and size distributions of inspiratory crackles were not different, suggesting that the airways were not affected by the elastase treatment. These findings emphasize the importance of absolute lung volumes and indicate that tissue destruction was not associated with airway dysfunction in this mouse model of emphysema.


Assuntos
Medidas de Volume Pulmonar , Pulmão/fisiologia , Elastase Pancreática , Enfisema Pulmonar/induzido quimicamente , Enfisema Pulmonar/fisiopatologia , Mecânica Respiratória/fisiologia , Resistência das Vias Respiratórias , Animais , Elasticidade , Feminino , Pulmão/anatomia & histologia , Camundongos , Camundongos Endogâmicos CBA , Sons Respiratórios , Suínos
7.
Respir Physiol Neurobiol ; 162(3): 190-6, 2008 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-18611450

RESUMO

This study aimed to determine whether the route of administration of methacholine (MCh) influenced the pattern of airway hyper-responsiveness (AHR) in mice. BALB/c mice were inoculated with a 50-microL volume containing 10(4.5)-pfu Influenza virus A/Mem/1/71(H3N1) or media. MCh responsiveness in vivo [inhaled (0.01-30 mg/mL), i.v. MCh (6-48 microg/min/kg)] and in vitro were measured at day 4 post-infection (D4) during acute lower respiratory infection (LRI) and following resolution of infection at day 20 (D20) using a low-frequency, forced oscillation technique. Inflammation was assessed in bronchoalveolar lavage fluid. Infected mice had pulmonary inflammation and heightened responsiveness to both inhaled (p<0.03) and intravenous (p<0.02) MCh on D4, but not on D20. In vitro responsiveness was not altered at either time point. Influenza A LRI results in AHR during acute infection associated with a marked inflammatory response and increased permeability of the alveolar-capillary barrier. These data suggest that intrinsic muscle properties are not altered but MCh has greater access to airway smooth muscle during acute infection.


Assuntos
Hiper-Reatividade Brônquica/etiologia , Vírus da Influenza A , Infecções por Orthomyxoviridae/complicações , Hipersensibilidade Respiratória/etiologia , Análise de Variância , Animais , Hiper-Reatividade Brônquica/tratamento farmacológico , Broncoconstritores/administração & dosagem , Contagem de Células/métodos , Citocinas/metabolismo , Dinoprostona/metabolismo , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Vias de Administração de Medicamentos , Feminino , Técnicas In Vitro , Vacinas contra Influenza/administração & dosagem , Pulmão/virologia , Cloreto de Metacolina/administração & dosagem , Camundongos , Camundongos Endogâmicos BALB C , Hipersensibilidade Respiratória/tratamento farmacológico , Fatores de Tempo , Fator A de Crescimento do Endotélio Vascular/metabolismo
8.
Clin Exp Allergy ; 38(5): 829-38, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18070158

RESUMO

BACKGROUND: Asthma is a chronic inflammatory disease that is characterized clinically by airway hyperresponsiveness (AHR) to bronchoconstricting agents. The physiological response of the asthmatic lung to inhaled allergen is often characterized by two distinct phases: an early-phase response (EPR) within the first hour following exposure that subsides and a late-phase response (LPR) that is more prolonged and may occur several hours later. Mouse models of asthma have become increasingly popular and should be designed to exhibit an EPR, LPR and AHR. OBJECTIVE: To determine whether a common model of asthma is capable of demonstrating an EPR, LPR and AHR. METHODS: BALB/c mice were sensitized to ovalbumin (OVA) and challenged with one or three OVA aerosols. Changes in lung mechanics in response to allergen inhalation were assessed using a modification of the low-frequency forced oscillation technique (LFOT). In order to assess AHR, changes in lung mechanics in response to aerosolized methacholine were assessed using LFOT. Inflammatory cell infiltration into the lung was measured via bronchoalveolar lavage (BAL). ELISAs were used to measure inflammatory cytokines in the BAL and levels of IgE in the serum. RESULTS: An EPR was only detectable after three OVA aerosols in approximately half of the mice studied. There was no evidence of an LPR despite a clear increase in cellular infiltration 6 h post-allergen challenge. AHR was present after a single OVA aerosol but not after three OVA aerosols. CONCLUSIONS: The lack of an LPR, limited EPR and the absence of a link between the LPR and AHR highlight the limitations of this mouse model as a complete model of the lung dysfunction associated with asthma.


