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Dynamic Hyperinflation

  • Conference paper
Ventilatory Failure

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 15))

Abstract

Pulmonary hyperinflation is defined by an increase in the functional residual capacity (FRC), which is the amount of gas in the lungs and the airways at the end of a spontaneous expiration. Under normal circumstances and also in some abnormal conditions, the elastic energy stored in the respiratory system during the preceding inspiration is sufficient to breathe out, and the FRC is determined by the opposing elastic forces of the lungs and the chest wall, such that it corresponds to the static equilibrium volume of the total respiratory system (Vr, relaxation volume) [1]. Assuming the quiet breathing of an adult, healthy subject in the standing or sitting position as the control situation, there are several physiological as well as pathological events which can modify the FRC. One of these events is an abnormal increase of FRC above Vr because of dynamic forces, i.e. dynamic hyperinflation [2, 3].

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Reference

  1. Agostoni E, Mead J (1964) Statics of the Respiratory System. In: Fenn WO, Rahn H (eds), Handbook of physiology. Section 3: Respiration. Vol I. Washington DC, American Physiological Society, pp 387–409

    Google Scholar 

  2. Macklem PT (1984) Hyperinflation. Am Rev Respir Dis 129:1–2

    PubMed  CAS  Google Scholar 

  3. Martin JG, De Troyer A (1985) The thorax and control of functional residual capacity. In: Roussos C, Macklem PT (eds), Lung biology in health and disease, the thorax, Vol. 29, Part B. Dekker Marcel Inc., New York, pp 899–921.

    Google Scholar 

  4. Reder K, Marsh HM (1986) Respiratory mechanics during anesthesia and mechanical ventilation. In: Macklem PT, Mead J (eds), Handbook of physiology. Section 3: Respiration. Vol III. Washington DC, American Physiological Society, pp. 737–752.

    Google Scholar 

  5. Pride NB, Macklem PT (1986) Lung mechanics in disease. In: Macklem PT, Mead J (eds) Handbook of physiology. Section 3: Respiration, Vol III. Washington DC, American Physiological Society, pp 659–692

    Google Scholar 

  6. Suter PM (1985) Assessment of respiratory mechanics in ARDS In: Zapol ZM, Falke KJ (eds) Acute respiratory failure. Vol. 24; Lung biology in health and disease. Marcel Dekker Inc, New York, pp 899–921

    Google Scholar 

  7. Gattinoni L, Pesenti A, Avalli L, Rossi F, Bombino M. (1987) Pressure-volume curve of total respiratory system in acute respiratory failure. Computed tomographic scan study. Am Rev Respir Dis 136:730–736

    Google Scholar 

  8. Slutsky AS, Scharf SM, Brown R, Ingram RH Jr (1980) The effect of oleic acid-induced pulmonary edema on pulmonary and chest wall mechanics in dogs. Am Rev Respir Dis 121:91–96

    PubMed  CAS  Google Scholar 

  9. Whipp BJ, Pardy RL (1986) Breathing during exercise. In: Macklem PT, Mead J (eds) Handbook of physiology. Section 3: Respiration. Vol III. Washington DC, American Physiological Society, pp 605–629

    Google Scholar 

  10. Mortola JP (1983) Dynamic of breathing in newborn mammals. Physiological Review 67:187–243

    Google Scholar 

  11. Demedts M (1990) Mechanism and consequences of hyperinflation. Eur Respir J 3:617–619

    PubMed  CAS  Google Scholar 

  12. Rossi A, Gottfried SB, Zocchi L et al (1985) Measurement of static compliance of total respiratory system in patients with acute respiratory failure during mechanical ventilation. Am Rev Respir Dis 131:672–678

    PubMed  CAS  Google Scholar 

  13. Dal Vecchio L, Polese G, Poggi R, Rossi A (1990) “Intrinsic” positive end-expiratory pressure in stable patients with chronic obstructive pulmonary disease. Eur Respir J 3:74–80

