Journal articles: 'Dynamic hyperinflation'

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McCarren, Bredge. "Dynamic pulmonary hyperinflation." Australian Journal of Physiotherapy 38, no. 3 (1992): 175–79. http://dx.doi.org/10.1016/s0004-9514(14)60560-2.

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van der Meer, Akke-Nynke, Kim de Jong, Aranka Hoekstra-Kuik, Elisabeth H. Bel, and Anneke ten Brinke. "Dynamic hyperinflation impairs daily life activity in asthma." European Respiratory Journal 53, no. 4 (January 24, 2019): 1801500. http://dx.doi.org/10.1183/13993003.01500-2018.

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IntroductionDynamic hyperinflation has been documented in asthma, yet its impact on overall health and daily life activities is unclear. We assessed the prevalence of dynamic hyperinflation in moderate to severe asthma and its relationship with the scores of a set of specific and general respiratory health questionnaires.Methods77 nonsmoking asthma patients (Global Initiative for Asthma steps 4–5) were recruited consecutively and completed five questionnaires: Asthma Control Questionnaire, Clinical COPD (chronic obstructive pulmonary disease) Questionnaire, St George's Respiratory Questionnaire, London Chest Activity of Daily Living scale (LCADL) and Shortness of Breath with Daily Activities (SOBDA). Dynamic hyperinflation was defined as ≥10% reduction in inspiratory capacity induced by standardised metronome-paced tachypnoea. Associations between level of dynamic hyperinflation and questionnaire scores were assessed and adjusted for asthma severity.Results81% (95% CI 71.7–89.4%) of patients showed dynamic hyperinflation. Higher levels of dynamic hyperinflation were related to poorer scores on all questionnaires (r=0.228–0.385, p<0.05). After adjustment for asthma severity, dynamic hyperinflation remained associated with poorer scores on LCADL (p=0.027) and SOBDA (p=0.031).ConclusionDynamic hyperinflation is associated with poorer overall health and impaired daily life activities, independent of asthma severity. Because of its major impact on everyday life activities, dynamic hyperinflation is an important target for treatment in asthma.

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van Dijk, Marlies, Karin Klooster, Jorine E. Hartman, Nick H. T. ten Hacken, and Dirk-Jan Slebos. "Change in Dynamic Hyperinflation After Bronchoscopic Lung Volume Reduction in Patients with Emphysema." Lung 198, no. 5 (July 24, 2020): 795–801. http://dx.doi.org/10.1007/s00408-020-00382-x.

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Abstract Background and Purpose In patients with severe emphysema, dynamic hyperinflation is superimposed on top of already existing static hyperinflation. Static hyperinflation reduces significantly after bronchoscopic lung volume reduction (BLVR). In this study, we investigated the effect of BLVR compared to standard of care (SoC) on dynamic hyperinflation. Methods Dynamic hyperinflation was induced by a manually paced tachypnea test (MPT) and was defined by change in inspiratory capacity (IC) measured before and after MPT. Static and dynamic hyperinflation measurements were performed both at baseline and 6 months after BLVR with endobronchial valves or coils (treatment group) or SoC (control group). Results Eighteen patients underwent BLVR (78% female, 57 (43–67) years, FEV1 25(18–37) %predicted, residual volume 231 (182–376) %predicted). Thirteen patients received SoC (100% female, 59 (44–74) years, FEV1 25 (19–37) %predicted, residual volume 225 (152–279) %predicted. The 6 months median change in dynamic hyperinflation in the treatment group was: + 225 ml (range − 113 to + 803) (p < 0.01) vs 0 ml (− 1067 to + 500) in the control group (p = 0.422). An increase in dynamic hyperinflation was significantly associated with a decrease in residual volume (r = − 0.439, p < 0.01). Conclusion Bronchoscopic lung volume reduction increases the ability for dynamic hyperinflation in patients with severe emphysema. We propose this is a consequence of improved static hyperinflation.

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Sutherland, Tim J. T., Jan O. Cowan, and D. Robin Taylor. "Dynamic Hyperinflation with Bronchoconstriction." American Journal of Respiratory and Critical Care Medicine 177, no. 9 (May 2008): 970–75. http://dx.doi.org/10.1164/rccm.200711-1738oc.

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van der Meer, Akke-Nynke, Kim de Jong, Aranka Hoekstra-Kuik, Elisabeth H. Bel, and Anneke ten Brinke. "Targeting dynamic hyperinflation in moderate-to-severe asthma: a randomised controlled trial." ERJ Open Research 7, no. 3 (June 3, 2021): 00738–2020. http://dx.doi.org/10.1183/23120541.00738-2020.