Assuntos
Alérgenos/administração & dosagem , Asma/fisiopatologia , Hiper-Reatividade Brônquica/imunologia , Modelos Animais de Doenças , Pulmão/fisiopatologia , Ovalbumina/administração & dosagem , Alérgenos/imunologia , Animais , Asma/imunologia , Hiper-Reatividade Brônquica/fisiopatologia , Líquido da Lavagem Broncoalveolar/citologia , Líquido da Lavagem Broncoalveolar/imunologia , Feminino , Humanos , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Pulmão/imunologia , Cloreto de Metacolina/farmacologia , Camundongos , Camundongos Endogâmicos BALB C , Ovalbumina/imunologia , Fatores de Tempo
10.
Eur Respir J ; 27(4): 808-16, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16585089

RESUMO

It was hypothesised that the recruitment of atelectatic lung areas is signified by changes in the airway and tissue mechanics, and by the appearance of crackle activity attributed to the sudden reopening of collapsed airways. The authors also assumed that the acoustic activity is an earlier indicator of lung recruitment than the change in the overall mechanical state of the lungs. Six thoracotomised and mechanically ventilated mini-pigs were studied. Low-frequency pulmonary impedance was measured at end-expiratory pauses at transpulmonary pressures of 4 and 1 hPa to estimate airway resistance (Raw) and the coefficient of lung tissue elastance (H), and tracheal sounds were recorded during subsequent slow inflations to 30 hPa, in the control state and following increasing doses of i.v. methacholine (Mch). Raw and H were higher at baseline and increased more in response to Mch at 1 hPa than at 4 hPa. The crackles detected during the subsequent inflations were concentrated around and associated with the development of the lower knee of the pressure-volume curve. The number of crackles increased faster following the Mch doses and reached statistical significance earlier than Raw and H. Crackle recording during mechanical ventilation can be employed as a simple method with which to monitor lung recruitment-derecruitment.


Assuntos
Obstrução das Vias Respiratórias/fisiopatologia , Respiração com Pressão Positiva , Atelectasia Pulmonar/fisiopatologia , Mecânica Respiratória/fisiologia , Sons Respiratórios/fisiopatologia , Resistência das Vias Respiratórias/fisiologia , Animais , Brônquios/fisiopatologia , Testes de Provocação Brônquica , Relação Dose-Resposta a Droga , Impedância Elétrica , Pulmão/fisiopatologia , Complacência Pulmonar/fisiologia , Cloreto de Metacolina , Modelos Animais , Espectrografia do Som , Suínos , Porco Miniatura , Traqueia/fisiopatologia
11.
Pediatr Pulmonol ; 38(6): 470-6, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15514973

RESUMO

To characterize the effect of changes in pulmonary hemodynamics on airway and tissue mechanics, forced oscillatory input impedance of the respiratory system (Zrs) was measured between 0.4-12 Hz in two groups of children undergoing surgical repair of congenital heart disease (CHD) immediately before sternotomy and after chest closure during short apneic intervals. Children with lesions associated with high pulmonary blood flow and/or pressure (septal defects; HP group, n = 12) and children with hypoperfused lungs (tetralogy of Fallot; LP group, n = 12) were included in the study. Airway resistance (Raw), and coefficients of respiratory tissue damping (G) and elastance (H), were estimated from Zrs by model-fitting. A postoperative reduction in pulmonary blood flow and/or pressure in the HP group resulted in an immediate decrease in Raw of 29 +/- 9 (SE)% (P < 0.05), whereas children in the LP group had increases in Raw (24 +/- 17%, no significance) after surgery. No significant change was observed in G in either the HP (6.4 +/- 13%) or LP (27 +/- 23%) group, while H increased in children of both the HP (23 +/- 8%, P < 0.05) and LP (36 +/- 7%, P < 0.01) groups. These results suggest that the preoperative pulmonary hemodynamic condition determines changes in airway mechanics: surgical repair of CHD leads to an improvement in airway function only in children with congested lungs. The adverse effects of surgery, mechanical ventilation, and/or cardiopulmonary bypass may be responsible for the increased stiffness of the respiratory system observed in both groups of children.


