A Study of Factors Influencing Relief of Discomfort in Breath-Holding in Normal Subjects

1974 ◽  
Vol 47 (3) ◽  
pp. 193-199 ◽  
Author(s):  
J. R. A. Rigg ◽  
A. S. Rebuck ◽  
E. J. M. Campbell
Keyword(s):  
Vital Capacity ◽  
Normal Subjects ◽  
Breaking Point ◽  
Breath Holding ◽  
Breath Hold ◽  
Afferent Activity ◽  
Local Pressure ◽  
Single Breath ◽  
Afferent Information ◽  
Series Of Experiments

1. Two series of experiments were performed in an attempt to elucidate the mechanism of relief of the discomfort of breath-holding. 2. In the first the effect of varying the size of a single breath at the breaking point of breath-holding on the time of a second breath-hold (BHT2) was observed in three normal subjects. The effect of two different non-ventilatory chest-wall manœuvres, performed at the breaking point, on the duration of a second breath-hold in two additional subjects was then studied. 3. The volume of an unrestricted relieving breath was always greater than 70% of vital capacity. When the size of the breath was restricted to as little as 20% of the free relieving volume, BHT2 was unchanged. 4. An inspiratory effort against an occluded airway or an isovolume movement of the rib cage and abdomen performed at the breaking point of breath-holding were as effective as a control relieving breath in allowing resumption of apnoea. 5. There seem to be two possible mechanisms of relief. First, afferent information may be generated by some consequence of diaphragmatic contraction. Secondly, changes of local pressure-volume relationships within the lung may alter the pattern of vagal afferent activity, independent of an overall change in lung volume.

Measurement of temporal changes in DLSBCO-3EQ from small alveolar samples in normal subjects

1994 ◽  
Vol 76 (4) ◽  
pp. 1494-1501 ◽  
Author(s):  
G. R. Soparkar ◽  
J. T. Mink ◽  
B. L. Graham ◽  
D. J. Cotton
Keyword(s):  
Hold Time ◽  
Normal Subjects ◽  
Gas Diffusion ◽  
Phase Iii ◽  
Mixing Efficiency ◽  
Breath Holding ◽  
Breath Hold ◽  
Inspiratory Capacity ◽  
Ventilation Inhomogeneity ◽  
Single Breath

The dynamic changes in CO concentration [CO] during a single breath could be influenced by topographic inhomogeneity in the lung or by peripheral inhomogeneity due to a gas mixing resistance in the gas phase of the lung or to serial gradients in gas diffusion. Ten healthy subjects performed single-breath maneuvers by slowly inhaling test gas from functional residual capacity to one-half inspiratory capacity and slowly exhaling to residual volume with target breath-hold times of 0, 1.5, 3, 6, and 9 s. We calculated the three-equation single-breath diffusing capacity of the lung for CO (DLSBCO-3EQ) from the mean [CO] in both the entire alveolar gas sample and in four successive equal alveolar gas samples. DLSBCO-3EQ from the entire alveolar gas sample was independent of breath-hold time. However, with 0 s of breath holding, from early alveolar gas samples DLSBCO-3EQ was reduced and from late alveolar gas samples it was increased. With increasing breath-hold time, DLSBCO-3EQ from the earliest alveolar gas sample rapidly increased, whereas from the last alveolar gas sample it rapidly decreased such that all values from the small alveolar gas samples approached DLSBCO-3EQ from the entire alveolar sample. These changes correlated with ventilation inhomogeneity, as measured by the phase III He concentration slope and the mixing efficiency, and were larger for maneuvers with inspired volumes to one-half inspiratory capacity vs. total lung capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

Single-breath breath-holding estimate of pulmonary blood flow in man: comparison with direct Fick cardiac output

1989 ◽  
Vol 76 (6) ◽  
pp. 673-676 ◽  
Author(s):  
A. H. Kendrick ◽  
A. Rozkovec ◽  
M. Papouchado ◽  
J. West ◽  
G. Laszlo
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Pulmonary Blood Flow ◽  
Hold Time ◽  
Normal Subjects ◽  
Breath Holding ◽  
Breath Hold ◽  
Single Breath ◽  
Significant Difference ◽  
Cardiac Disorders

1. Resting pulmonary blood flow (Q.), using the uptake of the soluble inert gas Freon-22 and an indirect estimate of lung tissue volume, has been estimated during breath-holding (Q.c) and compared with direct Fick cardiac output (Q.f) in 16 patients with various cardiac disorders. 2. The effect of breath-hold time was investigated by comparing Q.c estimated using 6 and 10 s of breath-holding in 17 patients. Repeatability was assessed by duplicate measurements of Q.c in the patients and in six normal subjects. 3. Q.c tended to overestimate Q.f, the bias and error being 0.09 l/min and 0.59, respectively. The coefficient of repeatability for Q.c in the patients was 0.75 l/min and in the normal subjects was 0.66 1/min. For Q.f it was 0.72 l/min. There was no significant difference in Q.c measured at the two breath-hold times. 4. The technique is simple to perform, and provides a rapid estimate of Q., monitoring acute and chronic changes in cardiac output in normal subjects and patients with cardiac disease.

