Emergent Behavior of Regional Heterogeneity in the Lung and Its Effects on Respiratory Impedance

Overview

Journal J Appl Physiol (1985)

Publisher American Physiological Society

Date 2011 Feb 5

PMID 21292840

Citations 17

Authors

David W Kaczka

Kenneth R Lutchen

Zoltan Hantos

Affiliations

Soon will be listed here.

Abstract

The ability to maintain adequate gas exchange depends on the relatively homogeneous distribution of inhaled gas throughout the lung. Structural alterations associated with many respiratory diseases may significantly depress this function during tidal breathing. These alterations frequently occur in a heterogeneous manner due to complex, emergent interactions among the many constitutive elements of the airways and parenchyma, resulting in unique signature changes in the mechanical impedance spectrum of the lungs and total respiratory system as measured by forced oscillations techniques (FOT). When such impedance spectra are characterized by appropriate inverse models, one may obtain functional insight into derangements in global respiratory mechanics. In this review, we provide an overview of the impact of structural heterogeneity with respect to dynamic lung function. Recent studies linking functional impedance measurements to the structural heterogeneity observed in acute lung injury, asthma, and chronic obstructive pulmonary disease are highlighted, as well as current approaches for the modeling and interpretation of impedance. Finally, we discuss the potential diagnostic role of FOT in the context of therapeutic interventions.

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References

Campana L, Kenyon J, Zhalehdoust-Sani S, Tzeng Y, Sun Y, Albert M . Probing airway conditions governing ventilation defects in asthma via hyperpolarized MRI image functional modeling. J Appl Physiol (1985). 2009; 106(4):1293-300. PMC: 2698646. DOI: 10.1152/japplphysiol.91428.2008. View

Kaczka D, Ingenito E, Body S, Duffy S, Mentzer S, DeCamp M . Inspiratory lung impedance in COPD: effects of PEEP and immediate impact of lung volume reduction surgery. J Appl Physiol (1985). 2001; 90(5):1833-41. DOI: 10.1152/jappl.2001.90.5.1833. View

Bates J . Lung mechanics--the inverse problem. Australas Phys Eng Sci Med. 1991; 14(4):197-203. View

Suki B . Nonlinear phenomena in respiratory mechanical measurements. J Appl Physiol (1985). 1993; 74(5):2574-84. DOI: 10.1152/jappl.1993.74.5.2574. View

OTIS A, MCKERROW C, Bartlett R, Mead J, McIlroy M, SELVER-STONE N . Mechanical factors in distribution of pulmonary ventilation. J Appl Physiol. 1956; 8(4):427-43. DOI: 10.1152/jappl.1956.8.4.427. View

Yuan H, Suki B, Lutchen K . Sensitivity analysis for evaluating nonlinear models of lung mechanics. Ann Biomed Eng. 1998; 26(2):230-41. DOI: 10.1114/1.117. View

Lorx A, Szabo B, Hercsuth M, Penzes I, Hantos Z . Low-frequency assessment of airway and tissue mechanics in ventilated COPD patients. J Appl Physiol (1985). 2009; 107(6):1884-92. DOI: 10.1152/japplphysiol.00151.2009. View

Lutchen K, Gillis H . Relationship between heterogeneous changes in airway morphometry and lung resistance and elastance. J Appl Physiol (1985). 1997; 83(4):1192-201. DOI: 10.1152/jappl.1997.83.4.1192. View

Tzeng Y, Hoffman E, Cook-Granroth J, Gereige J, Mansour J, Washko G . Investigation of hyperpolarized 3He magnetic resonance imaging utility in examining human airway diameter behavior in asthma through comparison with high-resolution computed tomography. Acad Radiol. 2008; 15(6):799-808. PMC: 2587251. DOI: 10.1016/j.acra.2008.02.003. View

10.

Amato M, Barbas C, Medeiros D, Magaldi R, Schettino G, Lorenzi-Filho G . Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med. 1998; 338(6):347-54. DOI: 10.1056/NEJM199802053380602. View

11.

Brower R, Matthay M, Morris A, Schoenfeld D, Thompson B, Wheeler A . Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000; 342(18):1301-8. DOI: 10.1056/NEJM200005043421801. View

12.

Tawhai M, Hunter P, Tschirren J, Reinhardt J, McLennan G, Hoffman E . CT-based geometry analysis and finite element models of the human and ovine bronchial tree. J Appl Physiol (1985). 2004; 97(6):2310-21. DOI: 10.1152/japplphysiol.00520.2004. View

13.

Lorx A, Suki B, Hercsuth M, Szabo B, Penzes I, Boda K . Airway and tissue mechanics in ventilated patients with pneumonia. Respir Physiol Neurobiol. 2010; 171(2):101-9. DOI: 10.1016/j.resp.2010.03.004. View

14.

Suki B, DAVEY B, Sato J, Bates J . A model of transient oscillatory pressure-flow relationships of canine airways. Ann Biomed Eng. 1995; 23(5):682-90. DOI: 10.1007/BF02584465. View

15.

Fredberg J, Stamenovic D . On the imperfect elasticity of lung tissue. J Appl Physiol (1985). 1989; 67(6):2408-19. DOI: 10.1152/jappl.1989.67.6.2408. View

16.

Bates J, Irvin C . Time dependence of recruitment and derecruitment in the lung: a theoretical model. J Appl Physiol (1985). 2002; 93(2):705-13. DOI: 10.1152/japplphysiol.01274.2001. View

17.

Gillis H, Lutchen K . How heterogeneous bronchoconstriction affects ventilation distribution in human lungs: a morphometric model. Ann Biomed Eng. 1999; 27(1):14-22. DOI: 10.1114/1.161. View

18.

Tgavalekos N, Tawhai M, Harris R, Musch G, Mush G, Vidal-Melo M . Identifying airways responsible for heterogeneous ventilation and mechanical dysfunction in asthma: an image functional modeling approach. J Appl Physiol (1985). 2005; 99(6):2388-97. DOI: 10.1152/japplphysiol.00391.2005. View

19.

Suki B, Yuan H, Zhang Q, Lutchen K . Partitioning of lung tissue response and inhomogeneous airway constriction at the airway opening. J Appl Physiol (1985). 1997; 82(4):1349-59. DOI: 10.1152/jappl.1997.82.4.1349. View

20.

Petak F, Hantos Z, Adamicza A, Asztalos T, Sly P . Methacholine-induced bronchoconstriction in rats: effects of intravenous vs. aerosol delivery. J Appl Physiol (1985). 1997; 82(5):1479-87. DOI: 10.1152/jappl.1997.82.5.1479. View