-
Sarcoidosis, Vasculitis, and Diffuse... 2021Sarcoidosis is a systemic inflammatory granulomatous disease which commonly affects intrathoracic lymph nodes, lung parenchyma and airways.
BACKGROUND
Sarcoidosis is a systemic inflammatory granulomatous disease which commonly affects intrathoracic lymph nodes, lung parenchyma and airways.
OBJECTIVES
To measure respiratory impedance using Impulse Oscillometry (IOS) in patients with pulmonary sarcoidosis and compare the parameters with healthy controls.
METHODS
Patients diagnosed with sarcoidosis (n=28); and age and gender matched healthy controls (n=17) were recruited. Lung volumes and capacities were measured by spirometry and respiratory system impedance was assessed using Impulse Oscillometry System (IOS). Measurements were performed before and 15 minutes after inhalation of a short acting bronchodilator. The IOS and spirometric parameters were compared between two groups and correlated. ROC curve analysis was also performed to identify the IOS parameters which can discriminate between sarcoidosis and healthy controls.
RESULTS
Resistance at 5 and 20 Hz (R5 and R20), small airway resistance (R5-R20), resonant frequency (F) and area of reactance (AX) were significantly higher in Sarcoidosis subjects compared with controls. Reactance at 5 and 20 Hz (X5 and X20) were significantly lower in sarcoidosis. FEV (% predicted) and FVC (% predicted) were significantly lower in patients with sarcoidosis while FEV/FVC ratio and peak expiratory flow rate (PEF) values were comparable. Post bronchodilator inhalation, there was improvement in airway resistance and reactance, but no significant changes observed in spirometric parameters. R5, X5 and R5-R20 are promising parameters to discriminate sarcoidosis from healthy controls.
CONCLUSION
Increased airway resistance is a better indicator of airway involvement than airflow limitation by spirometry in pulmonary sarcoidosis.
PubMed: 34744428
DOI: 10.36141/svdld.v38i3.8674 -
Clinical Otolaryngology : Official... Jan 2021This review discusses how nasal congestion may have benefits as a mechanism of defence against respiratory viruses. (Review)
Review
INTRODUCTION
This review discusses how nasal congestion may have benefits as a mechanism of defence against respiratory viruses.
METHODS
A literature research was conducted on respiratory viruses and nasal congestion, following a recently published review on how temperature sensitivity is important for the success of common respiratory viruses.
RESULTS
The literature reported that common respiratory viruses are temperature sensitive and replicate well at the cooler temperatures of the upper airways (32°C), but replication is restricted at body temperature (37°C). The amplitude of the phases of congestion and decongestion associated with the nasal cycle was increased on infection with respiratory viruses and this caused unilateral nasal congestion and obstruction. Nasal congestion and obstruction increase nasal mucosal temperature towards 37°C and therefore restricted the replication of respiratory viruses.
CONCLUSION
Nasal congestion associated with the nasal cycle may act as a mechanism of respiratory defence against infection with respiratory viruses.
Topics: Airway Resistance; Body Temperature; Humans; Immunity, Mucosal; Nasal Mucosa; Nasal Obstruction; Respiratory Tract Infections; Virus Diseases
PubMed: 33064350
DOI: 10.1111/coa.13658 -
Pediatric Pulmonology Dec 2022In children, obesity typically reduces functional residual capacity (FRC), which reduces airway caliber and increases airway resistance. Whether these obesity-related...
BACKGROUND
In children, obesity typically reduces functional residual capacity (FRC), which reduces airway caliber and increases airway resistance. Whether these obesity-related changes in respiratory function can alter bronchodilator responsiveness is unknown.
OBJECTIVE
To investigate bronchodilator responsiveness in nonasthmatic children with and without obesity.
METHODS
Seventy nonasthmatic children, 8-12 years old, without (n = 19) and with (n = 51) obesity, completed spirometry, impulse oscillometry, and airway resistance measurements through plethysmography pre/post 360 µg of inhaled albuterol. FRC was assessed pre albuterol. A two-way analysis of variance determined the effects of obesity (group) and inhaled albuterol (pre-post) on outcome measures.