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BackgroundDynamic hyperinflation is highly prevalent in moderate-to-severe asthma, which may significantly impede activities of daily life. We hypothesised that dynamic hyperinflation in asthma is due to inflammation of large and small airways and can be reduced by systemic anti-inflammatory treatment. Therefore, we investigated the effect of systemic glucocorticoids on dynamic hyperinflation in moderate-to-severe asthma patients and explored the relationships between inflammatory markers and changes in dynamic hyperinflation.MethodsIn this randomised placebo-controlled trial we included 32 asthma patients on inhaled glucocorticoid therapy showing dynamic hyperinflation, defined by a ≥10% reduction in inspiratory capacity measured by standardised metronome-paced tachypnea test. Patients received either triamcinolone (80 mg) or placebo intramuscularly. Before and 2 weeks after treatment, patients completed respiratory health questionnaires, had blood eosinophils and exhaled nitric oxide levels measured, and underwent lung function and dynamic hyperinflation testing.ResultsAfter adjustment for potential confounders, dynamic hyperinflation was significantly reduced by 28.1% in the triamcinolone group and increased by 9.4% in the placebo group (p=0.027). In the triamcinolone-treated patients, the reduction in dynamic hyperinflation was greater in patients with higher blood eosinophils at baseline (r=−0.592, p=0.020) and tended to be associated with a reduction in blood eosinophils (r=0.412, p=0.127) and exhaled nitric oxide (r=0.442, p=0.099).ConclusionsThis exploratory study suggests that dynamic hyperinflation in asthma can be reduced by systemic anti-inflammatory treatment, particularly in patients with elevated blood eosinophils. This supports the hypothesis that dynamic hyperinflation in asthma is due to airway inflammation and should be considered an important target for treatment.

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van Dijk, Marlies, Jorine E. Hartman, Sonja W. S. Augustijn, Nick H. T. ten Hacken, Karin Klooster, and Dirk-Jan Slebos. "Comparison of Multiple Diagnostic Tests to Measure Dynamic Hyperinflation in Patients with Severe Emphysema Treated with Endobronchial Coils." Lung 199, no. 2 (March 9, 2021): 195–98. http://dx.doi.org/10.1007/s00408-021-00430-0.

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Abstract Purpose For this study, we aimed to compare dynamic hyperinflation measured by cardiopulmonary exercise testing (CPET), a six-minute walking test (6-MWT), and a manually paced tachypnea test (MPT) in patients with severe emphysema who were treated with endobronchial coils. Additionally, we investigated whether dynamic hyperinflation changed after treatment with endobronchial coils. Methods Dynamic hyperinflation was measured with CPET, 6-MWT, and an MPT in 29 patients before and after coil treatment. Results There was no significant change in dynamic hyperinflation after treatment with coils. Comparison of CPET and MPT showed a strong association (rho 0.660, p < 0.001) and a moderate agreement (BA-plot, 202 ml difference in favor of MPT). There was only a moderate association of the 6-MWT with CPET (rho 0.361, p 0.024). Conclusion MPT can be a suitable alternative to CPET to measure dynamic hyperinflation in severe emphysema but may overestimate dynamic hyperinflation possibly due to a higher breathing frequency.

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Van Meerhaeghe, A. "Flow limitation and dynamic hyperinflation." European Respiratory Journal 25, no. 4 (April 1, 2005): 772. http://dx.doi.org/10.1183/09031936.05.00009905.

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Gelb, Arthur F., Carlos A. Gutierrez, Idelle M. Weisman, Randy Newsom, Colleen Flynn Taylor, and Noe Zamel. "Simplified Detection of Dynamic Hyperinflation." Chest 126, no. 6 (December 2004): 1855–60. http://dx.doi.org/10.1378/chest.126.6.1855.

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Hannink, Jorien D. C., Hanneke A. C. van Helvoort, P. N. Richard Dekhuijzen, and Yvonne F. Heijdra. "Dynamic Hyperinflation During Daily Activities." Chest 137, no. 5 (May 2010): 1116–21. http://dx.doi.org/10.1378/chest.09-1847.

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Maurer, J. R. "Simplified Detection of Dynamic Hyperinflation." Yearbook of Pulmonary Disease 2006 (January 2006): 76–77. http://dx.doi.org/10.1016/s8756-3452(08)70069-0.

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Gallego Gutierrez, Silvia, Delia Valverde Montoro, Jose Manuel González Gómez, and Guillermo Milano Manso. "Dynamic hyperinflation, a case report." Pediatrics International 62, no. 5 (May 2020): 647–49. http://dx.doi.org/10.1111/ped.14156.

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Wouters, E. F. M. "Nonpharmacological modulation of dynamic hyperinflation." European Respiratory Review 15, no. 100 (December 1, 2006): 90–96. http://dx.doi.org/10.1183/09059180.00010007.

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Calverley, P. M. A. "Dynamic Hyperinflation: Is It Worth Measuring?" Proceedings of the American Thoracic Society 3, no. 3 (May 1, 2006): 239–44. http://dx.doi.org/10.1513/pats.200508-084sf.

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Lougheed, M. Diane, Thomas Fisher, and Denis E. O’Donnell. "Dynamic Hyperinflation During Bronchoconstriction in Asthma." Chest 130, no. 4 (October 2006): 1072–81. http://dx.doi.org/10.1378/chest.130.4.1072.

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Volgyesi, G. A., L. N. Tremblay, P. Webster, N. Zamel, and A. S. Slutsky. "A new ventilator for monitoring lung mechanics in small animals." Journal of Applied Physiology 89, no. 2 (August 1, 2000): 413–21. http://dx.doi.org/10.1152/jappl.2000.89.2.413.

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Researchers investigating the genetic component of various disease states rely increasingly on murine models. We have developed a ventilator to simplify respiratory research in small animals down to murine size. The new ventilator provides constant-flow inflation and tidal volume delivery independent of respiratory parameter changes. The inclusion of end-inspiratory and end-expiratory pauses simplifies the measurement of airway resistance and compliance and allows the detection of dynamic hyperinflation (auto-positive end-expiratory pressure). After bench testing, we performed intravenous methacholine challenge on two strains of mice (A/J and C57bl/bj) known to differ in their responses by using the new ventilator. Dynamic hyperinflation and a decrease in compliance developed during methacholine challenge whenever respiratory rates of 60–120 breaths/min were employed. In contrast, if dynamic hyperinflation was prevented by lengthening expiratory time, (respiratory rate = 20 breaths/min), static compliance remained constant. More importantly, the coefficient of variation of the results decreased when lung volume shifts were prevented. In conclusion, airway challenge studies have greater precision when dynamic hyperinflation is prevented.