Assuntos
Resistência das Vias Respiratórias/fisiologia , Cardiopatias Congênitas/cirurgia , Complacência Pulmonar/fisiologia , Circulação Pulmonar/fisiologia , Pressão Propulsora Pulmonar/fisiologia , Mecânica Respiratória/fisiologia , Ponte Cardiopulmonar , Oscilação da Parede Torácica , Criança , Pré-Escolar , Feminino , Cardiopatias Congênitas/fisiopatologia , Humanos , Lactente , Masculino , Respiração Artificial , Resultado do Tratamento
12.
J Appl Physiol (1985) ; 97(2): 592-8, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15090488

RESUMO

The aim of this study was to test the hypothesis that the mechanism of recruitment and the lower knee of the pressure-volume curve in the normal lung are primarily determined by airway reopenings via avalanches rather than simple alveolar recruitments. In isolated dog lung lobes, the pressure-volume loops were measured, and crackle sounds were recorded intrabronchially during both the first inflation from the collapsed state to total lobe capacity and a second inflation without prior degassing. The inflation flow contained transients that were accompanied by a series of crackles. Discrete volume increments were estimated from the flow transients, and the energy levels of the corresponding crackles were calculated from the sound recordings. Crackles were concentrated in the early phase of inflation, with the cumulative energy exceeding 90% of its final value by the lower knee of the pressure-volume curve. The values of volume increments were correlated with crackle energy during the flow transient for both the first and the second inflations (r(2) = 0.29-0.73 and 0.68-0.82, respectively). Because the distribution of volume increments followed a power law, the correlation between crackle energy and discrete volume increments suggests that an avalanche-like airway opening process governs the recruitment of collapsed normal lungs.


Assuntos
Brônquios/fisiologia , Alvéolos Pulmonares/fisiologia , Sons Respiratórios/fisiologia , Animais , Cães , Elasticidade , Técnicas In Vitro , Medidas de Volume Pulmonar , Pressão , Atelectasia Pulmonar/fisiopatologia
13.
Acta Physiol Hung ; 91(3-4): 269-73, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25996077

RESUMO

Because of similar pathophysiologic changes, oleic acid (OA)-induced pulmonary edema has been well established as an experimental model of certain types of ARDS. Data in the literature indicate changes mostly in global pulmonary mechanical parameters (lung resistance and compliance) during permeability-type edema. Therefore, we designed this study (1) to separate the OA-induced mechanical responses into airway and parenchymal components, and (2) to examine the relationship between the mechanical parameters and the degree of edema. Anaesthetized, paralyzed, mechanically ventilated rats were given iv. OA in doses of 0 (C n=9), 0.05 (OA0.05 n=8), 0.1 (OA0.1 n=10) and 0.3 (OA0.3 n=5) ml/kg. Respiratory system impedance was measured with a wave-tube low-frequency forced oscillation technique, and a model fitting was used to estimate airway (Raw) and lung tissue parameters (G, parenchymal damping; H, elastance). Pulmonary edema was quantified by gravimetric analysis (WW/DW, wet-to-dry weight ratio). In the OAL0.05 group, transient, but significant increase in Raw, only slight increase in H, and no response in G was observed. Different responses were obtained in OA0.1: significant Raw, G, and H values in survivors; rapid and significantly higher responses in all three parameters in non-survivors. Extremely large parameter values were measured in OA0.3. We found that OA caused dose-related increases in WW, DW and WW/DW. Highly significant correlations were found between the degree of edema and G or H, but not Raw. This study demonstrates that low dose of OA had only transient lung mechanical effects; however, it resulted in mild edema. The higher dose elicited significant airway and tissue changes (smaller responses in survivors than in non-survivors), and severe edema. The strong correlation between lung tissue parameters and the degree of edema suggests that the OA-induced acute lung injury is manifested primarily in the alterations in parenchymal mechanics.

