scholarly journals STUDIES OF LUNG VOLUME

1918 ◽  
Vol 27 (1) ◽  
pp. 87-94 ◽  
Author(s):  
A. Garvin ◽  
Christen Lundsgaard ◽  
Donald D. Van Slyke

1. The total capacity, middle capacity, and residual air have been determined in 31 adult male patients suffering from tuberculosis of the lungs. 2. The chest volumes have been determined in each case and the normal lung volumes calculated by means of the ratios worked out in a previous paper. 3. In nine patients with incipient tuberculosis, the total lung volume was found within normal limits, whereas the vital capacity was diminished as a result of an increased residual air. The increase in the residual air was due to less complete expiration, caused partly by diminished movement of the diaphragm, partly by diminished compression of the chest wall. The diminished movement of the diaphragm was, as a rule, most marked on the most affected side. Whether these decreased movements are due to a reflex or to stiffness of the lung tissue we could not determine. The middle capacity was found practically normal. 4. In twenty-two cases of moderately advanced, and advanced tuberculosis, the total lung volume was in most cases markedly decreased. The vital capacity was substantially decreased, principally as a result of the diminished total capacity. The residual air was, as a rule, normal, although in a few cases an increase in residual air also contributed to the decrease in the vital capacity. The middle capacity, on which we do not want to put too much stress, was normal in some patients and considerably diminished in others.

1923 ◽  
Vol 38 (4) ◽  
pp. 445-476 ◽  
Author(s):  
Carl A. L. Binger

The lung volumes in a group of individuals suffering from chronic cardiac disease have been studied by a method which is applicable to patients suffering from dyspnea. In a number of instances the same patients were investigated during various stages of decompensation and compensation. The values found have been compared with those determined in a group of normal subjects. Lung volumes have been considered from three points of view: (1) relative lung volumes or subdivisions of total lung volume expressed as percentage of total lung volume; (2) the absolute lung volumes of patients with heart disease have been compared with lung volumes calculated for normal individuals having similar surface areas or chest measurements; and (3) in individual cases absolute lung volumes have been measured in various stages of compensation and decompensation. (1) In patients with heart disease it has been observed that the vital capacity forms a portion of the total lung volume relatively smaller than in normal individuals, and that the mid-capacity and residual air form relatively larger portions. When the patient progresses from the compensated to the decompensated state these changes become more pronounced. (2) When the absolute lung volumes determined for patients are compared with volumes of the same sort, as calculated for normal individuals of the same surface areas and chest measurements, the following differences are found. The vital capacities are always smaller in the patients and the volumes of residual air are always larger. There is a tendency for middle capacity and total capacity to be smaller, though, when the patients are in a compensated state, these volumes may approximate normal. (3) When decompensation occurs the absolute lung volumes undergo changes as follows: (a) vital capacity, mid-capacity, and total capacity decrease in volume; and (b) the residual air may either increase or decrease according to the severity of the state of decompensation. The significance of these changes has been discussed and an explanation offered for the occurrence of a residual air of normal volume in patients with heart disease. It results from a combination of two tendencies working in opposite directions: one to increase the residual air—stiffness of the lungs (Lungenstarre); the other to decrease it—distended capillaries (Lungenschwellung), edema, round cell infiltration.


1918 ◽  
Vol 27 (1) ◽  
pp. 129-142 ◽  
Author(s):  
A. Garvin ◽  
Christen Lundsgaard ◽  
Donald D. Van Slyke

The total capacity, middle capacity, and residual air have been determined in twenty adult women suffering from pulmonary tuberculosis. The chest volumes have been determined in each case and the normal lung volumes calculated by means of the ratios worked out in Paper I and applied to thirty-one men in Paper II. The excursions of the diaphragm have been determined by fluoroscopy in all cases. Of eight patients with incipient tuberculosis, five had lung capacities like those of men in the same group; i.e., about normal total capacity, slightly increased residual air, and consequently somewhat decreased vital capacity. Three had considerably diminished total capacity. In these three patients, however, clinical abnormalities were found (extensive miliary tuberculosis, obstruction of bronchus, fixation of diaphragm in expiratory position). In twelve patients with moderately advanced and advanced tuberculosis, the results agreed with those found in men, the total capacity and vital capacity being decreased, while the residual air was practically normal.