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Ort, Vaclav, and Karel Roubik. "Electrical Impedance Tomography Can Be Used to Quantify Lung Hyperinflation during HFOV: The Pilot Study in Pigs." Diagnostics 12, no. 9 (August 28, 2022): 2081. http://dx.doi.org/10.3390/diagnostics12092081.

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Dynamic hyperinflation is reported as a potential risk during high-frequency oscillatory ventilation (HFOV), and its existence has been documented both by physical models and by CT. The aim of this study is to determine the suitability of electrical impendence tomography (EIT) for the measurement of dynamic lung hyperinflation and hypoinflation during HFOV. Eleven healthy pigs were anaesthetized and ventilated using HFOV. The difference between the airway pressure at the airway opening and alveolar space was measured by EIT and esophageal balloons at three mean airway pressures (12, 18 and 24 cm H2O) and two inspiratory to expiratory time ratios (1:1, 1:2). The I:E ratio was the primary parameter associated with differences between airway and alveolar pressures. All animals showed hyperinflation at a 1:1 ratio (median 1.9 cm H2O) and hypoinflation at a 1:2 (median –4.0 cm H2O) as measured by EIT. EIT measurements had a linear correlation to esophageal balloon measurements (r2 = –0.915, p = 0.0085). EIT measurements were slightly higher than that of the esophageal balloon transducer with the mean difference of 0.57 cm H2O. Presence of a hyperinflation or hypoinflation was also confirmed independently by chest X-ray. We found that dynamic hyperinflation developed during HFOV may be detected and characterized noninvasively by EIT.

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Lundström, Niclas, Gert Henriksson, Ola Börjesson, Malin Jonsson Fagerlund, and Johan Petersson. "Circulatory Collapse due to Hyperinflation in a Patient with Tracheobronchomalacia: A Case Report and Brief Review." Case Reports in Critical Care 2019 (January 29, 2019): 1–5. http://dx.doi.org/10.1155/2019/2921819.

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We present a case of repeated cardiac arrests derived from dynamic hyperinflation in a patient with severe tracheobronchomalacia. Mechanical ventilation led to auto-PEEP with hemodynamic impairment and pulseless electric activity. Adjusted ventilation settings, deep sedation, and muscle paralysis followed by acute stenting of the affected collapsing airways restored ventilation and prevented recurrent circulatory collapse. We briefly review the pathophysiology and treatment options in patients with dynamic hyperinflation.

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Baldi, Bruno G., André L. P. Albuquerque, Suzana P. Pimenta, João M. Salge, Ronaldo A. Kairalla, and Carlos R. R. Carvalho. "Exercise Performance and Dynamic Hyperinflation in Lymphangioleiomyomatosis." American Journal of Respiratory and Critical Care Medicine 186, no. 4 (August 15, 2012): 341–48. http://dx.doi.org/10.1164/rccm.201203-0372oc.

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MYLES, P. S., H. MADDER, and E. B. MORGAN. "Intraoperative cardiac arrest after unrecognized dynamic hyperinflation." British Journal of Anaesthesia 74, no. 3 (March 1995): 340–42. http://dx.doi.org/10.1093/bja/74.3.340.

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Gelb, Arthur F., Colleen Flynn Taylor, Patricia A. McClean, Chris M. Shinar, Marcelo T. Rodrigues, Carlos A. Gutierrez, Kenneth R. Chapman, and Noe Zamel. "Tiotropium and Simplified Detection of Dynamic Hyperinflation." Chest 131, no. 3 (March 2007): 690–95. http://dx.doi.org/10.1378/chest.06-1662.

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Rao, Punita. "Chaos Models And The Monetary Dynamics Of Hyperinflation." International Business & Economics Research Journal (IBER) 10, no. 11 (January 17, 2012): 109. http://dx.doi.org/10.19030/iber.v10i11.6766.

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Modern methods of qualitative analysis of dynamic systems go back nearly a century to Poincare (1880, 1892). Since the classic work of Smale (1967), it has become clear that very complicated, or chaotic, trajectories (time path) can easily arise in certain dynamic systems and that such complicates trajectories can persist when small perturbations of the underlying systems occur. Such a phenomenon, referred to as chaos, a case that is emphatically not pathological, is essentially one in which a dynamic mechanism that is very simple, and, above all, deterministic yields a time path so complicated that it will invariably pass all the standard tests of randomness. The seminal contribution of Lorenz (1963), Li and Yorke (1975), May (1976), Stefan (1977), amongst others have greatly facilitated an exploration of the pertinence of such complicated dynamics, arising in simple first order dynamic non-linear systems, to a variety of fields, including physics, biology, ecology and of late economics. In the context of the above literature and the development thereafter we intend to build the model that comprises of four equations. These specific: (1) The demand for real balances, (2) The money- inflation link, (3) the government budget deficit, and (4) the inflation tax revenue. The reduced form of the model is seen to yield a three parameter system whose phase diagram for the inflation rate (expressed in terms of a transcendental equation) produces solutions which are capable of generating stable, cyclic, or chaotic behavior.

