Abstract
The statics of the respiratory system and its component parts is studied by determining and analysing corresponding volume-pressure (V-P) relationships. These relationships are usually represented as single lines, in spite of the fact that static pressures differ depending on volume, as well as on timing. V-P relationships obtained in subsequent steps from minimal to maximal lung volume and back again appear as loops, referred to as ‘hysteresis loops,’ that are attributed to both viscoelasticity, i.e. a rate-dependent phenomenon, and plasticity, i.e. a rate-independent phenomenon. Indeed, only plasticity is responsible for static hysteresis. Although there is no information concerning pressure related to tissue plasticity in humans, it has been suggested that this pressure component should be very small in the tidal volume range [1]. Moreover, the static pressure across the lung and chest wall varies at different sites because of the effects of gravity and different shapes of these two structures [2], while the static pressure across the respiratory system may become non- uniform under conditions involving airway closure. Nevertheless, for analytical purposes, static V-P relationships will be considered as single functions.
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References
Jonson B, Beydon L, Brauer K et al (1993) Mechanics of respiratory system in healthy anesthetized humans with emphasis on viscoelastic properties. J Appl Physiol 75:132–140
Agostoni E (1972) Mechanics of the pleural space. Physiol Rev 52:57–128
Gattinoni L, Mascheroni D, Basilico E et al (1987) Volume/pressure curve of total respiratory system in paralysed patients: artefacts and correction factors. Intensive Care Med 13:19–23
Woo SW, Berlin D, Hedly-Whyte J (1969) Surfactant function and anesthetic agents. J Appl Physiol 26:571–577
DAngelo E, Tavola M, Milic-Emili J (2000) Volume and time dependence of respiratory system mechanics in normal anaesthetized paralysed humans. Eur Resp J 16:665–672
Howell JBL, Peckett BW (1957)Studies of the elastic properties of the thorax of supine anaesthetized paralysed human subjects. J Physiol (London) 136:1–19
Hedenstierna G, Lofstrom B, Lundh R (1981) Thoracic gas volume and chest-abdomen dimensions during anesthesia and muscle paralysis. Anesthesiology 55:499–506
Krayer S, Rehder K, Beck KC et al (1987) Quantification of thoracic volumes by three-dimensional imaging. J Appl Physiol 62:591–598
Rehder K, Mallow JE, Fibuch EE et al (1974) Effects of isoflurane anesthesia and muscle paralysis on respiratory mechanics in normal man. Anesthesiology 41:477–485
Westbrook PR, Stubbs SE, Sessler AD et al (1973) Effects of anesthesia and muscle paralysis on respiratory mechanics in normal man. J Appl Physiol 34:81–86
Foster CA, Heaf PJD, Semple SJG (1957) Compliance of the lung in anesthetized paralyzed subjects. J Appl Physiol 11:383–384
Van Lith P, Johnson FN, Sharp JT (1967) Respiratory elastances in relaxed and paralyzed states in normal and abnormal men. J Appl Physiol 23:475–486
DAngelo E, Robatto F, Calderini E et al (1991) Pulmonary and chest wall mechanics in anesthetized paralyzed humans. J Appl Physiol 70:2602–2610
Pelosi P, Croci M, Calappi E et al (1995) The prone positioning during general anesthesia minimally affects respiratory mechanics while improving functional residual capacity and increasing oxygen tension. Anesth Analg 80:955–960
DAngelo E (1984) Techniques for studying the mechanics of the pleural space. In: Otis AB (ed) Techniques in life science, part II, vol. P415. Elsevier, Amsterdam, pp 1–32
Milic-Emili J (1984) Measurements of pressures in respiratory physiology. In: Otis AB (ed) Techniques in Life Science, part II, vol. P412. Elsevier, Amsterdam, pp 1–22(7A)
DAngelo E, Calderini E, Tavola M et al (1992) Effect of PEEP on respiratory mechanics in anesthetized paralyzed humans. J Appl Physiol 73:1736–1742
Wade OL (1954) Movements of the thoracic cage and diaphragm in respiration. J Physiol (London) 124:193–212
Agostoni E, Mognoni P, Torri G, Saracino F (1965) Relation between changes of rib cage circumference and lung volume. J Appl Physiol 20:1179–1186