RESULTS
FRC (%total lung capacity) was 16% lower in children with obesity compared with those without obesity. There was no significant group by pre-post albuterol interaction on any outcome variables. Albuterol inhalation reduced total, central and peripheral airway resistance and increased airway reactance (i.e., less negative) to a similar degree in children with and without obesity. In children with obesity, airway resistance was increased whether measured by impulse oscillometry or plethysmography. However, once airway resistance was adjusted for lung volumes (i.e., specific airway resistance or sR ), there were no differences between children with and without obesity. In addition, significant but moderate associations were detected between chest mass and FRC (r = -0.566; p < 0.001), FRC and total airway resistance (i.e., R ; r = -0.445; p < 0.001).
CONCLUSIONS
In nonasthmatic early pubescent children, obesity increases total, central, and peripheral respiratory system resistance. However, the added respiratory system resistance and low lung volume breathing with obesity are not sufficient to reduce bronchodilator responsiveness.
Topics: Child; Humans; Airway Resistance; Bronchodilator Agents; Albuterol; Lung; Obesity
PubMed: 35949183
DOI: 10.1002/ppul.26111 -
BMC Pulmonary Medicine Dec 2022Tracheostomy tube capping is a commonly used test to determine if the tracheostomy tube can be removed. The success of the capping trial depends on the patient's ability...
BACKGROUND
Tracheostomy tube capping is a commonly used test to determine if the tracheostomy tube can be removed. The success of the capping trial depends on the patient's ability to maintain sufficient spontaneous breathing with an occluded tracheostomy tube. The impact of an occluded tracheotomy tube on airway resistance is currently unknown. The aim of this study was to investigate tracheal pressure during capping or stoma button insertion and potential determinants concerning cuff.
METHODS
Eight cuffed and uncuffed tracheostomy tubes and three stoma buttons of various manufacturers and sizes were inserted into the trachea model. Cuffs were completely deflated or contained atmospheric pressure. The trachea was ventilated bidirectional with a respirator in volume-controlled mode and volume flows 15-60 L/min. Tracheal pressure drop during inspiration as a parameter of pressure required to move gas through the airway was measured.
RESULTS
Tracheal pressure drops occurred linearly or irregularly during capping trials to a maximum of 4.2 kPa at flow rates of 60 L/min for atmospheric pressure cuffs. In tracheostomy tubes with completely deflated cuffs, pressure drop in the trachea reaches a maximum of 3.4 kPa at a flow rate of 60 L/min. For tracheostomy tubes with cuff smaller inner or outer diameters do not regularly result in lower tracheal pressure drop. The pressure drop varies between different tracheostomy tubes depending on the manufacturer. In cuffed tracheostomy tubes, we observed three phenomena: sail-like positioning, folding over, and tightening of the cuff during flow. The maximum tracheal pressure drop during stoma button insertion reaches 0.014 kPa.
CONCLUSIONS
The cuff is a central element for the pressure drop in the airway and thus airway resistance during spontaneous translaryngeal breathing with a capped TT. Complete deflation reduces the pressure drop in the trachea. Due to deformation of the cuff, measured pressures are irregular as the volume flow is increased. Incomplete deflated cuffs and material characteristics of tracheostomy tubes and cuffs in addition to anatomical and clinical variables may cause unsuccessful capping trials due to increased airway resistance. All stoma buttons showed that pressure drop and thus airway resistance due to stoma buttons has no clinical relevance.
Topics: Humans; Trachea; Tracheostomy; Intubation, Intratracheal; Ventilators, Mechanical; Equipment Design
PubMed: 36539764
DOI: 10.1186/s12890-022-02277-4 -
Journal of Voice : Official Journal of... May 2020The objective of this observational study was to assess the relationship between established aging biobehavioral measures and voice decline in normally aging adults. (Observational Study)
Observational Study
OBJECTIVE
The objective of this observational study was to assess the relationship between established aging biobehavioral measures and voice decline in normally aging adults.