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Lotvall, J. O., R. J. Lemen, K. P. Hui, P. J. Barnes, and K. F. Chung. "Airflow obstruction after substance P aerosol: contribution of airway and pulmonary edema." Journal of Applied Physiology 69, no. 4 (October 1, 1990): 1473–78. http://dx.doi.org/10.1152/jappl.1990.69.4.1473.

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We have studied the effects of aerosolized substance P (SP) in guinea pigs with reference to lung resistance and dynamic compliance changes and their recovery after hyperinflation. In addition, we have examined the concomitant formation of airway microvascular leakage and lung edema. Increasing breaths of SP (1.5 mg/ml, 1.1 mM), methacholine (0.15 mg/ml, 0.76 mM), or 0.9% saline were administered to tracheostomized and mechanically ventilated guinea pigs. Lung resistance (RL) increased dose dependently with a maximum effect of 963 +/- 85% of baseline values (mean +/- SE) after SP (60 breaths) and 1,388 +/- 357% after methacholine (60 breaths). After repeated hyperinflations, methacholine-treated animals returned to baseline, but after SP, mean RL was still raised (292 +/- 37%; P less than 0.005). Airway microvascular leakage, measured by extravasation of Evans Blue dye, occurred in the brain bronchi and intrapulmonary airways after SP but not after methacholine. There was a significant correlation between RL after hyperinflation and Evans Blue dye extravasation in intrapulmonary airways (distal: r = 0.89, P less than 0.005; proximal: r = 0.85, P less than 0.01). Examination of frozen sections for peribronchial and perivascular cuffs of edema and for alveolar flooding showed significant degrees of pulmonary edema for animals treated with SP compared with those treated with methacholine or saline. We conclude that the inability of hyperinflation to fully reverse changes in RL after SP may be due to the formation of both airway and pulmonary edema, which may also contribute to the deterioration in RL.

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Marini, John J. "Dynamic Hyperinflation and Auto–Positive End-Expiratory Pressure." American Journal of Respiratory and Critical Care Medicine 184, no. 7 (October 2011): 756–62. http://dx.doi.org/10.1164/rccm.201102-0226pp.

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Dolmage, Thomas E., Rachael A. Evans, and Roger S. Goldstein. "Defining hyperinflation as ‘dynamic’: Moving toward the slope." Respiratory Medicine 107, no. 7 (July 2013): 953–58. http://dx.doi.org/10.1016/j.rmed.2013.02.012.

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Ranieri, V. Marco, Salvatore Grasso, Tommaso Fiore, and Rocco Giuliani. "AUTO–POSITIVE END-EXPIRATORY PRESSURE AND DYNAMIC HYPERINFLATION." Clinics in Chest Medicine 17, no. 3 (September 1996): 379–94. http://dx.doi.org/10.1016/s0272-5231(05)70322-1.

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Solway, J., T. H. Rossing, A. F. Saari, and J. M. Drazen. "Expiratory flow limitation and dynamic pulmonary hyperinflation during high-frequency ventilation." Journal of Applied Physiology 60, no. 6 (June 1, 1986): 2071–78. http://dx.doi.org/10.1152/jappl.1986.60.6.2071.

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Dynamic hyperinflation of the lungs occurs during high-frequency oscillatory ventilation (HFOV) and has been attributed to asymmetry of inspiratory and expiratory impedances. To identify the nature of this asymmetry, we compared changes in lung volume (VL) observed during HFOV in ventilator-dependent patients with predictions of VL changes from electrical analogs of three potential modes of impedance asymmetry. In the patients, when a fixed oscillatory tidal volume was applied at a low mean airway opening pressure (Pao), which resulted in little increase in functional residual capacity, progressively greater dynamic hyperinflation was observed as HFOV frequency, (f) was increased. When mean Pao was raised so that resting VL increased, VL remained at this level during HFOV as f was increased until a critical f was reached; above this value, VL increased further with f in a fashion nearly parallel to that observed when low mean Pao was used. Three modes of asymmetric inspiratory and expiratory impedance were modeled as electrical circuits: 1) fixed asymmetric resistance [Rexp greater than Rinsp]; 2) variable asymmetric resistance [Rexp(VL) greater than Rinsp, with Rexp(VL) decreasing as VL increased]; and 3) equal Rinsp and Rexp, but with superimposed expiratory flow limitation, the latter simulated using a bipolar transistor as a descriptive model of this phenomenon. The fixed and the variable asymmetric resistance models displayed a progressive increase of mean VL with f at either low or high mean Pao. Only the expiratory flow limitation model displayed a dependence of dynamic hyperinflation on mean Pao and f similar to that observed in our patients. We conclude that expiratory flow limitation can account for dynamic pulmonary hyperinflation during HFOV.

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Huang, Y. C., G. G. Weinmann, and W. Mitzner. "Effect of tidal volume and frequency on the temporal fall in lung compliance." Journal of Applied Physiology 65, no. 5 (November 1, 1988): 2040–45. http://dx.doi.org/10.1152/jappl.1988.65.5.2040.

