Abstract
The location of the flow-limiting segment and airway mechanics are important points for guiding and estimating interventional bronchoscopy. Analysis of the flow–volume curve could be used in defining the nature of the stenosis and provide reliable information for evaluating the efficacy of stenting. However, flow–volume curves cannot identify the location of the lesion where airway resistance increases nor can it immediately define the outcome of stenting. By measuring lateral airway pressure on each side of the stenosis and plotting the two pressures against each other (pressure–pressure curve) during quiet breathing, the site of maximum obstruction and the degree of the stenosis can be determined quantitatively.
Measuring lateral airway pressures was found to be useful in assessing the nature of the stenosis and the outcome of intervention. This approach provides useful information in real time to guide treatment decisions such as additional procedures.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Seijo LM, Sterman DH. Interventional pulmonology. N Engl J Med. 2001;344:740–9.
Dawson SV, Elliott EA. Wave-speed limitation on expiratory flow a unifying concept. J Appl Physiol. 1977;43:498–515.
Mead J. Expiratory flow limitation: a physiologist’s point of view. Fed Proc. 1980;39:2771–5.
Miyazawa T, Yamakido M, Ikeda S, Furukawa K, Takiguchi Y, Tada H, Shirakusa T. Implantation of Ultraflex nitinol stents in malignant tracheobronchial stenoses. Chest. 2000;118:959–65.
Miyazawa T, Miyazu Y, Iwamoto Y, Ishida A, Kanoh K, Sumiyoshi H, Doi M, Kurimoto N. Stenting at the flow–limiting segment in tracheobronchial stenosis due to lung cancer. Am J Respir Crit Care Med. 2004;169:1096–102.
Pedersen OF, Ingram Jr RH. Configuration of maximum expiratory flow-volume curve: model experiments with physiological implications. J Appl Physiol. 1985;58:1305–13.
Ohya N, Huang J, Fukunaga T, Toga H. Airway pressure-volume curve estimated by flow interruption during forced expiration. J Appl Physiol. 1989;67:2631–8.
Pedersen OF. The Peak Flow Working Group: physiological determinants of peak expiratory flow. Eur Respir J. 1997;10:11–6.
Aljuri N, Freitag L, Vegegas JG. Modeling expiratory flow from excised tracheal tube law. J Appl Physiol. 1999;87:1973–80.
Miller RD, Hyatt RE. Evaluation of obstructing lesions of the trachea and larynx by flow-volume loops. Am Rev Respir Dis. 1973;108:475–81.
Brouns M, Jayaraju ST, Lacor C, Mey JD, Noppen M, Vincken W, Verbanck S. Tracheal stenosis: a flow dynamics study. J Appl Physiol. 2007;102:1178–84.
Nishine H, Hiramoto T, Kida H, Matsuoka S, Mineshita M, Kurimoto N, Miyazawa T. Assessing the site of maximum obstruction in the trachea using lateral pressure measurement during bronchoscopy. Am J Respir Crit Care Med. 2011;185:24–33.
Mink S, Ziesmann M, Wood JDH. Mechanisms of increased maximum expiratory flow during HeO2 breathing in dogs. J Appl Physiol. 1979;47:490–502.
Smaldone GC, Itoh H, Swift DL, Wagner HN. Effect of flow-limiting segments and cough on particle deposition and mucociliary clearance in the lung. Am Rev Respir Dis. 1979;120:747–58.
Pedersen OF, Thiessen B, Lyager S. Airway compliance and flow limitation during forced expiration in dogs. J Appl Physiol. 1982;52:357–69.
Macklem PT, Fraser RG, Bates DV. Bronchial pressures and dimensions in health and obstructive airway disease. J Appl Physiol. 1963;18:699–706.
Smaldone GC, Smith PL. Location of flow-limiting segments via airway catheters near residual volume in humans. J Appl Physiol. 1985;59:502–8.
Pedersen OF, Brackel HJ, Bogaard JM, Kerrebijn KF. Wave-speed-determined flow limitation at peak flow in normal and asthmatic subjects. J Appl Physiol. 1997;83:1721–32.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Miyazawa, T., Nishine, H. (2013). Evaluating Outcomes After Interventional Procedures. In: Díaz-Jimenez, J., Rodriguez, A. (eds) Interventions in Pulmonary Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6009-1_5
Download citation
DOI: https://doi.org/10.1007/978-1-4614-6009-1_5
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-6008-4
Online ISBN: 978-1-4614-6009-1
eBook Packages: MedicineMedicine (R0)