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European Journal of Applied Physiology

, Volume 99, Issue 6, pp 567–583 | Cite as

Closing volume: a reappraisal (1967–2007)

  • Joseph Milic-Emili
  • Roberto Torchio
  • Edgardo D’Angelo
Review Article

Abstract

Measurement of closing volume (CV) allows detection of presence or absence of tidal airway closure, i.e. cyclic opening and closure of peripheral airways with concurrent (1) inhomogeneity of distribution of ventilation and impaired gas exchange; and (2) risk of peripheral airway injury. Tidal airway closure, which can occur when the CV exceeds the end-expiratory lung volume (EELV), is commonly observed in diseases characterised by increased CV (e.g. chronic obstructive pulmonary disease, asthma) and/or decreased EELV (e.g. obesity, chronic heart failure). Risk of tidal airway closure is enhanced by ageing. In patients with tidal airway closure (CV > EELV) there is not only impairment of pulmonary gas exchange, but also peripheral airway disease due to injury of the peripheral airways. In view of this, the causes and consequences of tidal airway closure are reviewed, and further studies are suggested. In addition, assessment of the “open volume”, as opposed to the “closing volume”, is proposed because it is easier to perform and it requires less equipment.

Keywords

Lung volumes  Closing volume Peripheral airway injury 

Abbreviations

AC

Airway closure

BAL

Bronchoalveolar lavage

COPD

Chronic obstructive pulmonary disease

CC

Closing capacity

CHF

Chronic heart failure

CV

Closing volume

EELV

End-expiratory lung volume

EFL

Expiratory flow limitation

ERS

European Respiratory Society

ERV

Expiratory reserve volume

FL

Flow limitation

FRC

Functional residual capacity

FVC

Forced vital capacity

FEV1

Forced expiratory volume in 1 s

IC

Inspiratory capacity

MV

Mechanical ventilation

NEEP

Negative end expiratory pressure

NOe

Exhaled NO concentration

OC

Open capacity

PaO2

Partial arterial oxygen pressure

PAD

Peripheral airway disease

PAI

Peripheral airway injury

Pc,max

Maximal closing pressure

Pc,min

Minimal closing pressure

PL

Transpulmonary pressure

Po,max

Maximal opening pressure

Ppl

Pleural surface pressure

PEEP

Positive end expiratory pressure

PO2

Partial oxygen pressure

RV

Residual volume

TGV

Trapped gas volume

TLC

Total lung capacity

TNF-α

Tumour necrosis factor alpha

V30

Lung volume at P L of 30 cmH2O

VILI

Ventilator induced lung injury

VIP

Vaso intestinal peptide

Vmax

Maximal flow

VP

Volume–pressure

V′/Q

Ventilation perfusion ratio

Vr,L

Resting lung volume

ZEEP

Zero end expiratory pressure

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Joseph Milic-Emili
    • 1
  • Roberto Torchio
    • 2
  • Edgardo D’Angelo
    • 3
  1. 1.Meakins-Christie LaboratoriesMcGill UniversityMontrealCanada
  2. 2.Laboratorio Indagini Funzionali Cardio-RespiratorieFisiopatologia Respiratoria ASO San Luigi GonzagaTorinoItaly
  3. 3.Istituto di Fisiologia Umana IUniversità degli Studi di MilanoMilanItaly

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