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In this study we have investigated how changes in respiratory frequency and tidal volume in anesthetized dogs affect the fall in dynamic compliance (Cdyn) that occurs with time after a hyperinflation. Results showed that increasing frequency [at controlled arterial (PaCO2)] PCO2 from 16 to 32 breaths/min had no effect on either the rate of fall or the magnitude of the fall up to 1 h after the hyperinflation. However, increasing the tidal volume from 300 to 750 ml abolished the fall in Cdyn from 10 to 50 min after the hyperinflation; the fall within the first 10 min remained unchanged. We also examined the effect of a simulated "hyperinflation" on the compliance of strips of parenchymal tissue in vitro. This result indicated that in the absence of surface forces, parenchymal tissue demonstrates a fall in compliance, which is complete within 10 min. Overall our findings are consistent with the hypothesis that the fall in Cdyn after hyperinflation is a two-phase process. The initial rapid fall in Cdyn (i.e., within 10 min) may simply represent a passive recovery process from the hyperinflation stress on the parenchymal tissue. The slower fall occurring after 10 min likely results from progressive increases in surface tension, and this increase can apparently be blocked by increases in tidal volume.

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Laher, Abdullah E., and Sean K. Buchanan. "Mechanically Ventilating the Severe Asthmatic." Journal of Intensive Care Medicine 33, no. 9 (November 5, 2017): 491–501. http://dx.doi.org/10.1177/0885066617740079.

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The management of the critically ill patients with asthma can be rather challenging. Potentially devastating complications relating to this presentation include hypoxemia, worsening bronchospasm, pulmonary aspiration, tension pneumothorax, dynamic hyperinflation, hypotension, dysrhythmias, and seizures. In contrast to various other pathologies requiring mechanical ventilation, acute asthma is generally associated with better outcomes. This review serves as a practical guide to the physician managing patients with severe acute asthma requiring mechanical ventilation. In addition to specifics relating to endotracheal intubation, we also discuss the interpretation of ventilator graphics, the recommended mode of ventilation, dynamic hyperinflation, permissive hypercapnia, as well as the role of extracorporeal membrane oxygenation and noninvasive mechanical ventilation.

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Soffler, Morgan I., Margaret M. Hayes, and Richard M. Schwartzstein. "Respiratory Sensations in Dynamic Hyperinflation: Physiological and Clinical Applications." Respiratory Care 62, no. 9 (June 27, 2017): 1212–23. http://dx.doi.org/10.4187/respcare.05198.

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Frazão, Murillo, Paulo Eugênio Silva, Wanessa Frazão, Vinícius Zacarias Maldaner da Silva, Marco Aurélio de Valois Correia, and Mansueto Gomes Neto. "Dynamic Hyperinflation Impairs Cardiac Performance During Exercise in COPD." Journal of Cardiopulmonary Rehabilitation and Prevention 39, no. 3 (May 2019): 187–92. http://dx.doi.org/10.1097/hcr.0000000000000325.

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Adler, Andy, Norihiro Shinozuka, Yves Berthiaume, Robert Guardo, and Jason H. T. Bates. "Electrical impedance tomography can monitor dynamic hyperinflation in dogs." Journal of Applied Physiology 84, no. 2 (February 1, 1998): 726–32. http://dx.doi.org/10.1152/jappl.1998.84.2.726.

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Adler, Andy, Norihiro Shinozuka, Yves Berthiaume, Robert Guardo, and Jason H. T. Bates. Electrical impedance tomography can monitor dynamic hyperinflation in dogs. J. Appl. Physiol. 84(2): 726–732, 1998.—We assessed in eight dogs the accuracy with which electrical impedance tomography (EIT) can monitor changes in lung volume by comparing the changes in mean lung conductivity obtained with EIT to changes in esophageal pressure (Pes) and to airway opening pressure (Pao) measured after airway occlusion. The average volume measurement errors were determined: 26 ml for EIT; 35 ml for Pao; and 54 ml for Pes. Subsequently, lung inflation due to applied positive end-expiratory pressure was measured by EIT (ΔVEIT) and Pao (ΔVPao) under both inflation and deflation conditions. Whereas ΔVPaowas equal under both conditions, ΔVEITwas 28 ml greater during deflation than inflation, indicating that EIT is sensitive to lung volume history. The average inflation ΔVEITwas 67.7 ± 78 ml greater than ΔVPao, for an average volume increase of 418 ml. Lung inflation due to external expiratory resistance was measured during ventilation by EIT (ΔVEIT,vent) and Pes (ΔVPes,vent) and at occlusion by EIT (ΔVEIT,occl), Pes, and Pao. The average differences between EIT estimates and ΔVEIT,occlwere 5.8 ± 44 ml for ΔVEIT,ventand 49.5 ± 34 ml for ΔVEIT,occl. The average volume increase for all dogs was 442.2 ml. These results show that EIT can provide usefully accurate estimates of changes in lung volume over an extended time period and that the technique has promise as a means of conveniently and noninvasively monitoring lung hyperinflation.

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Ferreira, Palmira Gabriele, Patrícia Duarte Freitas, Aline Grandi Silva, Desidério Cano Porras, Rafael Stelmach, Alberto Cukier, Frederico Leon Arrabal Fernandes, Milton Arruda Martins, and Celso R. F. Carvalho. "Dynamic hyperinflation and exercise limitations in obese asthmatic women." Journal of Applied Physiology 123, no. 3 (September 1, 2017): 585–93. http://dx.doi.org/10.1152/japplphysiol.00655.2016.

