Journal article
Chest wall strapping increases expiratory airflow and detectable airway segments in computer tomographic scans of normal and obstructed lungs
Journal of applied physiology (1985), Vol.124(5), pp.1186-1193
05/01/2018
DOI: 10.1152/japplphysiol.00184.2017
PMCID: PMC6008079
PMID: 29357485
Abstract
Chest wall strapping (CWS) induces breathing at low lung volumes but also increases parenchymal elastic recoil. In this study, we tested the hypothesis that CWS dilates airways via airway-parenchymal interdependence. In 11 subjects (6 healthy and 5 with mild to moderate COPD), pulmonary function tests and lung volumes were obtained in control (baseline) and the CWS state. Control and CWS-CT scans were obtained at 50% of control (baseline) total lung-capacity (TLC). CT lung volumes were analyzed by CT volumetry. If control and CWS-CT volumetry did not differ by more than 25%, airway dimensions were analyzed via automated airway segmentation. CWS-TLC was reduced on average to 71% of control-TLC in normal subjects and 79% of control-TLC in subjects with COPD. CWS increased expiratory airflow at 50% of control-TLC by 41% (3.50 ± 1.6 vs. 4.93 ± 1.9 l/s,
P
= 0.04) in normals and 316% in COPD(0.25 ± 0.05 vs 0.79 ± 0.39 l/s,
P
= 0.04). In 10 subjects (5 normals and 5 COPD), control and CWS-CT scans at 50% control-TLC did not differ more than 25% on CT volumetry and were included in the airway structure analysis. CWS increased the mean number of detectable airways with a diameter of ≤2 mm by 32.5% (65 ± 10 vs. 86 ± 124,
P
= 0.01) in normal subjects and by 79% (59 ± 19 vs. 104 ± 16,
P
= 0.01) in subjects with COPD. There was no difference in the number of detectable airways with diameters 2–4 mm and >4 mm in normal or in COPD subjects. In conclusion, CWS enhances the detection of small airways via automated CT airway segmentation and increases expiratory airflow in normal subjects as well as in subjects with mild to moderate COPD.
NEW & NOTEWORTHY
In normal and COPD subjects, chest wall strapping(CWS) increased the number of detectable small airways using automated CT airway segmentation. The concept of dysanapsis expresses the physiological variation in the geometry of the tracheobronchial tree and lung parenchyma based on development. We propose a dynamic concept to dysanapsis in which CWS leads to breathing at lower lung volumes with a corresponding increase in the size of small airways, a potentially novel, nonpharmacological treatment for COPD.
Details
- Title: Subtitle
- Chest wall strapping increases expiratory airflow and detectable airway segments in computer tomographic scans of normal and obstructed lungs
- Creators
- Hisham Taher - Department and Internal MedicineChristian Bauer - Department of Electrical and Computer EngineeringEric Abston - Department and Internal MedicineDavid W Kaczka - Department of AnesthesiologySurya P Bhatt - Division of Pulmonary, Allergy, and Critical Care MedicineJoseph Zabner - Department and Internal MedicineRoy G Brower - Division of Pulmonary and Critical Care MedicineReinhard R Beichel - Department and Internal MedicineMichael Eberlein - Department and Internal Medicine
- Resource Type
- Journal article
- Publication Details
- Journal of applied physiology (1985), Vol.124(5), pp.1186-1193
- Publisher
- American Physiological Society; Bethesda, MD
- DOI
- 10.1152/japplphysiol.00184.2017
- PMID
- 29357485
- PMCID
- PMC6008079
- ISSN
- 8750-7587
- eISSN
- 1522-1601
- Grant note
- R01HL111453 / ; ; UL1TR000442 / ; ;
- Alternative title
- CHEST WALL STRAPPING INCREASES DETECTABLE AIRWAY SEGMENTS
- Language
- English
- Date published
- 05/01/2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Pulmonary, Critical Care, and Occupational Medicine; Anesthesia; Internal Medicine
- Record Identifier
- 9984006481502771
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