14.
Eur Respir J ; 22(6): 1026-41, 2003 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-14680096

RESUMO

The forced oscillation technique (FOT) is a noninvasive method with which to measure respiratory mechanics. FOT employs small-amplitude pressure oscillations superimposed on the normal breathing and therefore has the advantage over conventional lung function techniques that it does not require the performance of respiratory manoeuvres. The present European Respiratory Society Task Force Report describes the basic principle of the technique and gives guidelines for the application and interpretation of FOT as a routine lung function test in the clinical setting, for both adult and paediatric populations. FOT data, especially those measured at the lower frequencies, are sensitive to airway obstruction, but do not discriminate between obstructive and restrictive lung disorders. There is no consensus regarding the sensitivity of FOT for bronchodilation testing in adults. Values of respiratory resistance have proved sensitive to bronchodilation in children, although the reported cutoff levels remain to be confirmed in future studies. Forced oscillation technique is a reliable method in the assessment of bronchial hyperresponsiveness in adults and children. Moreover, in contrast with spirometry where a deep inspiration is needed, forced oscillation technique does not modify the airway smooth muscle tone. Forced oscillation technique has been shown to be as sensitive as spirometry in detecting impairments of lung function due to smoking or exposure to occupational hazards. Together with the minimal requirement for the subject's cooperation, this makes forced oscillation technique an ideal lung function test for epidemiological and field studies. Novel applications of forced oscillation technique in the clinical setting include the monitoring of respiratory mechanics during mechanical ventilation and sleep.


Assuntos
Oscilometria/métodos , Testes de Função Respiratória/métodos , Mecânica Respiratória/fisiologia , Adolescente , Adulto , Brônquios/fisiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto
15.
Eur Respir J ; 20(6): 1538-44, 2002 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12503716

RESUMO

The interrupter technique is commonly adopted to monitor respiratory resistance (Rrs,int) during mechanical ventilation; however, Rrs,int is often interpreted as an index of airway resistance (Raw). This study compared the values of Rrs,int provided by a Siemens 940 Lung Mechanics Monitor with total respiratory impedance (Zrs) parameters in 39 patients with normal spirometric parameters, who were undergoing elective coronary bypass surgery. Zrs was determined at the airway opening with pseudorandom oscillations of 0.2-6 Hz at end inspiration. Raw and tissue resistance (Rti) were derived from the Zrs data by model fitting; Rti and total resistance (Rrs,osc=Raw+Rti) were calculated at the actual respirator frequencies. Lower airway resistance (Rawl) was estimated by measuring tracheal pressure. Although good agreement was obtained between Rrs,osc and Rrs,int, with a ratio of 1.07+/-0.19 (mean+/-SD), they correlated poorly (r2=0.36). Rti and the equipment component of Raw accounted for most of Rrs,osc (39.8+/-11.9 and 43.0+/-6.9%, respectively), whereas only a small portion belonged to Rawl (17.2+/-6.3%). It is concluded that respiratory resistance may become very insensitive to changes in lower airway resistance and therefore, inappropriate for following alterations in airway tone during mechanical ventilation, especially in patients with relatively normal respiratory mechanics, where the tissue and equipment resistances represent the vast majority of the total resistance.