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Obese individuals and patients with asthma can develop dynamic hyperinflation (DH) during exercise; however, no previous study has investigated DH as a factor associated with reduced exercise capacity in obese asthmatic women. The aim of the present study was to examine the occurrence of DH and exercise limitations in obese asthmatics. Obese grade II [obese group (Ob-G); BMI 35–39.9 kg/m2; n=36] and nonobese [nonobese group (NOb-G); BMI 18.5-29.9 kg/m2; n=18] asthmatic patients performed a cardiopulmonary test to quantify peak V̇o2 and a submaximal exercise test to assess DH. Anthropometric measurements, quadriceps endurance, and lung function were also evaluated. A forward stepwise regression was used to evaluate the association between exercise tolerance (wattage) and limiting exercise factors. Fifty-four patients completed the protocol. The Ob-G ( n = 36) presented higher peak V̇o2 values but lower power-to-weight ratio values than the NOb-G ( P <0 .05). DH was more common in the Ob-G (72.2%) than in the NOb-G (38.9%, P < 0.05). The Ob-G had a greater reduction in the inspiratory capacity (−18 vs. −4.6%, P < 0.05). Exercise tolerance was associated with quadriceps endurance ( r = 0.65; p<0.001), oxygen pulse ( r = 0.52; p=0.001), and DH ( r = −0.46, P = 0.005). The multiple regression analysis showed that the exercise tolerance could be predicted from a linear association only for muscular endurance ( r = 0.82 and r2 = 0.67). This study shows that dynamic hyperinflation is a common condition in obese asthmatics; they have reduced fitness for activities of daily living compared to nonobese asthmatics. However, peripheral limitation was the main factor associated with reduced capacity of exercise in these patients. NEW & NOTEWORTHY This is the first study to investigate the occurrence of dynamic hyperinflation (DH) in obese asthmatics. Our results demonstrate that obese asthmatics present a higher frequency and intensity of DH than nonobese asthmatics. We also show that physical deconditioning in this population is linearly associated with cardiac (O2 pulse), respiratory (DH), and peripheral muscle (resistance) limitation. However, multiple linear regression demonstrated that peripheral muscle limitation may explain the exercise limitation in this population.

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O'Donnell, Denis E., and Pierantonio Laveneziana. "The Clinical Importance of Dynamic Lung Hyperinflation in COPD." COPD: Journal of Chronic Obstructive Pulmonary Disease 3, no. 4 (January 2006): 219–32. http://dx.doi.org/10.1080/15412550600977478.

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Asano, Takamitsu, Hiroyuki Ohbayashi, Mitsue Ariga, Osamu Furuta, Sahori Kudo, Junya Ono, and Kenji Izuhara. "Serum periostin reflects dynamic hyperinflation in patients with asthma." ERJ Open Research 6, no. 2 (April 2020): 00347–2019. http://dx.doi.org/10.1183/23120541.00347-2019.

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IntroductionDynamic hyperinflation (DH) is sometimes observed and is associated with impaired daily life activities of asthma. We assessed the relationship between DH and asthma biomarkers (blood eosinophil, fractional exhaled nitric oxide (FeNO) and serum periostin) in patients with asthma.MethodsFifty patients with stable asthma were prospectively recruited and underwent blood test, FeNO measurement, spirometry and metronome-paced tachypnoea (MPT) test to assess DH. In MPT tests, inspiratory capacity (IC) was measured at baseline and after 30 s of MPT with breathing frequencies of 20, 30 and 40 breaths·min−1. DH was assessed by the decline of IC from baseline, and maximal IC reduction ≥10% was considered as positive DH.ResultsThirty patients (60%) showed positive DH. Patients with positive DH showed higher serum periostin levels (107.0±30.7 ng·mL−1) than patients with negative DH (89.7±23.7) (p=0.04). Patients in Global Initiative for Asthma treatment steps 4–5 (n=19) showed higher serum periostin levels (p=0.01) and more severe IC reduction after MPT (p<0.0001) than patients in steps 1–3 (n=31). Maximal IC reduction after MPT was significantly correlated with asthma control test score (r=−0.28, p=0.05), forced expiratory volume in 1 s (r=−0.56, p<0.0001), and serum periostin levels (r=0.41, p=0.003).ConclusionSerum periostin may have the possibility to reflect DH in patients with stable asthma.

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Perel, A., and E. Segal. "Systolic pressure variation-a way to recognize dynamic hyperinflation." British Journal of Anaesthesia 76, no. 1 (January 1996): 168–69. http://dx.doi.org/10.1093/bja/76.1.168-a.

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Agusti, A., and J. B. Soriano. "Dynamic hyperinflation and pulmonary inflammation: a potentially relevant relationship?" European Respiratory Review 15, no. 100 (December 1, 2006): 68–71. http://dx.doi.org/10.1183/09059180.00010003.

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Polkey, M. I. "Surgical procedures in emphysema: any impact on dynamic hyperinflation?" European Respiratory Review 15, no. 100 (December 1, 2006): 96–99. http://dx.doi.org/10.1183/09059180.00010008.

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LoMauro, Antonella, Ambra Cesareo, Fiorenza Agosti, Gabriella Tringali, Desy Salvadego, Bruno Grassi, Alessandro Sartorio, and Andrea Aliverti. "Effects of a multidisciplinary body weight reduction program on static and dynamic thoraco-abdominal volumes in obese adolescents." Applied Physiology, Nutrition, and Metabolism 41, no. 6 (June 2016): 649–58. http://dx.doi.org/10.1139/apnm-2015-0269.