Krayer S, Rehder K, Vettermann J et al (1989) Position and motion of the human diaphragm during anesthesia-paralysis. Anesthesiology 70:891–898
Grimby G, Hedenstierna G, Lofstrom B (1975) Chest wall mechanics during artificial ventilation. J Appl Physiol 38:576–580
Jones JG, Faithfull D, Jordan C, Minty B (1979) Rib cage movement during halothane anaethesia in man. Br J Anaesth 51:399–407
Vellody VP, Nassery M, Dius WS, Sharp JT (1978) Effects of body position change on thoracoabdominal motion. J Appl Physiol 45:581–589
Rehder K, Marsh M (1986) Respiratory mechanics during anesthesia and mechanical ventilation. In: Macklem PT, Mead J (eds) Handbook of Physiology. The Respiratory System, Mechanics of Breathing, Section 3, vol III, chp 43. American Physiological Society, Bethesda, pp 737–752
Hedenstierna C, Bindslev L, Santesson J, Norlander DP (1981) Airway closure in each lung of anesthetized human subjects. J Appl Physiol 50:55–64
Rehder K, Sittipong R, Sessler AD (1972) The effects of thiopental-meperidine anesthesia with succinylcholine paralysis on functional residual capacity and dynamic lung compliance in normal sitting man. Anesthesiology 37:395–398
Wright PE, Marini JJ, Bernard GR (1989) In vitro versus in vivo comparison of endotracheal tube airflow resistance. Am Rev Respir Dis 140:10–16
Druz WS, Sharp JT (1981) Activity of respiratory muscles in upright and recumbent humans. J Appl Physiol 51:1552–1561
Muller N, Volgyesi G, Becker L et al (1979) Diaphragmatic muscle tone. J Appl Physiol 47:279–284
Drummond GB, Allan PL, Logan MR (1986) Changes in diaphragmatic position in association with the induction of anaesthesia. Br J Anaesth 58:1246–1251
Hedenstierna G, Strandberg A, Brismar B et al (1985) Functional residual capacity, thoracoabdominal dimensions, and central blood volume during general anesthesia with muscle paralysis and mechanical ventilation. Anesthesiology 62:247–254
Freund F, Roos A, Dodd RB (1964) Expiratory activity of the abdominal muscles in man during general anesthesia. J Appl Physiol 19:693–697
Kimball WR, Loring SH, Basta SJ et al (1985) Effects of paralysis with pancuronium on chest wall statics in awake humans. J Appl Physiol 58:1638–1645
Gold ML, Helrich M (1965) Pulmonary compliance during anesthesia. Anesthesiology 26:281–288
Hedenstierna G, McCarthy G (1975) Mechanics of breathing, gas distribution and functional residual capacity at different frequencies of respiration during spontaneous and artificial ventilation. Br J Anaesth 47:706–712
Wu N, Miller WF, Luhn NR (1956) Studies of breathing in anesthesia. Anesthesiology 17:696–707
Brismar B, Hedenstierna G, Lundquist H et al (1985) Pulmonary densities during anesthesia with muscular relaxation: a proposal of atelectasis. Anesthesiology 62:422–428
Duggan CJ, Castle WD, Berend N (1990) Effects of continuous positive airway pressure breathing on lung volume and distensibility. J Appl Physiol 68:1121–1126
Goldberg HS, Mitzner W, Adams K et al (1975) Effect of intrathoracic pressure on pressure-volume characteristics of the lung in man. J Appl Physiol 38:411–417
Hillman DR, Finucane KE (1983) The effect of hyperinflation on lung elasticity in healthy subjects. Respir Physiol 54:295–305
Young SL, Tierney DF, Clements JA (1970) Mechanism of compliance change in excised rat lungs at low transpulmonary pressure. J Appl Physiol 29:780–785
Agostoni E, Hyatt R (1986) Static behavior of the respiratory system. In: Macklem PT, Mead J (eds) Handbook of Physiology. The Respiratory System, Mechanics of Breathing, Section 3, vol. III, chp 9. American Physiological Society, Bethesda, pp 113–130
Rehder K, Knopp TJ, Sessler AD (1978) Regional intrapulmonary gas distribution in awake and anesthetized-paralyzed prone man. J Appl Physiol 45 528–535
Rohrer F (1915) Der Stromungswiderstand in den menschlichen Atemwegen und der Einfluss der unregelmassigen Verzweigung des Bronchialsystems auf den Atmungsverlaud verschiedenen Lungenbezirken. Arch Gesamte Physiol Mens Tiere 162:225–299
Rohrer F (1925) Physiologie der Atembewegung. In: Bethe ATJ, von Bergmann G, Embden G, Ellinger A (eds) Handbuch der normalen und pathologischen Physiologie vol 2. Springer-Verlag, Berlin, pp 70–127
