scholarly journals The Role of Airway Shunt Elastance on the Compartmentalization of Respiratory System Impedance

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Jason H. T. Bates
Keyword(s):  
Respiratory System ◽  
Upper Airway ◽  
Inverse Model ◽  
Tree Model ◽  
Upper Airways ◽  
Peripheral Airways ◽  
Pulmonary Airways ◽  
Peripheral Airway ◽  
In Series ◽  
Airway Tree

An inverse model consisting of two elastic compartments connected in series and served by two airway conduits has recently been fit to measurements of respiratory impedance in obese subjects. Increases in the resistance of the distal conduit of the model with increasing body mass index have been linked to peripheral airway compression by mass loading of the chest wall. Nevertheless, how the two compartments and conduits of this simple model map onto the vastly more complicated structure of an actual lung remain unclear. To investigate this issue, we developed a multiscale branching airway tree model of the respiratory system that predicts realistic input impedance spectra between 5 and 20 Hz with only four free parameters. We use this model to study how the finite elastances of the conducting airway tree and the proximal upper airways affect impedance between 5 and 20 Hz. We show that progressive constriction of the peripheral airways causes impedance to appear to arise from two compartments connected in series, with the proximal compartment being a reflection of the elastance of upper airway structures proximal to the tracheal entrance and the lower compartment reflecting the pulmonary airways and tissues. We thus conclude that while this simple inverse model allows evaluation of overall respiratory system impedance between 5 and 20 Hz in the presence of upper airway shunting, it does not allow the separate contributions of central versus peripheral pulmonary airways to be resolved.

scholarly journals Reactance and elastance as measures of small airways response to bronchodilator in asthma

2019 ◽  
Vol 127 (6) ◽  
pp. 1772-1781 ◽  
Author(s):  
S. A. Bhatawadekar ◽  
D. Leary ◽  
V. de Lange ◽  
U. Peters ◽  
S. Fulton ◽  
...  
Keyword(s):  
Respiratory System ◽  
Healthy Subjects ◽  
Low Frequency ◽  
Upper Airway ◽  
Study Groups ◽  
Small Airways ◽  
Tree Model ◽  
Effective Measure ◽  
Bronchodilator Response ◽  
Airway Function

Bronchodilation alters both respiratory system resistance (Rrs) and reactance (Xrs) in asthma, but how changes in Rrs and Xrs compare, and respond differently in health and asthma, in reflecting the contributions from the large and small airways has not been assessed. We assessed reversibility using spirometry and oscillometry in healthy and asthma subjects. Using a multibranch airway-tree model with the mechanics of upper airway shunt, we compared the effects of airway dilation and small airways recruitment to explain the changes in Rrs and Xrs. Bronchodilator decreased Rrs by 23.0 (19.0)% in 18 asthma subjects and by 13.5 (19.5)% in 18 healthy subjects. Estimated respiratory system elastance (Ers) decreased by 23.2 (21.4)% in asthma, with no significant decrease in healthy subjects. With the use of the model, airway recruitment of 15% across a generation of the small airways could explain the changes in Ers in asthma with no recruitment in healthy subjects. In asthma, recruitment accounted for 40% of the changes in Rrs, with the remaining explained by airway dilation of 6.8% attributable largely to the central airways. Interestingly, the same dilation magnitude explained the changes in Rrs in healthy subjects. Shunt only affected Rrs of the model. Ers was unaltered in health and unaffected by shunt in both groups. In asthma, Ers changed comparably to Rrs and could be attributed to small airways, while the change in Rrs was split between large and small airways. This implies that in asthma Ers sensed through Xrs may be a more effective measure of small airways obstruction and recruitment than Rrs. NEW & NOTEWORTHY This is the first study to quantify to relative contributions of small and large airways to bronchodilator response in healthy subjects and patients with asthma. The response of the central airways to bronchodilator was similar in magnitude in both study groups, whereas the response of the small airways was significant among patients with asthma. These results suggest that low-frequency reactance and derived elastance are both sensitive measures of small airway function in asthma.