Effects of ventilation inhomogeneity on DLcoSB-3EQ in normal subjects

1992 ◽  
Vol 73 (6) ◽  
pp. 2623-2630 ◽  
Author(s):  
D. J. Cotton ◽  
M. B. Prabhu ◽  
J. T. Mink ◽  
B. L. Graham
Keyword(s):  
Lung Volume ◽  
Vital Capacity ◽  
Hold Time ◽  
Airflow Obstruction ◽  
Normal Subjects ◽  
Phase Iii ◽  
Mixing Efficiency ◽  
Breath Hold ◽  
Ventilation Inhomogeneity ◽  
Single Breath

In patients with airflow obstruction, we found that ventilation inhomogeneity during vital capacity single-breath maneuvers was associated with decreases in the three-equation single-breath CO diffusing capacity of the lung (DLcoSB-3EQ) when breath-hold time (tBH) decreased. We postulated that this was due to a significant resistance to diffusive gas mixing within the gas phase of the lung. In this study, we hypothesized that this phenomenon might also occur in normal subjects if the breathing cycle were altered from traditional vital capacity maneuvers to those that increase ventilation inhomogeneity. In 10 normal subjects, we examined the tBH dependence of both DLcoSB-3EQ and the distribution of ventilation, measured by the mixing efficiency and the normalized phase III slope for helium. Preinspiratory lung volume (V0) was increased by keeping the maximum end-inspiratory lung volume (Vmax) constant or by increasing V0 and Vmax. When V0 increased while Vmax was kept constant, we found that the tBH-independent and the tBH-dependent components of ventilation inhomogeneity increased, but DLcoSB-3EQ was independent of V0 and tBH. Increasing V0 and Vmax did not change ventilation inhomogeneity at a tBH of 0 s, but the tBH-dependent component decreased. DLcoSB-3EQ, although independent of tBH, increased slightly with increases in Vmax. We conclude that in normal subjects increases in ventilation inhomogeneity with increases in V0 do not result in DLcoSB-3EQ becoming tBH dependent.

The effect of conductive ventilation heterogeneity on diffusing capacity measurement

2008 ◽  
Vol 104 (4) ◽  
pp. 1094-1100 ◽  
Author(s):  
Sylvia Verbanck ◽  
Daniel Schuermans ◽  
Sophie Van Malderen ◽  
Walter Vincken ◽  
Bruce Thompson
Keyword(s):  
Carbon Monoxide ◽  
Vital Capacity ◽  
Experimental Situation ◽  
Normal Subjects ◽  
Diffusing Capacity ◽  
Capacity Measurement ◽  
Alveolar Volume ◽  
Estimation Errors ◽  
Single Breath ◽  
Ventilation Heterogeneity

It has long been assumed that the ventilation heterogeneity associated with lung disease could, in itself, affect the measurement of carbon monoxide transfer factor. The aim of this study was to investigate the potential estimation errors of carbon monoxide diffusing capacity (DlCO) measurement that are specifically due to conductive ventilation heterogeneity, i.e., due to a combination of ventilation heterogeneity and flow asynchrony between lung units larger than acini. We induced conductive airway ventilation heterogeneity in 35 never-smoker normal subjects by histamine provocation and related the resulting changes in conductive ventilation heterogeneity (derived from the multiple-breath washout test) to corresponding changes in diffusing capacity, alveolar volume, and inspired vital capacity (derived from the single-breath DlCO method). Average conductive ventilation heterogeneity doubled ( P < 0.001), whereas DlCO decreased by 6% ( P < 0.001), with no correlation between individual data ( P > 0.1). Average inspired vital capacity and alveolar volume both decreased significantly by, respectively, 6 and 3%, and the individual changes in alveolar volume and in conductive ventilation heterogeneity were correlated ( r = −0.46; P = 0.006). These findings can be brought in agreement with recent modeling work, where specific ventilation heterogeneity resulting from different distributions of either inspired volume or end-expiratory lung volume have been shown to affect DlCO estimation errors in opposite ways. Even in the presence of flow asynchrony, these errors appear to largely cancel out in our experimental situation of histamine-induced conductive ventilation heterogeneity. Finally, we also predicted which alternative combination of specific ventilation heterogeneity and flow asynchrony could affect DlCO estimate in a more substantial fashion in diseased lungs, irrespective of any diffusion-dependent effects.