Assuntos
Resistência das Vias Respiratórias/fisiologia , Respiração Artificial , Ponte de Artéria Coronária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Mecânica Respiratória/fisiologia , Espirometria
16.
Thorax ; 57(5): 396-9, 2002 May.
Artigo em Inglês | MEDLINE | ID: mdl-11978914

RESUMO

BACKGROUND: In infants the impedance of the nasal pathways (Zn) is a significant proportion of the total respiratory impedance (Zrs). METHODS: In 11 infants Zrs was partitioned into Zn and lower respiratory system impedance (Zlrs) using a nasal catheter. A low frequency oscillatory signal (0.5-20 Hz) was applied during a pause in breathing to obtain the impedance spectra. A model of the respiratory system containing an airway and tissue compartment was then fitted to Zrs and Zlrs. The airway compartment consisted of a frequency independent resistance (R) and inertance (I), while the tissue compartment was described by coefficients of tissue damping (G) and elastance (H). RESULTS: Zrs could be reliably partitioned into Zn and Zlrs. The nasal pathway acted as a purely resistive-inertive impedance and contributed approximately half of the airway resistance (mean (SE) 44.6 (4.9)%) and most of the respiratory system inertance (71.7 (3.5)%). CONCLUSIONS: In studies investigating changes in airway resistance in nasally breathing infants, the separation of nasal and lower respiratory system mechanics will increase the sensitivity of the tests.


Assuntos
Resistência das Vias Respiratórias/fisiologia , Nariz/fisiologia , Pré-Escolar , Humanos , Lactente , Sensibilidade e Especificidade
17.
Am J Respir Crit Care Med ; 164(8 Pt 1): 1387-91, 2001 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-11704583

RESUMO

Low-frequency forced oscillation (LFOT) and raised volume rapid thoracic compression (RVRTC) techniques were used to measure airways and respiratory tissue mechanics and forced expiratory volumes in 24 asymptomatic infants with recurrent wheeze. Total respiratory impedance spectra (Zrs) (0.5 to 20 Hz) were obtained (n = 22) and a model containing airway (resistance [Raw] and inertance [Iaw]) and constant-phase tissue (tissue damping [G] and tissue elastance [H]) compartments fitted to Zrs. Forced expiratory volumes (FEV(0.5)) were determined (n = 16). Standardized variants (Z scores) were calculated for comparison to a healthy population (Hall et al., Am J Respir Crit Care Med 2000;162:1397-1402). Wheezy infants had elevated H (Z scores: 0.61 +/- 0.20; p = 0.007) but not Raw (0.14 +/- 0.25; p > 0.2), G (0.41 +/- 0.21; p = 0.066), or FEV(0.5) (-0.25 +/- 0.25; p > 0.2) compared with healthy infants. Infants younger than 1 yr of age were not significantly different from normals, whereas lung function from infants older than 1 yr had deviated from normal infants, with Z scores of 0.58 +/- 0.2 (p = 0.018), 0.79 +/- 0.31 (p = 0.032), 1.06 +/- 0.25 (p = 0.002), and -0.94 +/- 0.22 (p = 0.007) for Raw, G, H, and FEV(0.5) respectively. We conclude that asymptomatic infants with recurrent wheeze have altered lung function. The abnormalities were more pronounced in respiratory tissue mechanics than in airway mechanics or forced volumes, highlighting the value of techniques capable of partitioning lung function into airway and respiratory tissue components.


Assuntos
Mecânica Respiratória , Sons Respiratórios/fisiopatologia , Pré-Escolar , Humanos , Lactente , Recidiva , Músculos Respiratórios/fisiopatologia
18.
Eur Respir J ; 17(5): 975-81, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11488335