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The objective of this study was to characterize static and dynamic thoraco-abdominal volumes in obese adolescents and to test the effects of a 3-week multidisciplinary body weight reduction program (MBWRP), entailing an energy-restricted diet, psychological and nutritional counseling, aerobic physical activity, and respiratory muscle endurance training (RMET), on these parameters. Total chest wall (VCW), pulmonary rib cage (VRC,p), abdominal rib cage (VRC,a), and abdominal (VAB) volumes were measured on 11 male adolescents (Tanner stage: 3–5; BMI standard deviation score: >2; age: 15.9 ± 1.3 years; percent body fat: 38.4%) during rest, inspiratory capacity (IC) maneuver, and incremental exercise on a cycle ergometer at baseline and after 3 weeks of MBWRP. At baseline, the progressive increase in tidal volume was achieved by an increase in end-inspiratory VCW (p < 0.05) due to increases in VRC,p and VRC,a with constant VAB. End-expiratory VCW decreased with late increasing VRC,p, dynamically hyperinflating VRC,a (p < 0.05), and progressively decreasing VAB (p < 0.05). After MBWRP, weight loss was concentrated in the abdomen and total IC decreased. During exercise, abdominal rib cage hyperinflation was delayed and associated with 15% increased performance and reduced dyspnea at high workloads (p < 0.05) without ventilatory and metabolic changes. We conclude that otherwise healthy obese adolescents adopt a thoraco-abdominal operational pattern characterized by abdominal rib cage hyperinflation as a form of lung recruitment during incremental cycle exercise. Additionally, a short period of MBWRP including RMET is associated with improved exercise performance, lung and chest wall volume recruitment, unloading of respiratory muscles, and reduced dyspnea.

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Benfante, Alida, Fabiano Di Marco, Silvia Terraneo, Stefano Centanni, and Nicola Scichilone. "Dynamic hyperinflation during the 6-min walk test in severely asthmatic subjects." ERJ Open Research 4, no. 2 (April 2018): 00143–2017. http://dx.doi.org/10.1183/23120541.00143-2017.

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We tested the hypothesis that dynamic hyperinflation develops in severe asthmatic subjects during exercise. Changes in inspiratory capacity (IC) were measured during the 6-min walk test (6MWT) in severe asthmatic subjects compared with chronic obstructive pulmonary disease (COPD) subjects with a similar degree of bronchial obstruction. We assessed whether changes in IC were associated with changes in dyspnoea perception.27 severe asthmatic subjects (10 males and 17 females) and 43 COPD subjects (35 males and eight females) were recruited. The two groups performed similarly in the 6MWT (p=0.90). At the end of the test, the Borg score increased significantly in both groups (mean difference: for asthmatic subjects 1.7±1.6; p<0.0001; for COPD subjects 3.1±1.9; p<0.0001). IC measured at the beginning of 6MWT was not different between groups (2.25±0.47 L in asthmatic subjects versus 2.38±0.60 L in COPD subjects; p=0.32) and decreased in both groups (mean difference: for asthmatic subjects 0.160 L; p=0.02; for COPD subjects 0.164 L; p<0.0001). However, changes in IC were significantly associated with changes in the Borg score in the COPD group (r2=0.17; p=0.006), but not in the asthma group (r2=0.06; p=0.20).In severe asthmatic subjects, IC significantly drops during the 6MWT to the same extent as COPD subjects with a similar degree of lung impairment, indicating the development of dynamic hyperinflation. Contrary to COPD, in asthmatic subjects the occurrence of dynamic hyperinflation was not associated with changes in dyspnoea perception.

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Cheyne, William S., Jinelle C. Gelinas, and Neil D. Eves. "Hemodynamic effects of incremental lung hyperinflation." American Journal of Physiology-Heart and Circulatory Physiology 315, no. 3 (September 1, 2018): H474—H481. http://dx.doi.org/10.1152/ajpheart.00229.2018.

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Dynamic hyperinflation (DH) is common in chronic obstructive pulmonary disease and is associated with dyspnea and exercise intolerance. DH also has adverse cardiac effects, although the magnitude of DH and the mechanisms responsible for the hemodynamic impairment remain unclear. We hypothesized that incrementally increasing DH would systematically reduce left ventricular (LV) end-diastolic volume (LVEDV) and LV stroke volume (LVSV) because of direct ventricular interaction. Twenty-three healthy subjects (22 ± 2 yr) were exposed to varying degrees of expiratory loading to induce DH such that inspiratory capacity was decreased by 25%, 50%, 75%, and 100% (100% DH = inspiratory capacity of resting tidal volume plus inspiratory reserve volume ≈ 0.5 l). LV volumes, LV geometry, inferior vena cava collapsibility, and LV end-systolic wall stress were assessed by triplane echocardiography. 25% DH reduced LVEDV (−6 ± 5%) and LVSV (−9 ± 8%). 50% DH elicited a similar response in LVEDV (−6 ± 7%) and LVSV (−11 ± 10%) and was associated with significant septal flattening [31 ± 32% increase in the radius of septal curvature at end diastole (RSC-ED)]. 75% DH caused a larger reduction in LVEDV and LVSV (−9 ± 7% and −16 ± 10%, respectively) and RSC-ED (49 ± 70%). 100% DH caused the largest reduction in LVEDV and LVSV (−13 ± 9% and −18 ± 9%) and an increase in RSC-ED (56 ± 63%). Inferior vena cava collapsibility and LV afterload (LV end-systolic wall stress) were unchanged at all levels of DH. Modest DH (−0.6 ± 0.2 l inspiratory reserve volume) reduced LVSV because of reduced LVEDV, likely because of increased pulmonary vascular resistance. At higher levels of DH, direct ventricular interaction may be the primary cause of attenuated LVSV, as indicated by septal flattening because of a greater relative increase in right ventricular pressure and/or mediastinal constraint. NEW & NOTEWORTHY By systematically reducing inspiratory capacity during spontaneous breathing, we demonstrate that dynamic hyperinflation (DH) progressively reduces left ventricular (LV) end diastolic volume and LV stroke volume. Evidence of significant septal flattening suggests that direct ventricular interaction may be primarily responsible for the reduced LV stroke volume during DH. Hemodynamic impairment appears to occur at relatively lower levels of DH and may have important clinical implications for patients with chronic obstructive pulmonary disease.