Changing effect of lung volume on respiratory drive in man

1975 ◽  
Vol 38 (5) ◽  
pp. 768-773 ◽  
Author(s):  
N. N. Stanley ◽  
M. D. Altose ◽  
S. G. Kelsen ◽  
C. F. Ward ◽  
N. S. Cherniack
Keyword(s):  
Human Subjects ◽  
Inhibitory Effect ◽  
Breath Holding ◽  
Breath Hold ◽  
Respiratory Drive ◽  
Lung Inflation ◽  
Single Breath ◽  
Single Breath Hold ◽  
Sustained Effect ◽  
Residual Capacity

Experiments were conducted on human subjects to study the effect of lung inflation during breath holding on respiratory drive. Two series of experiments were performed: the first to examine respiratory drive during a single breath hold, the second designed to examine the sustained effect of lung inflation on subsequent breath holds. The experiments involved breath holding begun either at the end of a normal expiration or after a maximum inspiration. When breath holding was repeated at 10-min intervals, the increase in BHT produced by lung inflation was greater in short breath holds (after CO2 rebreathing) than in long breath holds (after hyperventilation). If breath holds were made in rapid succession, the first breath hold was much longer when made at total lung capacity than at functional residual capacity, but this effect of lung inflation diminished in subsequent breath holds. It is concluded that the inhibitory effect of lung inflation decays during breath holding and is regained remarkably slowly during the period of breathing immediately after breath holding.

Fast vs. slow exhalation before O2 inhalation alters subsequent phase III slope

1984 ◽  
Vol 56 (1) ◽  
pp. 52-56 ◽  
Author(s):  
T. S. Hurst ◽  
B. L. Graham ◽  
D. J. Cotton
Keyword(s):  
Total Lung Capacity ◽  
Normal Subjects ◽  
Phase Iii ◽  
Breath Holding ◽  
Small Airways ◽  
Residual Volume ◽  
Lung Capacity ◽  
Single Breath ◽  
Subsequent Phase ◽  
Phase Iii Slope

We studied 10 symptom-free lifetime non-smokers and 17 smokers all with normal pulmonary function studies. All subjects performed single-breath N2 washout tests by either exhaling slowly (“slow maneuver”) from end inspiration (EI) to residual volume (RV) or exhaling maximally (“fast maneuver”) from EI to RV. After either maneuver, subjects then slowly inhaled 100% O2 to total lung capacity (TLC) and without breath holding, exhaled slowly back to RV. In the nonsmokers seated upright phase III slope of single-breath N2 test (delta N2/l) was lower (P less than 0.01) for the fast vs. the slow maneuver, but this difference disappeared when the subjects repeated the maneuvers in the supine position. In contrast, delta N2/l was higher for the fast vs. the slow maneuver (P less than 0.01) in smokers seated upright. For the slow maneuver, delta N2/l was similar between smokers and nonsmokers but for the fast maneuvers delta N2/l was higher in smokers than nonsmokers (P less than 0.01). We suggest that the fast exhalation to RV decreases delta N2/l in normal subjects by decreasing apex-to-base differences in regional ratio of RV to TLC (RV/TLC) but increases delta N2/l in smokers, because regional RV/TLC increases distal to sites of small airways obstruction when the expiratory flow rate is increased.

Mode shift of an inhaled aerosol bolus is correlated with flow sequencing in the human lung

2002 ◽  
Vol 92 (3) ◽  
pp. 1232-1238 ◽  
Author(s):  
Christopher N. Mills ◽  
Chantal Darquenne ◽  
G. Kim Prisk
Keyword(s):  
Vital Capacity ◽  
Normal Subjects ◽  
Phase Iii ◽  
Mode Shift ◽  
Nitrogen Washout ◽  
Single Breath ◽  
Posture Change ◽  
Supine Posture ◽  
Residual Capacity ◽  
Phase Iii Slope

We studied the effects on aerosol bolus inhalations of small changes in convective inhomogeneity induced by posture change from upright to supine in nine normal subjects. Vital capacity single-breath nitrogen washout tests were used to determine ventilatory inhomogeneity change between postures. Relative to upright, supine phase III slope was increased 33 ± 11% (mean ± SE, P < 0.05) and phase IV height increased 25 ± 11% ( P < 0.05), consistent with an increase in convective inhomogeneity likely due to increases in flow sequencing. Subjects also performed 0.5-μm-particle bolus inhalations to penetration volumes (Vp) between 150 and 1,200 ml during a standardized inhalation from residual volume to 1 liter above upright functional residual capacity. Mode shift (MS) in supine posture was more mouthward than upright at all Vp, changing by 11.6 ml at Vp = 150 ml ( P < 0.05) and 38.4 ml at Vp = 1,200 ml ( P < 0.05). MS and phase III slope changes correlated positively at deeper Vp. Deposition did not change at any Vp, suggesting that deposition did not cause the MS change. We propose that the MS change results from increased sequencing in supine vs. upright posture.