Head position modifies upper airway resistance in men

1988 ◽  
Vol 64 (3) ◽  
pp. 1285-1288 ◽  
Author(s):  
G. Liistro ◽  
D. Stanescu ◽  
G. Dooms ◽  
D. Rodenstein ◽  
C. Veriter
Keyword(s):  
Magnetic Resonance ◽  
Respiratory System ◽  
Airway Resistance ◽  
Upper Airway ◽  
Magnetic Resonance Images ◽  
Head Position ◽  
Upper Airways ◽  
Total Head ◽  
Head Flexion ◽  
Head Positions

We measured in healthy volunteers airway resistance (R(aw)), resistance of the respiratory system (Rrs), and supralaryngeal resistance (Rsl) in the following head positions: neutral, extended, and partially and fully flexed. Sagittal magnetic resonance images of the upper airways were recorded in neutral and flexed head positions. We observed significant increases in Raw (P less than 0.01), Rrs (P less than 0.001), and Rsl (P less than 0.001) in the flexed position, with respect to the neutral one, and corresponding decreases of specific airway and specific respiratory conductances. Resistances decreased (although not significantly) when the subjects' heads were extended. A decrease in both diameter and surface area of the hypopharyngeal airways (as shown by magnetic resonance images) with total head flexion was accompanied by significant increases in all measured resistances. Changes in the caliber of hypopharynx appear to be responsible for the increase in resistance during head flexion.

Effect of negative expiratory pressure on respiratory system flow resistance in awake snorers and nonsnorers

1999 ◽  
Vol 87 (3) ◽  
pp. 969-976 ◽  
Author(s):  
Claudio Tantucci ◽  
Alexandre Duguet ◽  
Anna Ferretti ◽  
Selma Mehiri ◽  
Isabelle Arnulf ◽  
...  
Keyword(s):  
Respiratory System ◽  
Supine Position ◽  
Flow Resistance ◽  
Upper Airway ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Upper Airways ◽  
Flow Interruption ◽  
Expiratory Flow ◽  
Spontaneously Breathing

In spontaneously breathing subjects, intrathoracic expiratory flow limitation can be detected by applying a negative expiratory pressure (NEP) at the mouth during tidal expiration. To assess whether NEP might increase upper airway resistance per se, the interrupter resistance of the respiratory system (Rint,rs) was computed with and without NEP by using the flow interruption technique in 12 awake healthy subjects, 6 nonsnorers (NS), and 6 nonapneic snorers (S). Expiratory flow (V˙) and Rint,rs were measured under control conditions with V˙ increased voluntarily and during random application of brief (0.2-s) NEP pulses from −1 to −7 cmH2O, in both the seated and supine position. In NS, Rint,rs with spontaneous increase inV˙ and with NEP was similar [3.10 ± 0.19 and 3.30 ± 0.18 cmH2O ⋅ l−1 ⋅ s at spontaneous V˙ of 1.0 ± 0.01 l/s and atV˙ of 1.1 ± 0.07 l/s with NEP (−5 cmH2O), respectively]. In S, a marked increase in Rint,rs was found at all levels of NEP ( P < 0.05). Rint,rs was 3.50 ± 0.44 and 8.97 ± 3.16 cmH2O ⋅ l−1 ⋅ s at spontaneous V˙ of 0.81 ± 0.02 l/s and atV˙ of 0.80 ± 0.17 l/s with NEP (−5 cmH2O), respectively ( P < 0.05). With NEP, Rint,rs was markedly higher in S than in NS both seated ( F = 8.77; P < 0.01) and supine ( F = 9.43; P < 0.01). In S,V˙ increased much less with NEP than in NS and was sometimes lower than without NEP, especially in the supine position. This study indicates that during wakefulness nonapneic S have more collapsible upper airways than do NS, as reflected by the marked increase in Rint,rs with NEP. The latter leads occasionally to an actual decrease in V˙ such as to invalidate the NEP method for detection of intrathoracic expiratory flow limitation.

Motor responses to positive-pressure breathing in the developing opossum

1985 ◽  
Vol 58 (5) ◽  
pp. 1489-1495 ◽  
Author(s):  
J. P. Farber
Keyword(s):  
Airway Resistance ◽  
Upper Airway ◽  
Abdominal Muscle ◽  
Positive Pressure ◽  
Postnatal Life ◽  
Abdominal Muscles ◽  
Upper Airways ◽  
Motor Responses ◽  
Upper Airway Resistance ◽  
Upper Airway Muscles