    Google Scholar 

  14. Morris, MJ, Lane DJ (1981) Tidal expiratory flow patterns in patients with airflow obstruction. Thorax 36:135–142

    Article  PubMed  CAS  Google Scholar 

  15. Jonson B, Nordstrom L, Olsson SG, Akerback D (1975) Monitoring of ventilation and lung mechanics during automatic ventilation. A new device. Bull Eur Physiopathol Respir 11:729–743

    CAS  Google Scholar 

  16. Pepe PE, Marini J J (1982) Occult positive end-expiratory pressure in mechanically ventilated patients with airflow obstruction. Am Rev Respir Dis 126:166–170

    PubMed  CAS  Google Scholar 

  17. Gottfried SB, Rossi A, Higgs BD et al. (1985) Noninvasive determination of respiratory system mechanics during mechanical ventilation for acute respiratory failure. Am Rev Respir Dis 131:414–420

    PubMed  CAS  Google Scholar 

  18. Broseghini C, Brandolese R, Poggi R et al. (1988) Respiratory mechanics during the first day of mechanical ventilation in patients with pulmonary edema and chronic airway obstruction. Am Rev Respir Dis 138:355–361

    PubMed  CAS  Google Scholar 

  19. Poggi R, Brandolese R, Bernasconi M, Manzin E, Rossi A (1989) Doxofylline and respiratory mechanics. Short term effects in mechanically ventilated patients with airflow obstruction and respiratory failure. Chest 96:772–778

    CAS  Google Scholar 

  20. Bernasconi M, Ploysongsang Y, Gottfried SB, Milic-Emili J, Rossi A (1988) Respiratory compliance and resistance in mechanically ventilated patients with acute respiratory failure. Intensive Care Med 14:547–553.

    Article  PubMed  CAS  Google Scholar 

  21. Kimball WR, Leith DE, Robins AG (1982) Dynamic hyperinflation and ventilator dependence in chronic obstructive pulmonary disease. Am Rev Respir Dis 126:991–995.

    PubMed  CAS  Google Scholar 

  22. Rossi A, Brandolese R, Milic-Emili J, Gottfried SB (1990) The role of PEEP in patients with chronic obstructive pulmonary disease during assisted ventilation. Eur Resp J 3:816–822.

    Google Scholar 

  23. Saetta M, Rossi A, Gottfried SB et al. (1985) Expiratory volume-flow relationship during mechanical ventilation in patients with acute respiratory failure. Am Rev Respir Dis 131:A132.

    Google Scholar 

  24. Connors AF Jr, McCaffree DR, Gray BA (1981) Effect of inspiratory flow rate on gas exchange during mechanical ventilation. Am Rev Respir Dis 124:537–543.

    PubMed  Google Scholar 

  25. Bernasconi M, Brandolese R, Poggi R, Manzin E, Rossi A (1990) Dose-response effects and time course of effects of inhaled fenoterol on respiratory mechanics and arterial oxygen tension in mechanically ventilated patients with chronic airflow obstruction. Intensive Care Med 16:108–114.

    Article  PubMed  CAS  Google Scholar 

  26. Conti G, Bufi M, Antonelli M, Rocco M, Gasparetto A (1989) Pressure support ventilation (PSV) reverses hyperinflation induced isorhythmic A-V dissociation. Intensive Care Med 15:319–321.

    Article  PubMed  CAS  Google Scholar 

  27. Braschi A, Iotti G, Rodi G, Emmi V, Sala Gallini G (1988) Dynamic pulmonary hyperinflation during intermittent mandatory ventilation. Intensive Care Med 14:284.