RESUMO

Endothelin-1 (ET-1) has been shown to have a constrictor effect on the airways and parenchyma; however, the roles of the ETA and ETB receptors in the ET-1-induced changes in the airway and tissue compartments have not been fully explored. Low-frequency pulmonary impedance (ZL) was measured in anaesthetized, paralysed, open-chest guinea-pigs. ZL spectra were fitted by a model to estimate airway resistance (Raw) and inertance (Iaw), and coefficients of tissue damping (G) and elastance (H), and hysteresivity (eta = G/H). Two successive doses of ET-1 (0.05 and 0.2 nmol x kg(-1)) each evoked significant dose-related increases in Raw, G, H and eta. Pretreatment with 20 nmol x kg(-1) BQ-610 (a highly selective ETA receptor antagonist) resulted in a significantly decreased elevation only in H after the lower dose of ET-1. However, all parameters changed significantly less on the administration of ET-1 after pretreatment with 80 nmol-kg(-1) BQ-610, with 20 nmol x kg(-1) ETR-P1/fl (a novel ETA receptor antagonist) or with 20 nmol x kg(-1) IRL 1038 (an ETB receptor antagonist). The results of the separate assessments of the airway and tissue mechanics demonstrate that endothelin-1 induces airway and parenchymal constriction via stimulation of both receptor types in both compartments.


Assuntos
Resistência das Vias Respiratórias/fisiologia , Endotelina-1/fisiologia , Receptores de Endotelina/fisiologia , Mecânica Respiratória/fisiologia , Animais , Cobaias , Receptor de Endotelina A , Receptor de Endotelina B
19.
Phys Rev Lett ; 87(5): 058102, 2001 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-11497807

RESUMO

We analyze the problem of fluid flow in a bifurcating structure containing random blockages that can be removed by fluid pressure. We introduce an asymmetric tree model and find that the predicted pressure-volume relation is connected to the distribution Pi(n) of the generation number n of the tree's terminal segments. We use this relation to explore the branching structure of the lung by analyzing experimental pressure-volume data from dog lungs. The Pi(n) extracted from the data using the model agrees well with experimental data on the branching structure. We can thus obtain information about the asymmetric structure of the lung from macroscopic, noninvasive pressure-volume measurements.


Assuntos
Pulmão/anatomia & histologia , Modelos Biológicos , Animais , Brônquios/anatomia & histologia , Brônquios/fisiologia , Cães , Pulmão/fisiologia , Alvéolos Pulmonares/fisiologia , Mecânica Respiratória/fisiologia
20.
J Appl Physiol (1985) ; 90(6): 2221-30, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11356786

RESUMO

Hyperoxia-induced lung damage was investigated via airway and respiratory tissue mechanics measurements with low-frequency forced oscillations (LFOT) and analysis of spontaneous breathing indexes by barometric whole body plethysmography (WBP). WBP was performed in the unrestrained awake mice kept in room air (n = 12) or in 100% oxygen for 24 (n = 9), 48 (n = 8), or 60 (n = 9) h, and the indexes, including enhanced pause (Penh) and peak inspiratory and expiratory flows, were determined. The mice were then anesthetized, paralyzed, and mechanically ventilated. Airway resistance, respiratory system resistance at breathing frequency, and tissue damping and elastance were identified from the LFOT impedance data by model fitting. The monotonous decrease in airway resistance during hyperoxia correlated best with the increasing peak expiratory flow. Respiratory system resistance and tissue damping and elastance were unchanged up to 48 h of exposure but were markedly elevated at 60 h, with associated decreases in peak inspiratory flow. Penh was increased at 24 h and sharply elevated at 60 h. These results indicate no adverse effect of hyperoxia on the airway mechanics in mice, whereas marked parenchymal damage develops by 60 h. The inconsistent relationships between LFOT parameters and WBP indexes suggest that the changes in the latter reflect alterations in the breathing pattern rather than in the mechanical properties. It is concluded that, in the presence of diffuse lung disease, Penh is inadequate for characterization of the mechanical status of the respiratory system.


Assuntos
Hiperóxia/fisiopatologia , Pulmão/fisiologia , Pletismografia Total , Mecânica Respiratória/fisiologia , Pressão do Ar , Resistência das Vias Respiratórias/fisiologia , Animais , Feminino , Hiperóxia/patologia , Pulmão/patologia , Camundongos , Camundongos Endogâmicos C57BL , Tamanho do Órgão/fisiologia
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