The total lung volume consists of the vital capacity plus the residual air. Since the vital capacity may be measured directly, determination of the total lung volume depends on the measurement of the residual air. Alternatively, the functional residual air may be measured and the figure added to the complemental air (terminology of Christie 1932). As the volume of reserve air expelled from the lungs in untrained subjects is liable to fortuitous variations, calculations of the residual air based on gas dilution at the end of a forced expiration are open to considerable error; for the same reason, determinations of the functional residual air at the end of an ordinary expiration may be inaccurate. Van Slyke and Binger (1923) and Christie (1932) have shown that this source of error may be avoided by taking graphic spirometer records of respiration during the period of mixing. Since the dilution of the lung gases is achieved by ordinary quiet respiration, this method requires no special respiratory efforts and is thus eminently suitable for clinical investigation. Determination of lung volume by Christie’s method, the underlying principle of which is exceedingly simple, involves only the recording of an ordinary spirometer tracing and the analysis of the oxygen and nitrogen content of the spirometer gas at the end of a period of rebreathing. The essence of the method is as follows:


1994 ◽  
Vol 77 (2) ◽  
pp. 789-794 ◽  
Author(s):  
G. E. Tzelepis ◽  
D. L. Vega ◽  
M. E. Cohen ◽  
F. D. McCool

We examined the extent to which training-related increases of inspiratory muscle (IM) strength are limited to the lung volume (VL) at which the training occurs. IM strength training consisted of performing repeated static maximum inspiratory maneuvers. Three groups of normal volunteers performed these maneuvers at one of three lung volumes: residual volume (RV), relaxation volume (Vrel), or Vrel plus one-half of inspiratory capacity (Vrel + 1/2IC). A control group did not train. We constructed maximal inspiratory pressure-VL curves before and after a 6-wk training period. For each group, we found that the greatest improvements in strength occurred at the volume at which the subjects trained and were significantly greater for those who trained at low (36% for RV and 26% for Vrel) than at high volumes (13% for Vrel + 1/2IC). Smaller increments in strength were noted at volumes adjacent to the training volume. The range of vital capacity (VC) over which strength was increased was greater for those who trained at low (70% of VC) than at high VL (20% of VC). We conclude that the greatest improvements in IM strength are specific to the VL at which training occurs. However, the increase in strength, as well as the range of volume over which strength is increased, is greater for those who trained at the lower VL.


2013 ◽  
Vol 110 (3) ◽  
pp. 680-687 ◽  
Author(s):  
Corey R. Tomczak ◽  
Krista R. Greidanus ◽  
Carol A. Boliek

Chest wall muscle recruitment varies as a function of the breathing task performed. However, the cortical control of the chest wall muscles during different breathing tasks is not known. We studied chest wall intermuscular coherence during various task-related lung volume excursions in 10 healthy adults (34 ± 15 yr; 2 men, 8 women) and determined if transcranial direct current stimulation (tDCS) could modulate chest wall intermuscular coherence during these tasks. Simultaneous assessment of regional intercostal and oblique electromyographic activity was measured while participants performed standardized tidal breathing, speech, maximum phonation, and vital capacity tasks. Lung volume and chest wall kinematics were determined using variable inductance plethysmography. We found that chest wall area of intermuscular coherence was greater during tidal and speech breathing compared with phonation and vital capacity (all P < 0.05) and between tidal breathing compared with speech breathing ( P < 0.05). Anodal tDCS increased chest wall area of intermuscular coherence from 0.04 ± 0.09 prestimulation to 0.18 ± 0.19 poststimulation for vital capacity ( P < 0.05). Sham tDCS and cathodal tDCS had no effect on coherence during lung volume excursions. Chest wall kinematics were not affected by tDCS. Our findings indicate that lung volume excursions about the midrange of vital capacity elicit a greater area of chest wall intermuscular coherence compared with lung volume excursions spanning the entire range of vital capacity in healthy adults. Our findings also demonstrate that brief tDCS may modulate the cortical control of the chest wall muscles in a stimulation- and lung volume excursion task-dependent manner but does not affect chest wall kinematics in healthy adults.