    Google Scholar 

  28. Broseghini C, Brandolese R, Poggi R, Bernasconi M, Manzin E, Rossi A (1988) Respiratory resistance and intrinsic positive end-expiratory pressure (PEEP) in patients with the adult respiratory distress syndrome (ARDS). Eur Respir J 1:726–731

    PubMed  CAS  Google Scholar 

  29. Polese G, Rossi A, Brandi G et al. (1990) Partitioning of respiratory mechanics in mechanically ventilated COPD patients. Eur Respir J 2:337s

    Google Scholar 

  30. Wright PE, Barnard GR (1989) The role of airflow resistance in patients with the adult respiratory distress syndrome. Am Rev Respir Dis 139:1169–1174

    PubMed  CAS  Google Scholar 

  31. Wright PE, Marini J J, Bernard GR (1989) In vitro versus in vivo comparison on endotracheal tube airflow resistance. Am Rev Respir Dis 10:10–16

    Article  Google Scholar 

  32. Gurevitch MJ, Van Dyke JV, Young ES, Jackson K (1986) Improved oxygenation and lower peak airway pressure in severe adult respiratory distress syndrome. Chest 2:211–213

    Article  Google Scholar 

  33. Abraham E, Yoshihara G (1989) Cardiorespiratory effects of pressure controlled inverse ratio ventilation in severe respiratory failure. Chest 96:1356–1359

    Article  PubMed  CAS  Google Scholar 

  34. Gattinoni L, Marcolin R, Caspani ML, Fumagalli R, Mascheroni D, Pesenti A (1985) Constant mean airway pressure with different patterns of positive pressure breathing during the adult respiratory distress syndrome. Bull Eur Physiopathol Respir 21:275–279

    PubMed  CAS  Google Scholar 

  35. Brandolese R, Broseghini C, Polese G, Milic-Emili J, Brandi G, Rossi A (1991) Effect of intrinsic PEEP on pulmonary gas exchange in mechanically ventilated patients with pulmonary edema (in press)

    Google Scholar 

  36. Haake R, Schlichtig R, Ulstad DR, Henschen R (1987) Barotrauma. Pathophysiology, risk factors, and prevention. Chest 91:608–613

    Article  PubMed  CAS  Google Scholar 

  37. Rossi A, Gottfried SB, Higgs BD, Zocchi L, Grassino A, Milic-Emili J (1985) Respiratory mechanics in mechanically ventilated patients with respiratory failure. J Appl Physiol 58:1849–1858

    PubMed  CAS  Google Scholar 

  38. Conti G, Bufi M, Rocco M et al (1990) Auto-PEEP and dynamic hyperinflation in COPD patients during controlled mechanical ventilation and high frequency jet ventilation. Intensive Care Med 16:81–84

    Article  PubMed  CAS  Google Scholar 

  39. Smith TC, Marini JJ (1988) Impact of PEEP on lung mechanics and work of breathing in severe airflow obstruction. J Appl Physiol 65:1488–1499

    PubMed  CAS  Google Scholar 

  40. Gottfried SB, Rossi A, Milic-Emili J (1986) Dynamic hyperinflation, intrinsic PEEP, and the mechanically ventilated patient. Intensive Crit Care Dig 5:30–33

    Google Scholar 

  41. Brochard L, Harf A, Lorino H, Lemaire F (1989) Inspiratory pressure support prevents diaphragmatic fatigue during weaning from mechanical ventilation. Am Rev Respir Dis 139:513–521

    Article  PubMed  CAS  Google Scholar 

  42. Milic-Emili J (1986) Is weaning an art or a science? Am Rev Respir Dis 134:1107–1108

    PubMed  CAS  Google Scholar 

  43. Roussos C, Macklem PT (1986) Inspiratory muscle fatigue. In: Macklem PT, Mead J (eds) Handbook of physiology. Section 3: Respiration, Vol III. American Physiological Society. Washington DC, pp 511–527

    Google Scholar 

  44. Brochard L, Isabey D, Piquet J et al. (1990) Reversal of acute exacerbation of chronic obstructive lung disease by inspiratory assistance with a face mask. N Engl J Med 323:1523–1530

    Article  PubMed  CAS  Google Scholar 

  45. Meduri GU (1990) Ventilator-associated pneumonia in patients with respiratory failure. A diagnostic approach. Chest 97:1208–1219