Use of aerosols to estimate pulmonary air-space dimensions

1981 ◽  
Vol 51 (2) ◽  
pp. 465-476 ◽  
Author(s):  
J. Gebhart ◽  
J. Heyder ◽  
W. Stahlhofen
Keyword(s):  
Particle Deposition ◽  
Continuous Monitoring ◽  
Region Of Interest ◽  
Normal Subjects ◽  
Breath Holding ◽  
Experimental Conditions ◽  
Single Breath ◽  
Inhaled Particles ◽  
Respiratory Flow ◽  
Air Space

Single-breath inhalations of monodisperse aerosols were performed with a group of normal subjects to determine aerosol recovery from the human lung after periods of breath holding. Aerosols of monodisperse nonhygroscopic droplets of bis(2-ethylhexyl) sebacate of between 0.5 and about 2.5 micron diam were used for the inhalation. The inhalation apparatus allows continuous monitoring of particle number concentration and flow rate close to the mouth. Experiments were designed to find the optimum experimental conditions for the principal concept of Palmes et al (In: Inhaled Particles and Vapours. London: Pergamon, 1976, vol. II. p. 339-347) to evaluate pulmonary air-space dimensions by means of aerosols. The experimental results obtained for various respiratory flow rates (125, 250, and 500 cm3 X s-1), settling velocities of the particles (10(-3) to 1.5 X 10(-2) cm X s-1) and volumes of inspired aerosols (500, 1,000, and 2,000 cm3) are compared with the results derived from a mathematical model for the particle deposition during respiratory pauses. Monodisperse aerosols with particles between 1 and about 1.5 micron diam. inspired for breath holding into the lung region of interest, may provide optimum conditions for the sizing of air spaces by means of aerosols.

“Alveolar plateau” of the single breath nitrogen elimination curve in normal subjects

1959 ◽  
Vol 14 (1) ◽  
pp. 105-108 ◽  
Author(s):  
Ingemar Kjellmer ◽  
Lars Sandqvist ◽  
Erik Berglund
Keyword(s):  
Flow Rate ◽  
Normal Subjects ◽  
Holding Time ◽  
Breath Holding ◽  
Flow Rates ◽  
Alveolar Plateau ◽  
Single Breath ◽  
The Difference ◽  
Nitrogen Elimination ◽  
Elimination Curve

The single breath N2 elimination test, as standardized by Comroe and Fowler, has been used in normal subjects. The N2 difference, i.e. the difference in N2 concentration between Ve = 1250 and Ve = 750 ml, showed a tendency to increase with increasing volumes of inspired O2 and with increasing inspiratory flow rates. It decreased with increasing breath-holding time and was not consistently influenced by expiratory flow rate. The findings are compared with those of Fowler and of Shephard on normal subjects; different results were obtained, largely depending on different analytical procedures. These factors must be considered when evaluating results in patients. Submitted on July 21, 1958

Anomalous behavior of helium and sulfur hexafluoride during single-breath tests in sustained microgravity

1996 ◽  
Vol 80 (4) ◽  
pp. 1126-1132 ◽  
Author(s):  
G. K. Prisk ◽  
A. M. Lauzon ◽  
S. Verbanck ◽  
A. R. Elliot ◽  
H. J. Guy ◽  
...  
Keyword(s):  
Conformational Changes ◽  
Sulfur Hexafluoride ◽  
Anomalous Behavior ◽  
Phase Iii ◽  
Breath Holding ◽  
Breath Hold ◽  
Breath Tests ◽  
Single Breath ◽  
Lung Periphery ◽  
Phase Iii Slope

We performed single-breath wash-in tests for He and SF6 in four subjects exposed to 14 days of microgravity (microG) during the Spacelab flight Spacelab Life Sciences-2. Subjects inspired a vital capacity breath of 5% He-1.25% SF6-balance O2 and then exhaled to residual volume at 0.5l/s. The tests were also performed with a 10-s breath hold at the end of inspiration. Measurements were also made with the subjects standing and supine in 1 G. Phase III slope was measured after the dead-space washout and before the onset of airway closure. In all subjects in 1 G, whether standing or supine, phase III slope for SF6 was significantly steeper than that for He. However, in microG, the slopes became the same. Furthermore, after breath holding in microG, the SF6 slopes were significantly flatter than those for He. On return to 1 G, the changes were reversed, and there was no difference between preflight and postflight values. Because most of the phase III slope reflects events occurring in the acinar regions of the lung, the results suggest that microG causes conformational changes in the acini or changes in cardiogenic mixing in the lung periphery, but in either case the mechanism is unclear.

Sign in / Sign up

Export Citation Format

Share Document