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Casaburi, Richard. "Strategies to reduce dynamic hyperinflation in chronic obstructive pulmonary disease." Pneumonologia i Alergologia Polska 77, no. 2 (March 16, 2009): 192–95. http://dx.doi.org/10.5603/arm.27840.

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O'DONNELL, DENIS E, SUSAN M REVILL, and KATHERINE A WEBB. "Dynamic Hyperinflation and Exercise Intolerance in Chronic Obstructive Pulmonary Disease." American Journal of Respiratory and Critical Care Medicine 164, no. 5 (September 2001): 770–77. http://dx.doi.org/10.1164/ajrccm.164.5.2012122.

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Pecchiari, Matteo, Andrea Pelucchi, Emanuela D'Angelo, Antonio Foresi, Joseph Milic-Emili, and Edgardo D'Angelo. "Effect of Heliox Breathing on Dynamic Hyperinflation in COPD Patients." Chest 125, no. 6 (June 2004): 2075–82. http://dx.doi.org/10.1378/chest.125.6.2075.

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Silva, Cláudia S., Fabiana R. Nogueira, Elias F. Porto, Mariana R. Gazzotti, Oliver A. Nascimento, Aquiles Camelier, and José R. Jardim. "Dynamic hyperinflation during activities of daily living in COPD patients." Chronic Respiratory Disease 12, no. 3 (April 20, 2015): 189–96. http://dx.doi.org/10.1177/1479972315576143.

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YAN, SHENG, and BENGT KAYSER. "Differential Inspiratory Muscle Pressure Contributions to Breathing during Dynamic Hyperinflation." American Journal of Respiratory and Critical Care Medicine 156, no. 2 (August 1997): 497–503. http://dx.doi.org/10.1164/ajrccm.156.2.9611073.

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Richter, Manuel J., Robert Voswinckel, Henning Tiede, Richard Schulz, Christian Tanislav, Andreas Feustel, Rory E. Morty, Hossein A. Ghofrani, Werner Seeger, and Frank Reichenberger. "Dynamic hyperinflation during exercise in patients with precapillary pulmonary hypertension." Respiratory Medicine 106, no. 2 (February 2012): 308–13. http://dx.doi.org/10.1016/j.rmed.2011.10.018.

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Bake, Björn, Birgitta Houltz, and Patrik Sjölund. "High tidal end expiratory flow ? an index of dynamic hyperinflation?" Clinical Physiology and Functional Imaging 27, no. 2 (March 2007): 116–21. http://dx.doi.org/10.1111/j.1475-097x.2007.00721.x.

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Lahaije, Anke J. M. C., Laura M. Willems, Hieronymus W. H. van Hees, P. N. Richard Dekhuijzen, Hanneke A. C. van Helvoort, and Yvonne F. Heijdra. "Diagnostic accuracy of metronome-paced tachypnea to detect dynamic hyperinflation." Clinical Physiology and Functional Imaging 33, no. 1 (September 2, 2012): 62–69. http://dx.doi.org/10.1111/j.1475-097x.2012.01164.x.

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Mediano, Olga, Raquel Casitas, Carlos Villasante, Elisabet Martínez-Cerón, Raúl Galera, Ester Zamarrón, and Francisco García-Río. "Dynamic hyperinflation in patients with asthma and exercise-induced bronchoconstriction." Annals of Allergy, Asthma & Immunology 118, no. 4 (April 2017): 427–32. http://dx.doi.org/10.1016/j.anai.2017.01.005.

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Myles, P. S., A. B. Evans, H. Madder, and A. M. Weeks. "Dynamic Hyperinflation: Comparison of Jet Ventilation versus Conventional Ventilation in Patients with Severe End-Stage Obstructive Lung Disease." Anaesthesia and Intensive Care 25, no. 5 (October 1997): 471–75. http://dx.doi.org/10.1177/0310057x9702500503.

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Positive pressure ventilation in patients with obstructive lung disease may result in over-inflation of the relatively compliant lungs, resulting in dynamic hyperinflation (DHI). Using a crossover trial design, we compared high-frequency jet ventilation (HFJV) versus “optimal” intermittent positive pressure ventilation (IPPV) in ten patients undergoing lung transplantation for severe, end-stage obstructive lung disease. We measured haemodynamics and the degree of DHI after both modes of ventilation. There were no significant differences between IPPV and HFJV, with respect to efficiency of ventilation (PaCO2), haemodynamic effects (stroke volume, blood pressure and cardiac output), or lung hyperinflation (trapped gas volume). This study suggests that HFJV, when compared with optimal IPPV, is no better at minimizing DHI in patients with severe, end-stage obstructive lung disease.

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Journal articles on the topic 'Dynamic hyperinflation'

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