STUDY DESIGN
Cross-sectional study.
METHODS
Participants 60-85 years of age were divided into two age and sex-matched groups, based on the presence or absence of presbylaryngeus. Both groups underwent a battery of tests measuring anthropometric variables, inflammatory markers, general health measures, and vocal function parameters. Differences from the norm were calculated for all variables. Parametric and nonparametric tests were performed to assess group differences. In addition, variable selection analysis was performed to determine variables that were most influential in predicting the occurrence of presbylaryngeus in our current sample.
RESULTS
Fifty-three participants were divided into age and sex-matched groups of "presbylaryngeus" (n = 26) and "non-presbylaryngeus" (n = 27). The two groups were statistically different in select measures of inflammatory markers, general health measures, and vocal function parameters. Anthropometric measures were not statistically different. Based on variable selection, the variables most predictive of the presence of presbylaryngeus were measures of the Physical Activity Scale of the Elderly, C-reactive protein, laryngeal airway resistance, and vocal roughness.
CONCLUSIONS
In addition to group differences in vocal function measures, results for the presbylaryngeus group consistently trended sub-optimally on anthropometric measures, two inflammatory markers, and general health measures. These results suggest that this sample of individuals with presbylaryngeus demonstrated greater biobehavioral deficits associated with aging as compared to age and sex-matched non-presbylaryngeus individuals.
Topics: Acoustics; Age Factors; Aged; Aged, 80 and over; Aging; Airway Resistance; Anthropometry; Biomarkers; Case-Control Studies; Female; Functional Status; Geriatric Assessment; Humans; Inflammation Mediators; Male; Middle Aged; Predictive Value of Tests; Speech Production Measurement; Voice Disorders; Voice Quality
PubMed: 30503609
DOI: 10.1016/j.jvoice.2018.11.005 -
Respirology (Carlton, Vic.) May 2016Preterm birth, low birth weight and rapid infant weight gain are associated with increased risks of asthma symptoms in childhood. The underlying mechanism may include...
BACKGROUND AND OBJECTIVE
Preterm birth, low birth weight and rapid infant weight gain are associated with increased risks of asthma symptoms in childhood. The underlying mechanism may include persistently higher airway resistance (Rint). The aim of our study was to examine the associations of longitudinally measured foetal and infant growth characteristics with Rint and asthma outcomes in school-age children.
METHODS
This study was embedded in a population-based prospective cohort study in Rotterdam, The Netherlands. Foetal growth was estimated by ultrasound in the second and third trimesters. Infant growth was measured at birth, 3, 6 and 12 months. At age 6 years, Rint was measured, and information about wheezing and asthma was obtained by questionnaires. The number of subjects per analysis differed per available outcome (3954-5066 subjects).
RESULTS
Longitudinal growth analyses showed that school-age children with increased Rint had lower foetal length growth and weight gain, and lower infant length growth. Children with persistent wheezing until age 6 years and physician-diagnosed asthma had a higher Rint compared with children who never wheezed or without asthma (difference z-scores Rint: 0.58 (0.19, 0.97) and 0.55 (0.15, 0.95), respectively).
CONCLUSION
Rint in school-age children is influenced by foetal growth restriction and is associated with asthma outcomes. See article, page 574.
Topics: Airway Resistance; Asthma; Child; Child Development; Female; Fetal Growth Retardation; Health Surveys; Humans; Infant; Infant, Newborn; Longitudinal Studies; Male; Prospective Studies; Respiratory Sounds; Risk Factors
PubMed: 26699232
DOI: 10.1111/resp.12718 -
International Journal of Clinical and... 2015The typical pathological features of asthma are airway remodeling and airway hyperresponsiveness (AHR). KyoT2, a negative modulator of Notch signaling, has been linked...
