Pulmonary function with expiratory resistive loading in healthy volunteers.

Expiratory flow limitation is a key characteristic in obstructive pulmonary diseases. To study abnormal lung mechanics isolated from heterogeneities of obstructive disease, we measured pulmonary function in healthy adults with expiratory loading. Thirty-seven volunteers (25±5 yr) completed spirometr...

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Autores principales:	Jyotika Erram, Monica Bari, Antoinette Domingo, Daniel T Cannon
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5b29868a632a463eb36b5cd92c27bd2e
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spelling	oai:doaj.org-article:5b29868a632a463eb36b5cd92c27bd2e2021-12-02T20:10:44ZPulmonary function with expiratory resistive loading in healthy volunteers.1932-620310.1371/journal.pone.0252916https://doaj.org/article/5b29868a632a463eb36b5cd92c27bd2e2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252916https://doaj.org/toc/1932-6203Expiratory flow limitation is a key characteristic in obstructive pulmonary diseases. To study abnormal lung mechanics isolated from heterogeneities of obstructive disease, we measured pulmonary function in healthy adults with expiratory loading. Thirty-seven volunteers (25±5 yr) completed spirometry and body plethysmography under control and threshold expiratory loading of 7, 11 cmH2O, and a subset at 20 cmH2O (n = 11). We analyzed the shape of the flow-volume relationship with rectangular area ratio (RAR; Ma et al., Respir Med 2010). Airway resistance was increased (p<0.0001) with 7 and 11 cmH2O loading vs control (9.20±1.02 and 11.76±1.68 vs. 2.53± 0.80 cmH2O/L/s). RAR was reduced (p = 0.0319) in loading vs control (0.45±0.07 and 0.47±0.09L vs. 0.48±0.08). FEV1 was reduced (p<0.0001) in loading vs control (3.24±0.81 and 3.23±0.80 vs. 4.04±1.05 L). FVC was reduced (p<0.0001) in loading vs control (4.11±1.01 and 4.14±1.03 vs. 5.03±1.34 L). Peak expiratory flow (PEF) was reduced (p<0.0001) in loading vs control (6.03±1.67 and 6.02±1.84 vs. 8.50±2.81 L/s). FEV1/FVC (p<0.0068) was not clinically significant and FRC (p = 0.4) was not different in loading vs control. Supra-physiologic loading at 20 cmH2O did not result in further limitation. Expiratory loading reduced FEV1, FVC, PEF, but there were no clinically meaningful differences in FEV1/FVC, FRC, or RAR. Imposed expiratory loading likely leads to high airway pressures that resist dynamic airway compression. Thus, a concave expiratory flow-volume relationship was consistently absent-a key limitation for model comparison with pulmonary function in COPD. Threshold loading may be a useful strategy to increase work of breathing or induce dynamic hyperinflation.Jyotika ErramMonica BariAntoinette DomingoDaniel T CannonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252916 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jyotika Erram Monica Bari Antoinette Domingo Daniel T Cannon Pulmonary function with expiratory resistive loading in healthy volunteers.
description	Expiratory flow limitation is a key characteristic in obstructive pulmonary diseases. To study abnormal lung mechanics isolated from heterogeneities of obstructive disease, we measured pulmonary function in healthy adults with expiratory loading. Thirty-seven volunteers (25±5 yr) completed spirometry and body plethysmography under control and threshold expiratory loading of 7, 11 cmH2O, and a subset at 20 cmH2O (n = 11). We analyzed the shape of the flow-volume relationship with rectangular area ratio (RAR; Ma et al., Respir Med 2010). Airway resistance was increased (p<0.0001) with 7 and 11 cmH2O loading vs control (9.20±1.02 and 11.76±1.68 vs. 2.53± 0.80 cmH2O/L/s). RAR was reduced (p = 0.0319) in loading vs control (0.45±0.07 and 0.47±0.09L vs. 0.48±0.08). FEV1 was reduced (p<0.0001) in loading vs control (3.24±0.81 and 3.23±0.80 vs. 4.04±1.05 L). FVC was reduced (p<0.0001) in loading vs control (4.11±1.01 and 4.14±1.03 vs. 5.03±1.34 L). Peak expiratory flow (PEF) was reduced (p<0.0001) in loading vs control (6.03±1.67 and 6.02±1.84 vs. 8.50±2.81 L/s). FEV1/FVC (p<0.0068) was not clinically significant and FRC (p = 0.4) was not different in loading vs control. Supra-physiologic loading at 20 cmH2O did not result in further limitation. Expiratory loading reduced FEV1, FVC, PEF, but there were no clinically meaningful differences in FEV1/FVC, FRC, or RAR. Imposed expiratory loading likely leads to high airway pressures that resist dynamic airway compression. Thus, a concave expiratory flow-volume relationship was consistently absent-a key limitation for model comparison with pulmonary function in COPD. Threshold loading may be a useful strategy to increase work of breathing or induce dynamic hyperinflation.
format	article
author	Jyotika Erram Monica Bari Antoinette Domingo Daniel T Cannon
author_facet	Jyotika Erram Monica Bari Antoinette Domingo Daniel T Cannon
author_sort	Jyotika Erram
title	Pulmonary function with expiratory resistive loading in healthy volunteers.
title_short	Pulmonary function with expiratory resistive loading in healthy volunteers.
title_full	Pulmonary function with expiratory resistive loading in healthy volunteers.
title_fullStr	Pulmonary function with expiratory resistive loading in healthy volunteers.
title_full_unstemmed	Pulmonary function with expiratory resistive loading in healthy volunteers.
title_sort	pulmonary function with expiratory resistive loading in healthy volunteers.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/5b29868a632a463eb36b5cd92c27bd2e
work_keys_str_mv	AT jyotikaerram pulmonaryfunctionwithexpiratoryresistiveloadinginhealthyvolunteers AT monicabari pulmonaryfunctionwithexpiratoryresistiveloadinginhealthyvolunteers AT antoinettedomingo pulmonaryfunctionwithexpiratoryresistiveloadinginhealthyvolunteers AT danieltcannon pulmonaryfunctionwithexpiratoryresistiveloadinginhealthyvolunteers
_version_	1718374947413295104

Pulmonary function with expiratory resistive loading in healthy volunteers.

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