180 research outputs found
Closing volume detection by single breath gas washout and forced oscillation technique
Closing volume (CV) is commonly measured by single-breath nitrogen washout (CVSBW). A method based on the forced oscillation technique was recently introduced to detect a surrogate CV (CVFOT). As the two approaches are based on different physiological mechanisms, we aim to investigate CVFOT and CVSBW relationship at different degrees and patterns of airway obstruction. A mathematical model was developed to evaluate the CVSBW and CVFOT sensitivity to different patterns of airway obstruction, either located in a specific lung region or equally distributed throughout the lung. The two CVs were also assessed during slow vital capacity (VC) maneuvers in triplicate in 13 healthy subjects and pre and post-methacholine challenge (Mch) in 12 mild-moderate asthmatics. Model simulations suggest that CVSBW is more sensitive than CVFOT to the presence of few flow-limited or closed airways that modify the contribution of tracer-poor and tracer-rich lung regions to the overall exhaled gas. Conversely, CVFOT occurs only when at least ~65% of lung units are flow-limited or closed, regardless of their regional distribution. CVSBW did not differ between healthy subjects and asthmatics (17±9%VC vs 22±10%VC) while CVFOT did (16±5%VC vs 23±6%VC, p<0.01). In asthmatics, both CVSBW and CVFOT increased post-Mch (33±7%VC p<0.001 and 43±12%VC p<0.001, respectively). CVSBW weakly correlated with CVFOT (r=0.45, p<0.01). The closing capacities (CV+residual volume) were correlated (r=0.74, p<0.001) but the changes with Mch in both CVs and closing capacities did not correlate. CVFOT is easy to measure and provides a reproducible parameter useful for describing airway impairment in obstructive respiratory diseases
Axial distribution heterogeneity of nitric oxide airway production in healthy adults.
Model simulations of nitric oxide (NO) transport considering molecular diffusion showed that the total bronchial NO production needed to reproduce a given exhaled value is deeply influenced by its axial distribution. Experimental data obtained by fibroscopy were available about proximal airway contribution (Silkoff PE, McClean PA, Caramori M, Slutsky AS. Zamel N. Respir Physiol 113: 33-38, 1998), and recent experiments using heliox instead of air gave insight on the peripheral airway production (Shin HW, Condorelli P, Rose-Gottron CM, Cooper DM, George SC. J Appl Physiol 97: 874-882, 2004; Kerckx Y, Michils A, Van Muylem A. J Appl Physiol 104: 918-924, 2008). This theoretical work aimed at obtaining a realistic distribution of NO production in healthy adults by meeting both proximal and peripheral experimental constraints. To achieve this, a model considering axial diffusion with geometrical boundaries derived from Weibel's morphometrical data was divided into serial compartments, each characterized by its axial boundaries and its part of bronchial NO production. A four-compartment model was able to meet both criteria. Two compartments were found to share all the NO production: one proximal (generations 0 and 1; 15-25% of the NO production) and one inside the acinus (proximal limit, generations 14-16; distal limit, generations 16 and 17; 75-85% of the NO production). Remarkably, this finding implies a quasi nil production in the main part of the conducting airways and in the acinar airways distal to generation 17. Given the chosen experimental outcomes and reliant on their accuracy, this very inhomogeneous distribution is likely the more realistic one that may be achieved with a "one-trumpet"-shaped model. Refinement should come from a more realistic description of the acinus structure.Journal ArticleResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe
The use of time‐of‐flight camera to assess respiratory rates and thoracoabdominal depths in patients with chronic respiratory disease
Introduction: Over the last 5 years, the analysis of respiratory patterns presents a growing usage in clinical and research purposes, but there is still currently a lack of easy-to-use and affordable devices to perform such kind of evaluation. Objectives: The aim of this study is to validate a new specifically developed method, based on Kinect sensor, to assess respiratory patterns against spirometry under various conditions. Methods: One hundred and one participants took parts in one of the three validations studies. Twenty-five chronic respiratory disease patients (14 with chronic obstructive pulmonary disease (COPD) [65 ± 10 years old, FEV1 = 37 (15% predicted value), VC = 62 (20% predicted value)], and 11 with lung fibrosis (LF) [64 ± 14 years old, FEV1 = 55 (19% predicted value), VC = 62 (20% predicted value)]) and 76 healthy controls (HC) were recruited. The correlations between the signal of the Kinect (depth and respiratory rate) and the spirometer (tidal volume and respiratory rate) were computed in part 1. We then included 66 HC to test the ability of the system to detect modifications of respiratory patterns induced by various conditions known to modify respiratory pattern (cognitive load, inspiratory load and combination) in parts 2 and 3. Results: There is a strong correlation between the depth recorded by the Kinect and the tidal volume recorded by the spirometer: r = 0.973 for COPD patients, r = 0.989 for LF patients and r = 0.984 for HC. The Kinect is able to detect changes in breathing patterns induced by different respiratory disturbance conditions, gender and oral task. Conclusions: Measurements performed with the Kinect sensors are highly correlated with the spirometer in HC and patients with COPD and LF. Kinect is also able to assess respiratory patterns under various loads and disturbances. This method is affordable, easy to use, fully automated and could be used in the current clinical context. Respiratory patterns are important to assess in daily clinics. However, there is currently no affordable and easy-to-use tool to evaluate these parameters in clinics. We validated a new system to assess respiratory patterns using the Kinect sensor in patients with chronic respiratory diseases.SCOPUS: ar.jinfo:eu-repo/semantics/publishe
Asthma control is not related to large airways function
info:eu-repo/semantics/nonPublishe
Asthma control and exhaled nitric oxide in the real life
info:eu-repo/semantics/nonPublishe
Improvement of asthma control assessed by exhaled nitric oxide: a real life longitudinal study
info:eu-repo/semantics/nonPublishe
Etude de la distribution de la ventilation dans la périphérie du poumon: application à la détection d'altérations de structure et de fonction
Doctorat en sciences médicalesinfo:eu-repo/semantics/nonPublishe
Acinar effect of inhaled steroids evidenced by exhaled nitric oxide.
The effects of inhaled corticosteroids (ICSs) on distal lung inflammation, as assessed by alveolar nitric oxide concentration (C(A)NO), are a matter of debate. Recently, a theoretic study suggested that acinar airway obstruction that is relieved by ICS treatment and associated with a decrease in fraction of exhaled nitric oxide (FeNO) concentration might, paradoxically, increase C(A)NO. This increase could be a hallmark effect of ICSs at the acinar level.Journal ArticleResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe
Early and late effect of acute bronchodilation on exhaled nitric oxide in asthma
info:eu-repo/semantics/nonPublishe
Pulmonary emphysema: effect of lung volume on objective quantification at thin-section CT.
To prospectively investigate the effect of submaximal inspiration on computed tomographic (CT) indexes used to quantify emphysema and to discriminate between effects of lung tissue loss and increase in total lung capacity (TLC) on these indexes.Journal ArticleResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe
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