The typical pathological features of asthma are airway remodeling and airway hyperresponsiveness (AHR). KyoT2, a negative modulator of Notch signaling, has been linked to asthma in several previous studies. However, whether KyoT2 is involved in the regulation of airway remodeling or the modulation of airway resistance in asthma is unclear. In this study, we aimed to evaluate the therapeutic potential of KyoT2 in preventing asthma-associated airway remodeling and AHR. BALB/c mice were used to generate a mouse model of asthma. Additionally, the expression of Hes1 and Notch1 in airway was analyzed using Immunofluorescence examination. The asthmatic mice were intranasally administered adenovirus expressing KyoT2 and were compared to control groups. Furthermore, subepithelial fibrosis and other airway remodeling features were analyzed using hematoxylin and eosin staining, Van Gieson's staining and Masson's trichrome staining. AHR was also evaluated. This study revealed that KyoT2 downregulated the expression of Hes1, repressed airway remodeling, and alleviated AHR in asthmatic mice. It is reasonable to assume that KyoT2 downregulates airway remodeling and resistance in asthmatic mice through a Hes1-dependent mechanism. Therefore, KyoT2 is a potential clinical treatment strategy for asthma.
Topics: Adenoviridae; Airway Remodeling; Airway Resistance; Animals; Asthma; Basic Helix-Loop-Helix Transcription Factors; Bronchial Hyperreactivity; Disease Models, Animal; Fibrosis; Gene Transfer Techniques; Genetic Therapy; Genetic Vectors; Homeodomain Proteins; Intracellular Signaling Peptides and Proteins; LIM Domain Proteins; Lung; Male; Mice, Inbred BALB C; Muscle Proteins; Receptor, Notch1; Signal Transduction; Transcription Factor HES-1
PubMed: 26823730
DOI: No ID Found -
PloS One 2022Obesity can increase the airways resistance, mainly in the periphery, leading to dyspnea perception that can impair the functional capacity. This study aimed to analyze...
BACKGROUND AND OBJECTIVE
Obesity can increase the airways resistance, mainly in the periphery, leading to dyspnea perception that can impair the functional capacity. This study aimed to analyze if airways resistance could be related to the walking capacity of women with morbid obesity.
METHODS
Thirty-seven women with grade III obesity in preoperative bariatric surgery were evaluated using the spirometry test, impulse oscillometry system (IOS), and six-minute walk test (6MWT). Additionally, data about their daily dyspnea perception and physical activity level were collected.
RESULTS
Variables of the spirometry test did not detect ventilator disorders. Compared to the predicted values, the IOS identified significant increase in airways resistance (kPa/L/s) (R5: 0.36 (0.34; 0.36) and 0.53 (0.47; 0.61); R20: 0.30 (0.28; 0.30) and 0.41 (0.35; 0.45); R5-20: 0.06 (0.06; 0.06) and 0.14 (0.10; 0.15); X5: -0.03 (-0.04; -0.01) and -0.20 (-0.27; -0.18), respectively). The distance walked in the 6MWT, 491.4±60.4m was significantly correlated to R5 (rho = -0.41, p = 0.01), R5-20 (rho = -0.52, p = 0.001), and X5 (rho = 0.54, p = 0.0006).
CONCLUSION
The IOS is able to identify changes in airway resistance even before the onset of symptoms. When evaluated by IOS women with severe obesity and normal spirometry exhibited central and peripheral airways obstruction. The correlations between the IOS and six-minute walk distance suggest that increased peripheral airways resistance could be related to worsening functional capacity.