1992 ◽  
Vol 73 (6) ◽  
pp. 2373-2381 ◽  
Author(s):  
S. J. Cala ◽  
J. Edyvean ◽  
L. A. Engel

We measured the electromyographic (EMG) activity in four chest wall and trunk (CWT) muscles, the erector spinae, latissimus dorsi, pectoralis major, and trapezius, together with the parasternal, in four normal subjects during graded inspiratory efforts against an occlusion in both upright and seated postures. We also measured CWT EMGs in six seated subjects during inspiratory resistive loading at high and low tidal volumes [1,280 +/- 80 (SE) and 920 +/- 60 ml, respectively]. With one exception, CWT EMG increased as a function of inspiratory pressure generated (Pmus) at all lung volumes in both postures, with no systematic difference in recruitment between CWT and parasternal muscles as a function of Pmus. At any given lung volume there was no consistent difference in CWT EMG at a given Pmus between the two postures (P > 0.09). However, at a given Pmus during both graded inspiratory efforts and inspiratory resistive loading, EMGs of all muscles increased with lung volume, with greater volume dependence in the upright posture (P < 0.02). The results suggest that during inspiratory efforts, CWT muscles contribute to the generation of inspiratory pressure. The CWT muscles may act as fixators opposing deflationary forces transmitted to the vertebral column by rib cage articulations, a function that may be less effective at high lung volumes if the direction of the muscular insertions is altered disadvantageously.


Author(s):  
Davide Ippolito ◽  
Maria Ragusi ◽  
Davide Gandola ◽  
Cesare Maino ◽  
Anna Pecorelli ◽  
...  

Abstract Objectives To evaluate a semi-automated segmentation and ventilated lung quantification on chest computed tomography (CT) to assess lung involvement in patients affected by SARS-CoV-2. Results were compared with clinical and functional parameters and outcomes. Methods All images underwent quantitative analyses with a dedicated workstation using a semi-automatic lung segmentation software to compute ventilated lung volume (VLV), Ground-glass opacity (GGO) volume (GGO-V), and consolidation volume (CONS-V) as absolute volume and as a percentage of total lung volume (TLV). The ratio between CONS-V, GGO-V, and VLV (CONS-V/VLV and GGO-V/VLV, respectively), TLV (CONS-V/TLV, GGO-V/TLV, and GGO-V + CONS-V/TLV respectively), and the ratio between VLV and TLV (VLV/TLV) were calculated. Results A total of 108 patients were enrolled. GGO-V/TLV significantly correlated with WBC (r = 0.369), neutrophils (r = 0.446), platelets (r = 0.182), CRP (r = 0.190), PaCO2 (r = 0.176), HCO3− (r = 0.284), and PaO2/FiO2 (P/F) values (r = − 0.344). CONS-V/TLV significantly correlated with WBC (r = 0.294), neutrophils (r = 0.300), lymphocytes (r = −0.225), CRP (r = 0.306), PaCO2 (r = 0.227), pH (r = 0.162), HCO3− (r = 0.394), and P/F (r = − 0.419) values. Statistically significant differences between CONS-V, GGO-V, GGO-V/TLV, CONS-V/TLV, GGO-V/VLV, CONS-V/VLV, GGO-V + CONS-V/TLV, VLV/TLV, CT score, and invasive ventilation by ET were found (all p < 0.05). Conclusion The use of quantitative semi-automated algorithm for lung CT elaboration effectively correlates the severity of SARS-CoV-2-related pneumonia with laboratory parameters and the need for invasive ventilation. Key Points • Pathological lung volumes, expressed both as GGO-V and as CONS-V, can be considered a useful tool in SARS-CoV-2-related pneumonia. • All lung volumes, expressed themselves and as ratio with TLV and VLV, correlate with laboratory data, in particular C-reactive protein and white blood cell count. • All lung volumes correlate with patient’s outcome, in particular concerning invasive ventilation.


2001 ◽  
Vol 90 (4) ◽  
pp. 1441-1446 ◽  
Author(s):  
Mario Filippelli ◽  
Riccardo Pellegrino ◽  
Iacopo Iandelli ◽  
Gianni Misuri ◽  
Joseph R. Rodarte ◽  
...  

