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Risk factors – Treatable traits
Published in Vibeke Backer, Peter G. Gibson, Ian D. Pavord, The Asthmas, 2023
Vibeke Backer, Peter G. Gibson, Ian D. Pavord
Obesity results in extrapulmonary thoracic restriction leading to altered pulmonary mechanics. The earliest change in static lung volumes is a reduction in end-expiratory reserve volume. Obesity can also lead to airway closure during tidal breathing. This results in the loss of the ‘physiological breathing space’, that is the gap between tidal airflow and maximal expiratory airflow.
Assessment for Rehabilitation of COVID-19
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
Lung volume includes tidal volume, inspiratory reverse volume, inspiratory capacity, vital capacity, residual volume, functional residual capacity, and total lung capacity, among which vital capacity is the most commonly used.
The patient with acute respiratory problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Another important lung volume is the functional residual capacity (FRC). This is the volume of air in the lungs at the end of expiration and consists of expiratory reserve volume (ERV) and residual volume (RV) (see Figure 5.4). An important aim in clinical practice, particularly where pulmonary status is compromised, is to maintain FRC so that alveolar volume does not fall further. Poor positioning, where patients are nursed flat or not well supported with pillows, can reduce FRC by up to 30% and may precipitate closure of alveoli (atelectasis), resulting in reduced oxygenation.
The rationale of applying inspiratory/expiratory muscle training within the same respiratory cycle in children with bronchial asthma: a placebo-controlled randomized clinical investigation
Published in Journal of Asthma, 2023
Ragab K. Elnaggar, Ahmad M. Osailan, Mohammed F. Elbanna
The maximal inspiratory (IPmax) and expiratory (EPmax) pressures were measured to reflect inspiratory and expiratory muscle strength, respectively. The measurements were taken in conformity with the European Respiratory Society and the American Thoracic Society guidelines [21], and were accomplished by an electronic respiratory pressure meter (Micro RPM®, Micro Medical, UK) connected with a rigid mouthpiece. For determining IPmax, participants were required to generate pressure over full inspiratory effort, from the residual lung volume to the total lung capacity, followed by maximal expiration. For EPmax measurement, participants were instructed to create pressure over maximal expiratory effort after full inspiration (i.e. from total lung capacity to residual lung volume) [5]. The IPmax and EPmax were the maximal pressure (in cmH2O) developed in the first second of inspiration and expiration, respectively. Participants performed five testing trials with 30-s rest intervals. The highest-pressure value of three acceptable trials including two reproducible values (i.e. differed by < 5%) was documented [21]. Then, a previously suggested equation was used to calculate the percent predicted IPmax and EPmax values, which were adopted for the analysis [22].
Rapid resolution of refractory hypoxemia and vascular spiders following liver transplantation
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2022
Allison Love, Rachel Jen, Lindsay Van Tongeren, C. Francis Ryan
A 65-year-old man was admitted for assessment for possible lung transplantation to manage severe refractory hypoxemia, platypnea and orthodeoxia, suspected to be due to hereditary hemorrhagic telangiectasia (HHT). He had a previous diagnosis of mild unclassifiable interstitial lung disease based on findings on chest CT imaging and review at multidisciplinary interstitial lung disease rounds. He also had mild centrilobular and paraseptal emphysema. He had a 45-pack-year smoking history prior to quitting 10 years previously. Pulmonary function testing showed forced vital capacity (FVC) 5.54 L (112% predicted), forced expiratory volume in 1 second (FEV1) 4.10 L (104% predicted), post-bronchodilator FEV1/FVC 0.74 with no significant bronchodilator response, and normal flow-volume loop. Lung volumes were normal with total lung capacity of 105% predicted and residual volume of 102% predicted. Diffusing capacity of lung for carbon monoxide (DLCO) was 64% predicted.
Effect of muscle distribution on lung function in young adults
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Wenbo Shu, Mengchi Chen, Zhengyi Xie, Liqian Huang, Binbin Huang, Peng Liu
VC was positively correlated with LLMM for men with normal weight or obesity and with TKMM for women with normal weight or obesity. This phenomenon may be related to different fat distribution between sexes. The accumulation of fat tissue is affected by sex hormones. Androgen mainly promotes the accumulation of fat in the internal organs of the abdomen in men, resulting in the development trend of male obesity as “concentric obesity.” By contrast, female hormones were mainly estrogen-based. Estrogen promotes the accumulation of fat under the skin and limbs, which made the development trend of female obesity “peripheral obesity” (Blaak 2001). This study found that the difference in VAT between males and females was not statistically significant, in line with the above results. The excessive accumulation of visceral fat in the abdomen of men has an adverse effect on lung ventilation function (Lee and Arslanian 2007). This phenomenon was attributed to abdominal visceral fat that hinders the contraction of the diaphragm (Manika et al. 2012), reduces the volume of the chest cavity, and reduces the respiratory reserve (Paralikar et al. 2012). In addition, men with normal weight or who are mildly obese, the distribution of the upper body fat may be related to lung volume damage (Collins et al. 1995). Studies have found that the visceral fat area of young men was larger than that of women. The larger the visceral fat area, the more inflammatory mediators in the visceral fat tissue, the stronger the pro-inflammatory effect, and the more severe the damage to lung function (Tu et al. 2015).