Topics: Airway Resistance; Dyspnea; Female; Forced Expiratory Volume; Humans; Lung; Obesity; Oscillometry; Pulmonary Disease, Chronic Obstructive; Spirometry
PubMed: 35671283
DOI: 10.1371/journal.pone.0267546 -
Medicine Sep 2020Airway compliance is an important index in the surgery of pediatric patients. This study aimed to explore factors affecting dynamic airway compliance (Cdyn) and airway... (Observational Study)
Observational Study
Airway compliance is an important index in the surgery of pediatric patients. This study aimed to explore factors affecting dynamic airway compliance (Cdyn) and airway resistance (Raw) after general anesthesia endotracheal intubation for adenotonsillectomy of pediatric patients.A prospective study was undertaken of 107 children who underwent adenotonsillectomy in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine between January and June 2018. The values of Cdyn and Raw were recorded at 5, 10, and 15 minute during general anesthesia endotracheal intubation. Univariate analysis and multiple linear regression analysis were performed for factors that affected Cdyn and Raw.Of the 107 patients aged 56.67 ± 18.28 months, 69 (64%) patients were male, and 26 (24%) and 12 (11%) had an upper respiratory infection in the past week and 1 to 2 weeks, respectively. During anesthesia, Cdyn showed a decreasing trend (P < .001) while Raw showed an increasing trend (P < .001). Multivariate analysis revealed that height (β=0.177-0.193) had the strongest correlation with Cdyn; rales during pulmonary auscultation (β= -2.727 to -1.363) and sputum suction (β= -1.670 to -0.949) were also associated with Cdyn (all P < .05). Height was the factor with the strongest negative correlation with Raw (β= -0.382 to -0.305). Rales during pulmonary auscultation (β=10.063-11.326) and sputum suction (β=3.863-9.003) were also associated with Raw (All P < .05).Height, rales during preoperative auscultation and sputum suction were all associated with intraoperative Cydn and Raw for pediatric patients undergoing adenotonsillectomy and should be considered before the surgery.
Topics: Adenoidectomy; Airway Resistance; Anesthesia, General; Auscultation; Body Height; Child; Child, Preschool; Female; Humans; Intubation, Intratracheal; Lung Compliance; Male; Prospective Studies; Respiratory Tract Infections; Tonsillectomy
PubMed: 32899092
DOI: 10.1097/MD.0000000000022101 -
BMC Pediatrics Mar 2022During puberty, changes in body composition due to sex hormones are associated with lung mechanics. However, little is known about the mediation effect of sex...
BACKGROUND
During puberty, changes in body composition due to sex hormones are associated with lung mechanics. However, little is known about the mediation effect of sex differences in body composition during puberty with total airway resistance.
METHODS
We prospectively recruited 620 children (10-12 years old) from the general population and conducted a cross-sectional study. This study assessed pubertal status according to the five Tanner stages using a questionnaire, line drawings, and each subject's blood sex hormone profile. Both the impulse oscillation system for total lung mechanics and multifrequency bioelectrical impedance for body composition analyses were conducted. The effects of puberty on body composition and subsequent total lung resistance were evaluated using mediation analysis.
RESULTS
Among the 503 children enrolled, there were 261 males (51.9%) and 242 females (48.1%). In males, higher testosterone levels corresponded with reduced total lung resistance (β = -0.13, 95% CI = -0.21 to -0.05, p < 0.001), and the proportion of the mediating effect through the muscle-fat ratio was 19% (95% CI = 4 to 59, p = 0.02). In contrast, in females, pubertal status reduced total lung resistance (β = -0.27, 95% CI = -0.58 to -0.05, p = 0.04), however, the proportion of the mediating effect through the body mass index was -51% (95% CI = -244 to -4%, p = 0.04).
CONCLUSION
The muscle-fat ratio in adolescent males had a synergistic effect with testosterone on improving total airway resistance, whereas improvements in lung resistance by pubertal status were partially masked by body mass index in adolescent females. In conclusion, body composition changes during puberty between males and females have differing effects on total airway resistance.
Topics: Adolescent; Airway Resistance; Body Composition; Body Mass Index; Child; Cross-Sectional Studies; Female; Humans; Lung; Male; Puberty; Sex Characteristics; Testosterone
PubMed: 35300646
DOI: 10.1186/s12887-022-03198-1