Thoracic weighting of restrained subjects during exhaustion recovery causes loss of lung reserve volume in a model of police arrest

Abstract Restraint asphyxia has been proposed as a mechanism for some arrest-related deaths that occur during or shortly after a suspect is taken into custody. Our analysis of the literature found that prone positioning, weight applied to the back, recovery after simulated pursuit, and restraint pos...

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Autores principales:	Mark Campbell, Roslyn Dakin, Symon Stowe, Kira Burton, Brianna Raven, Malitela Mapani, Jeff W. Dawson, Andy Adler
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/cfa404c3510d42f49a8aec8d686459fe
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spelling	oai:doaj.org-article:cfa404c3510d42f49a8aec8d686459fe2021-12-02T18:50:47ZThoracic weighting of restrained subjects during exhaustion recovery causes loss of lung reserve volume in a model of police arrest10.1038/s41598-021-94157-w2045-2322https://doaj.org/article/cfa404c3510d42f49a8aec8d686459fe2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-94157-whttps://doaj.org/toc/2045-2322Abstract Restraint asphyxia has been proposed as a mechanism for some arrest-related deaths that occur during or shortly after a suspect is taken into custody. Our analysis of the literature found that prone positioning, weight applied to the back, recovery after simulated pursuit, and restraint position have led to restrictive, but non life-threatening respiratory changes when tested in subsets. However, the combined effects of all four parameters have not been tested together in a single study. We hypothesized that a complete protocol with high-sensitivity instrumentation could improve our understanding of breathing physiology during weighted restraint. We designed an electrical impedance tomography (EIT)-based protocol for this purpose and measured the 3D distribution of ventilation within the thorax. Here, we present the results from a study on 17 human subjects that revealed FRC declines during weighted restrained recovery from exercise for subjects in the restraint postures, but not the control posture. These prolonged FRC declines were consistent with abdominal muscle recruitment to assist the inspiratory muscles, suggesting that subjects in restraint postures have increased work of breathing compared to controls. Upon removal of the weighted load, lung reserve volumes gradually increased for the hands-behind-the-head restraint posture but continued to decrease for subjects in the hands-behind-the-back restraint posture. We discuss the possible role this increased work of breathing may play in restraint asphyxia.Mark CampbellRoslyn DakinSymon StoweKira BurtonBrianna RavenMalitela MapaniJeff W. DawsonAndy AdlerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mark Campbell Roslyn Dakin Symon Stowe Kira Burton Brianna Raven Malitela Mapani Jeff W. Dawson Andy Adler Thoracic weighting of restrained subjects during exhaustion recovery causes loss of lung reserve volume in a model of police arrest
description	Abstract Restraint asphyxia has been proposed as a mechanism for some arrest-related deaths that occur during or shortly after a suspect is taken into custody. Our analysis of the literature found that prone positioning, weight applied to the back, recovery after simulated pursuit, and restraint position have led to restrictive, but non life-threatening respiratory changes when tested in subsets. However, the combined effects of all four parameters have not been tested together in a single study. We hypothesized that a complete protocol with high-sensitivity instrumentation could improve our understanding of breathing physiology during weighted restraint. We designed an electrical impedance tomography (EIT)-based protocol for this purpose and measured the 3D distribution of ventilation within the thorax. Here, we present the results from a study on 17 human subjects that revealed FRC declines during weighted restrained recovery from exercise for subjects in the restraint postures, but not the control posture. These prolonged FRC declines were consistent with abdominal muscle recruitment to assist the inspiratory muscles, suggesting that subjects in restraint postures have increased work of breathing compared to controls. Upon removal of the weighted load, lung reserve volumes gradually increased for the hands-behind-the-head restraint posture but continued to decrease for subjects in the hands-behind-the-back restraint posture. We discuss the possible role this increased work of breathing may play in restraint asphyxia.
format	article
author	Mark Campbell Roslyn Dakin Symon Stowe Kira Burton Brianna Raven Malitela Mapani Jeff W. Dawson Andy Adler
author_facet	Mark Campbell Roslyn Dakin Symon Stowe Kira Burton Brianna Raven Malitela Mapani Jeff W. Dawson Andy Adler
author_sort	Mark Campbell
title	Thoracic weighting of restrained subjects during exhaustion recovery causes loss of lung reserve volume in a model of police arrest
title_short	Thoracic weighting of restrained subjects during exhaustion recovery causes loss of lung reserve volume in a model of police arrest
title_full	Thoracic weighting of restrained subjects during exhaustion recovery causes loss of lung reserve volume in a model of police arrest
title_fullStr	Thoracic weighting of restrained subjects during exhaustion recovery causes loss of lung reserve volume in a model of police arrest
title_full_unstemmed	Thoracic weighting of restrained subjects during exhaustion recovery causes loss of lung reserve volume in a model of police arrest
title_sort	thoracic weighting of restrained subjects during exhaustion recovery causes loss of lung reserve volume in a model of police arrest
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/cfa404c3510d42f49a8aec8d686459fe
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Thoracic weighting of restrained subjects during exhaustion recovery causes loss of lung reserve volume in a model of police arrest

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