Lung and chest wall mechanics were studied during fits of laughter in 11 normal subjects. Laughing was naturally induced by showing clips of the funniest scenes from a movie by Roberto Benigni. Chest wall volume was measured by using a three-dimensional optoelectronic plethysmography and was partitioned into upper thorax, lower thorax, and abdominal compartments. Esophageal (Pes) and gastric (Pga) pressures were measured in seven subjects. All fits of laughter were characterized by a sudden occurrence of repetitive expiratory efforts at an average frequency of 4.6 ± 1.1 Hz, which led to a final drop in functional residual capacity (FRC) by 1.55 ± 0.40 liter ( P < 0.001). All compartments similarly contributed to the decrease of lung volumes. The average duration of the fits of laughter was 3.7 ± 2.2 s. Most of the events were associated with sudden increase in Pes well beyond the critical pressure necessary to generate maximum expiratory flow at a given lung volume. Pga increased more than Pes at the end of the expiratory efforts by an average of 27 ± 7 cmH2O. Transdiaphragmatic pressure (Pdi) at FRC and at 10% and 20% control forced vital capacity below FRC was significantly higher than Pdi at the same absolute lung volumes during a relaxed maneuver at rest ( P < 0.001). We conclude that fits of laughter consistently lead to sudden and substantial decrease in lung volume in all respiratory compartments and remarkable dynamic compression of the airways. Further mechanical stress would have applied to all the organs located in the thoracic cavity if the diaphragm had not actively prevented part of the increase in abdominal pressure from being transmitted to the chest wall cavity.


A method of determining the lung volume has been described in the preceding paper (Herrald and McMichael 1938). During the course of an investigation on chronic pulmonary disease in the South Wales coalfield, sixty-six normal adult male subjects were studied as controls, and the results of this part of the investigation are here presented. The only previous work on comparable numbers was carried out in Rochester, New York, by Hurtado and his co-workers, who examined a hundred young adult normals (fifty males and fifty females) and, more recently, fifty middle-aged normal males, in the recumbent position (Hurtado and Boller 1933; Hurtado, Fray, kaltreider and Brooks 1934; Kaltreider, Fray and Hyde 1938). They also contrasted the results on males with ten subsidiary observations, made in the sitting posture, in each of the two series (Hurtado and Fray 1933 b; Kaltreider, Fray and Hyde 1938). These workers point out that no satisfactory standards of normality for total lung volume together with its subdivisions had previously been available. Their own standards would be generally acceptable were it nor for the fact that doubt has been thrown on the validity of the method used (Lassen, Cournand and Richards 1937). The source of error in the method is briefly discussed in the preceding paper, and it is shown to be most pronounced at functional residual air values of over 3.5 l. Since most normal values of this measurement are below this figure it is not surprising that our present results show remarkable general agreement with the figures of the Rochester workers. 1.Terminology Throughout this paper we use the following terminology: 2. Methods (a)Lung volume determinations The technique adopted was that described in the preceding paper. By this method the possible error of the original Christie technique is avoided.


1995 ◽  
Vol 78 (5) ◽  
pp. 1993-1997 ◽  
Author(s):  
J. Hammer ◽  
C. J. Newth

The rapid thoracoabdominal compression (RTC) technique is commonly used in pulmonary function laboratories to assess flow-volume relationships in infants unable to produce a voluntary forced expiration maneuver. This technique produces forced expiratory flows over only a small lung volume segment (i.e., tidal volume). It has been argued that the RTC technique should be modified to measure flow-volume relationships over a larger portion of the vital capacity range to imitate the voluntary maximal forced expiratory maneuver obtained in older children and adults. We examined the effect of volume history on forced expiratory flows by generating forced expiratory flow-volume curves by RTC from well-defined inspiratory volumes delineated by inspiratory pressures of 10, 20, 30, and 40 cmH2O down to residual volume (i.e., the reference volume) in seven intubated and anesthetized infants with normal lungs [age 8.0 +/- 2.0 (SE) mo, weight 6.7 +/- 0.6 kg]. We compared maximal expiratory flows at isovolume points (25 and 10% of forced vital capacity) and found no significant differences in maximal isovolume flow rates measured from the different lung volumes. We conclude that there is no obvious need to initiate RTC from higher lung volumes if the technique is used for flow comparisons. However, compared with measurements of maximal flows at functional residual capacity by RTC from end-tidal inspiration, the initiation of RTC from a defined and reproducible inspiratory level appears to decrease the intrasubject variability of the maximal expiratory flows at low lung volumes.


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