The usefulness of inspiratory muscle training (IMT) in chronic airflow limitation (CAL) patients is a controversial issue, mainly due to differences in the training load. To further evaluate this aspect, we studied the effect of the magnitude of the load using a threshold pressure trainer. Ten CAL patients (5 males, 5 females) 67 +/- 2 yrs (mean +/- SEM) and forced expiratory volume in one seco...

BACKGROUND In patients with severe chronic obstructive pulmonary disease (COPD), pursed-lips breathing (PLB) improves the pulmonary gas exchange and hyperinflation measured by electro-optic coupling. The response to PLB in inspiratory lung function tests is not known. OBJECTIVES The purpose of this study was to measure the effect of PLB on inspiratory parameters. METHODS Thirty-five subject...

It is not readily apparent how pulmonary function could be improved by resecting portions of the lung in patients with emphysema. In emphysema, elevation in residual volume relative to total lung capacity reduces forced expiratory volumes, increases inspiratory effort, and impairs inspiratory muscle mechanics. Lung volume reduction surgery (LVRS) better matches the size of the lungs to the size...

When patients breathe spontaneously through a ventilator circuit, a fall in airway pressure during the inspiratory cycle may increase inspiratory effort. A system of delivery which incorporates a distensible reservoir bag and delivers a constant flow of gas that is two or three times the patient's minute volume will prevent a significant drop in inspiratory airway pressure. Unfortunately, the c...

RATIONALE AND OBJECTIVES To evaluate the relationship between measurements of lung volume (LV) on inspiratory/expiratory computed tomography (CT) scans, pulmonary function tests (PFT), and CT measurements of emphysema in individuals with chronic obstructive pulmonary disease. MATERIALS AND METHODS Forty-six smokers (20 females and 26 males; age range 46-81 years), enrolled in the Lung Tissue ...

Lung volumes are decreased by tense ascites and increase after large volume paracentesis (LVP). The overall effect of ascites and LVP on the respiratory function is poorly understood. We studied eight cirrhotic patients with tense ascites before and after LVP. Inspiratory muscle force (maximal transdiaphragmatic pressure (Pdi,max), and the lowest pleural pressure (Pp1,min)) was assessed while t...

BACKGROUND Lung volume reduction (LVR) improves breathing mechanics by reducing hyperinflation. Lobar selection usually focuses on choosing the most destroyed emphysematous lobes as seen on an inspiratory CT scan. However, it has never been shown to what extent these densitometric CT parameters predict the least deflation of an individual lobe during expiration. The addition of expiratory CT an...

Inspiratory muscle strength and the flow and elastic pressure opposing inspiration were measured in seven patients with severe airways obstruction who found inspiration difficult at rest. A comparison was made of measurements obtained from seven normal subjects and five patients with airways obstruction not experiencing inspiratory dyspnoea at rest. Measurements were also obtained when inspirat...

Thoracic gas volume (Vtg) can be measured with body plethysmography by either repetitive panting or one single inspiratory effort against a shutter occluding the airways. The panting technique is preferred, but may be demanding. We aimed to assess the precision of these two methods and the degree of agreement between them. Vtg and functional residual capacity (FRC) were measured in 155 subjects...