The suckling opossum exhibits an expiration-phased discharge in abdominal muscles during positive-pressure breathing (PPB); the response becomes apparent, however, only after the 3rd-5th wk of postnatal life. The purpose of this study was to determine whether the early lack of activation represented a deficiency of segmental outflow to abdominal muscles or whether comparable effects were observed in cranial outflows to muscles of the upper airways due to immaturity of afferent and/or supraspinal pathways. Anesthetized suckling opossums between 15 and 50 days of age were exposed to PPB; electromyogram (EMG) responses in diaphragm and abdominal muscles were measured, along with EMG of larynx dilator muscles and/or upper airway resistance. In animals older than approximately 30 days of age, the onset of PPB was associated with a prolonged expiration-phased EMG activation of larynx dilator muscles and/or decreased upper airway resistance, along with expiratory recruitment of the abdominal muscle EMG. These effects persisted as long as the load was maintained. Younger animals showed only those responses related to the upper airway; in fact, activation of upper airway muscles during PPB could be associated with suppression of the abdominal motor outflow. After unilateral vagotomy, abdominal and upper airway motor responses to PPB were reduced. The balance between PPB-induced excitatory and inhibitory or disfacilitory influences from the supraspinal level on abdominal motoneurons and/or spinal processing of information from higher centers may shift toward net excitation as the opossum matures.

Mechanics of respiratory system in healthy anesthetized humans with emphasis on viscoelastic properties

1993 ◽  
Vol 75 (1) ◽  
pp. 132-140 ◽  
Author(s):  
B. Jonson ◽  
L. Beydon ◽  
K. Brauer ◽  
C. Mansson ◽  
S. Valind ◽  
...  
Keyword(s):  
Respiratory System ◽  
Driving Force ◽  
Viscoelastic Behavior ◽  
Elastic Recoil ◽  
Inspiratory Flow Rate ◽  
Static Compliance ◽  
Viscoelastic System ◽  
Flow Interruption ◽  
In Series ◽  
Flow Dependency

The classic model of the respiratory system (RS) is comprised of a Newtonian resistor in series with a capacitor and a viscoelastic unit including a resistor and a capacitor. The flow interruption technique has often been used to study the viscoelastic behavior under constant inspiratory flow rate. To study the viscoelastic behavior of the RS during complete respiratory cycles and to quantify viscoelastic resistance (Rve) and compliance (Cve) under unrestrained conditions, we developed an iterative technique based on a differential equation. We, as others, assumed Rve and Cve to be constant, which concords with volume and flow dependency of model behavior. During inspiration Newtonian resistance (R) was independent of flow and volume. During expiration R increased. Static elastic recoil showed no significant hysteresis. The viscoelastic behavior of the RS was in accordance with the model. The magnitude of Rve was 3.7 +/- 0.7 cmH2O.l-1 x s, i.e., two times R. Cve was 0.23 +/- 0.051 l/cmH2O, i.e., four times static compliance. The viscoelastic time constant, i.e., Cve.Rve, was 0.82 +/- 0.11s. The work dissipated against the viscoelastic system was 0.62 +/- 0.13 cmH2O x 1 for a breath of 0.56 liter, corresponding to 32% of the total energy loss within the RS. Viscoelastic recoil contributed as a driving force during the initial part of expiration.

Inspiratory coactivation of the genioglossus enlarges retroglossal space in laryngectomized humans

1996 ◽  
Vol 80 (5) ◽  
pp. 1595-1604 ◽  
Author(s):  
I. Kobayashi ◽  
A. Perry ◽  
J. Rhymer ◽  
B. Wuyam ◽  
P. Hughes ◽  
...  
Keyword(s):  
Upper Airway ◽  
Dependent Manner ◽  
Tongue Movement ◽  
Forward Movement ◽  
Upper Airways ◽  
Posterior Aspect ◽  
Airway Patency ◽  
Significant Movement ◽  
Tongue Position ◽  
Tracheal Stoma

To investigate the relationship between the electrical activity of the genioglossus (GG-EMG) and associated tongue movement, seven laryngectomized subjects breathing through a tracheal stoma (without pressure or flow change in the upper airway) were studied in the supine position. Tongue movement, with the use of lateral fluoroscopy, and GG-EMG expressed as a percentage of maximum voluntary genioglossal activation were monitored simultaneously during 1) spontaneous inspiration (SI), 2) resistive loaded inspiration (LI), and 3) rapid inspiration (RI). Tongue position during each maneuver was compared with its position during spontaneous expiration. Peak GG-EMG during the three maneuvers was significantly different from each other (SI: 5.4 +/- 1.6, LI: 11.9 +/- 1.8, and RI: 51.6 +/- 9.4 (SE) %, respectively). Associated forward movement of the posterior aspect of the tongue was minimum during SI; however, significant movement was observed during LI, and this was increased during RI. Significant covariance existed between peak GG-EMG and this movement. Genioglossal coactivation with inspiration enlarges the glossopharyngeal airway, particularly in its caudal part. In subjects with intact upper airways, this activation may protect or enhance upper airway patency in an effort-dependent manner.