Briscoe WA, DuBois AB (1958) The relationship between airway resistance, airway conductance and lung volume in subjects of different age and body size. J Clin Invest 37:1279–1285
Mead J, Agostoni E (1964) Dynamics of breathing. In: Fenn OW, Rahn H (eds) Handbook of Physiology. Respiration, vol 1. American Physiological Society, Washington DC, pp 411–427
D’Angelo E, Salvo Calderini I, Tavola M (2001) The effects of CO2 on respiratory mechanics in normal anesthetized paralyzed humans. Anesthesiology 94:604–610
Mead J, Whittenberger JL (1954) Evaluation of airway interruption technique as a method for measuring pulmonary air-flow resistance. J Appl Physiol 6:408–416
D’Angelo E, Calderini E, Torri G et al (1989) Respiratory mechanics in anesthetized-paralyzed humans: effects of flow, volume and time. J Appl Physiol 67:2556–2564
D’Angelo E, Prandi E, Tavola M et al (1994) Chest wall interrupter resistance in anesthetized paralyzed humans. J Appl Physiol 77:883–887
Liistro GD, Stanescu D, Rodenstein D, Veriter C (1989) Reassessment of the interruption technique for measuring flow resistance in humans. J Appl Physiol 67:933–937
D’Angelo E, Calderini E, Robatto FM et al (1997) Lung and chest wall mechanics in patients with acquired immunodeficiency syndrome and severe Pneumocystis carinii pneumonia. Eur Respir J 10:2343–2350
Bates JHT, Ludwig MS, Sly PD et al (1988) Interrupter resistance elucidated by alveolar pressure measurement in open-chest normal dogs. J Appl Physiol 65:408–414
Saldiva PHN, Zin WA, Santos RLB et al (1992) Alveolar pressure measurement in open-chest rats. J Appl Physiol 72:302–306
D’Angelo E, Rocca E, Milic-Emili J (1999) A model analysis of the effects of different inspiratory flow patterns on inspiratory work during mechanical ventilation. Eur Respir Mon 4:279–295
Mount LE (1955) The ventilation flow-resistance and compliance of rat lungs. J Physiol (London) 127:157–167
Hildebrandt J (1970) Pressure-volume data of cat lung interpreted by a plastoelastic linear viscoelastic model. J Appl Physiol 28:365–372
Fredberg JJ, Stamenovic D (1989) On the imperfect elasticity of lung tissue. J Appl Physiol 67:2408–2419
Hoppin FG, Stothert JC, Greaves IA et al (1986) Lung recoil: elastic and rheological properties. In: Mead J, Macklem PT (eds) Handbook of physiology. The respiratory system, mechanics of breathing, vol 3. American Physiological Society, Bethesda MD, 195–216
Stamenovic D, Glass GM, Barnas GM, Fredberg JJ (1990) Viscoplasticity of respiratory tissues. J Appl Physiol 69:973–988
Sharp JT, Johnson FN, Goldberg NB, Van Lith P (1967) Hysteresis and stress adaptation in the human respiratory system. J Appl Physiol 23:487–497
Marik PE, Krikorian J (1997) Pressure-controlled ventilation in ARDS: a practical approach. Chest 112:1102–06
Kacmarek RM, Hess DR (1993) Airway pressure, flow and volume waveforms, and lung mechanics during mechanical ventilation. In: Kacmarek RM, Hess D, Stoller JK (eds) Monitoring in respiratory care. Mosby, London, pp 497–543
Lauzon AM, Bates JHT (1991) Estimation of time-varying respiratory mechanical parameters by recursive least squares. J Appl Physiol 71:1159–1165
Iotti GA, Braschi A, Brunner JX et al (1995) Respiratory mechanics by least square fitting in mechanically ventilated patients: applications during paralysis and during pressure support ventilation. Intensive Care Med 21:406–413
Milic-Emili J, Gottfried SB, Rossi A (1987) Non-invasive measurement of respiratory mechanics in ICU patients. Int J Clin Monit Comput 4:11–20
Ranieri VM, Giuliani R, Fiore T et al (1994) Volume-pressure curve of the respiratory system predicts effects of PEEP in ARDS: ‘occlusion’ versus ‘onstant flow’ technique. Am J Respir Crit Care Med 149:19–2
Ranieri VM, Zhang H, Mascia L et al (2000) Pressure-time curve predicts minimally injurious ventilatory strategy in an isolated rat lung model. Anesthesiology 93:1320–1328
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D’Angelo, E., Lucangelo, A. (2006). Respiratory Mechanics in Health. In: Gullo, A., Berlot, G. (eds) Perioperative and Critical Care Medicine. Springer, Milano. https://doi.org/10.1007/88-470-0417-9_2
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DOI: https://doi.org/10.1007/88-470-0417-9_2
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