    CAS  Google Scholar 

  46. Pingleton SK (1988) Complications of acute respiratory failure. Am Rev Respir Dis 137:1463–1493

    PubMed  CAS  Google Scholar 

  47. Decramer M (1989) Effects of hyperinflation on the respiratory muscle. Eur Respir J 2:299–302

    PubMed  CAS  Google Scholar 

  48. Haluszka J, Chartrand DA, Grassino AE, Milic-Emili J (1990) Intrinsic PEEP and arterial PC02 in stable patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 141:1194–1197

    PubMed  CAS  Google Scholar 

  49. Petroff BJ, Legare M, Goldberg P, Milic-Emili J, Gottfried SB (1990) Continuous positive airway pressure reduces work of breathing and dyspnea during weaning from mechanical ventilation in severe chronic obstructive pulmonary disease. Am Rev Respir Dis 141:281–289

    Google Scholar 

  50. Derenne JP, Fleury B, Pariente R (1988) Acute respiratory failure of chronic obstructive pulmonary disease. Am Rev Respir Dis 138:1006–1033

    Article  PubMed  CAS  Google Scholar 

  51. Fleury B, Murciano D, Talamo C, Aubier M, Pariente R, Milici-Emili J (1985) Work of breathing in patients with chronic obstructive pulmonary disease in acute respiratory failure. Am Rev Respir Dis 132:822–827

    Google Scholar 

  52. Roussos C (1985) Energetics. In: Roussos C, Macklem PT (eds) Lung biology in health and disease, Vol 29, The thorax, part A. Marcel Dekker Inc, New York, pp 437–492.

    Google Scholar 

  53. Cormier Y, Lecours R, Legris C (1990) Mechanism of hyperinflation in asthma. Eur Respir J 3:619–624.

    PubMed  CAS  Google Scholar 

  54. Blackie SP, Al-Majed S, Staples CA, Hilliam C, Pare PD (1990) Changes in total lung capacity during acute spontaneous asthma. Am Rev Respir Dis 142:79–83.

    PubMed  CAS  Google Scholar 

  55. Wheatley JR, West S, Cala SJ, Engel LA (1990) The effect of hyperinflation on respiratory muscle work in acute induced asthma. Eur Respir J 3:625–632.

    PubMed  CAS  Google Scholar 

  56. Citterio G, Agostoni E, Del Santo A, Marazzini L (1981) Decay of inspiratory muscle activity in chronic airway obstruction. J Appl Physiol 51:1388–1397.

    PubMed  CAS  Google Scholar 

  57. Rodriguez-Roisin R, Ballester E, Roca J, Torres A, Wagner PD (1989) Mechanism of hypoxemia in patients with status asthmaticus requiring mechanical ventilation. Am Rev Respir Dis 139:732–739.

    PubMed  CAS  Google Scholar 

  58. Perret C (1989) Sudden asphyxia in asthma. In: Vincent JL (ed) Update in intensive care and emergency medicine, Vol 12. Springer, Berlin Heidelberg New York, pp 86–90.

    Google Scholar 

  59. Branthwaite MA (1990) An update on mechanical ventilation for severe acute asthma. Clinical Intensive Care 1:4–6.

    PubMed  CAS  Google Scholar 

  60. Luksza AR, Smith P, Coakley J, Gordan I J, Atherton ST (1986) Acute severe asthma treated by mechanical ventilation: 10 years’ experience from a district general hospital. Thorax 41:459–463.

    Article  PubMed  CAS  Google Scholar 

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© 1991 Springer-Verlag Berlin Heidelberg

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Rossi, A., Polese, G., Brandi, G. (1991). Dynamic Hyperinflation. In: Marini, J.J., Roussos, C. (eds) Ventilatory Failure. Update in Intensive Care and Emergency Medicine, vol 15. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84554-3_12

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  • DOI: https://doi.org/10.1007/978-3-642-84554-3_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-84556-7

  • Online ISBN: 978-3-642-84554-3

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