Uvula Dynamic Characteristics

2013 ◽  
Author(s):  
A. M. Al-Jumaily ◽  
S. Ashaat ◽  
B. A. Martin ◽  
R. Heinzer ◽  
J. Haba Rubio ◽  
...  
Keyword(s):  
Dynamic Characteristics ◽  
Structural Model ◽  
Fluid Layer ◽  
Structural Characteristics ◽  
Upper Airway ◽  
Mode Shapes ◽  
Tissue Elasticity ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Mri Scans

The airway binary fluid layer and the structural characteristics of the upper airways have significant influence on the activity of the airway muscles by changing airway compliance and collapsibility during obstructive sleep apnea trauma. The uvula plays an important role in the collapse process. Using MRI scans, this paper develops a structural model for the uvula and determines its dynamic characteristics in terms of natural frequencies and mode shapes as a preliminary process to determine optimum conditions to therapeutically relieve upper airway obstruction. The effect of the variation of tissue elasticity due to water content is elaborated on.

scholarly journals Experimental Evaluation of Dry Powder Inhalers During In- and Exhalation Using a Model of the Human Respiratory System (xPULM™)

2021 ◽  
Author(s):  
Richard Pasteka ◽  
Joao Pedro Santos da Costa ◽  
Mathias Forjan
Keyword(s):  
Respiratory Tract ◽  
Respiratory System ◽  
Particle Number ◽  
Particle Diameter ◽  
Upper Airway ◽  
System Model ◽  
Dry Powder Inhalers ◽  
Dry Powder ◽  
Pharmaceutical Aerosols ◽  
Airway Model

Dry powder inhalers are used by a large number of patients worldwide to treat respiratory diseases. The objective of this work is to experimentally investigate changes in aerosol particle diameter and particle number concentration of pharmaceutical aerosols generated by five dry powder inhalers under realistic inhalation and exhalation conditions. The active respiratory system model (xPULM&trade;) was used as a model of the human respiratory system and to simulate a patient undergoing inhalation therapy. A mechanical upper airway model was developed, manufactured and introduced as a part of the xPULM&trade; to represent the human upper respiratory tract with high fidelity. Integration of optical aerosol spectrometry technique into the setup allowed for evaluation of pharmaceutical aerosols. The results show that the upper airway model increases the resistance of the overall system and act as a filter for bigger particles (&gt;3 &micro;m). Furthermore, there is a significant difference (p &lt; 0.05) in mean particle diameter between inhaled and exhaled particles with the majority of the particles depositing in the lung. The minimum deposition is reached for particle size of 0.5 &micro;m. The mean particle number concentrations exhaled are 2.94% (BreezHaler&reg;), 2.66% (Diskus&reg;), 10.24% (Ellipta&reg;) 2.13% (HandiHaler&reg;) and 6.22% (Turbohaler&reg;). In conclusion, the xPULM&trade; active respiratory system model is a viable option for studying interactions of pharmaceutical aerosols and the respiratory tract in terms of applicable deposition mechanisms. The model can support the reduction of animal experimentation in aerosol research and provide an alternative to experiments with human subjects.

scholarly journals The Microbiota/Host Immune System Interaction in the Nose to Protect from COVID-19

Life ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 345
Author(s):  
Arianna Di Stadio ◽  
Claudio Costantini ◽  
Giorgia Renga ◽  
Marilena Pariano ◽  
Giampietro Ricci ◽  
...  
Keyword(s):  
Immune System ◽  
Viral Entry ◽  
Upper Airway ◽  
Organ Damage ◽  
Host Immune System ◽  
Upper Airways ◽  
Mucosal Homeostasis ◽  
Resistance To Infection ◽  
Variable Clinical Presentation

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is characterized by variable clinical presentation that ranges from asymptomatic to fatal multi-organ damage. The site of entry and the response of the host to the infection affect the outcomes. The role of the upper airways and the nasal barrier in the prevention of infection is increasingly being recognized. Besides the epithelial lining and the local immune system, the upper airways harbor a community of microorganisms, or microbiota, that takes an active part in mucosal homeostasis and in resistance to infection. However, the role of the upper airway microbiota in COVID-19 is not yet completely understood and likely goes beyond protection from viral entry to include the regulation of the immune response to the infection. Herein, we discuss the hypothesis that restoring endogenous barriers and anti-inflammatory pathways that are defective in COVID-19 patients might represent a valid strategy to reduce infectivity and ameliorate clinical symptomatology.

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