Chest wall hyperinflation during acute bronchoconstriction in asthma

Massimo Gorini, Iacopo Iandelli, Gianni Misuri, Francesco Bertoli, Mario Filippelli, Marco Mancini, Roberto Duranti, Francesco Gigliotti, Giorgio Scano

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

The mechanics of the chest wall was studied in seven asthmatic patients before and during histamine-induced bronchoconstriction (B). The volume of the chest wall (VCW) was calculated by three-dimensional tracking of 89 chest wall markers. Pleural (PpI) and gastric (Pga) pressures were simultaneously recorded. VCW was modeled as the sum of the volumes of the pulmonary-apposed rib cage (VRC,p), diaphragm-apposed rib cage (VRC,a), and abdomen (VAB). During B, hyperinflation was due to the increase in end-expiratory volume of the rib cage (0.63 ± 0.09 L, p <0.01), whereas change in VAB was inconsistent (0.09 ± 0.07 L, NS) because of phasic recruitment of abdominal muscles during expiration. Changes in end-expiratory VRC,p and VRC,a) were along the rib cage relaxation configuration, indicating that both compartments shared proportionally the hyperinflation. VRC,p-PpI plot during B was displaced leftward of the relaxation curve, suggesting persistent activity of rib cage inspiratory muscles throughout expiration. Changes in end-expiratory VCW during B did not relate to changes in FEV1 or time and volume components of the breathing cycle. We concluded that during B in asthmatic patients: (1) rib cage accounts largely for the volume of hyperinflation, whereas abdominal muscle recruitment during expiration limits the increase in VAB; (2) hyperinflation is influenced by sustained postinspiratory activity of the inspiratory muscles; (3) this pattern of respiratory muscle recruitment seems to minimize volume distortion of the rib cage at end-expiration and to preserve diaphragm length despite hyperinflation.

Original languageEnglish
Pages (from-to)808-816
Number of pages9
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume160
Issue number3
Publication statusPublished - 1999

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Bronchoconstriction
Thoracic Wall
Asthma
Abdomen
Abdominal Muscles
Diaphragm
Muscles
Respiratory Muscles
Rib Cage
Mechanics
Histamine
Stomach
Respiration
Pressure
Lung

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Gorini, M., Iandelli, I., Misuri, G., Bertoli, F., Filippelli, M., Mancini, M., ... Scano, G. (1999). Chest wall hyperinflation during acute bronchoconstriction in asthma. American Journal of Respiratory and Critical Care Medicine, 160(3), 808-816.

Chest wall hyperinflation during acute bronchoconstriction in asthma. / Gorini, Massimo; Iandelli, Iacopo; Misuri, Gianni; Bertoli, Francesco; Filippelli, Mario; Mancini, Marco; Duranti, Roberto; Gigliotti, Francesco; Scano, Giorgio.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 160, No. 3, 1999, p. 808-816.

Research output: Contribution to journalArticle

Gorini, M, Iandelli, I, Misuri, G, Bertoli, F, Filippelli, M, Mancini, M, Duranti, R, Gigliotti, F & Scano, G 1999, 'Chest wall hyperinflation during acute bronchoconstriction in asthma', American Journal of Respiratory and Critical Care Medicine, vol. 160, no. 3, pp. 808-816.
Gorini M, Iandelli I, Misuri G, Bertoli F, Filippelli M, Mancini M et al. Chest wall hyperinflation during acute bronchoconstriction in asthma. American Journal of Respiratory and Critical Care Medicine. 1999;160(3):808-816.
Gorini, Massimo ; Iandelli, Iacopo ; Misuri, Gianni ; Bertoli, Francesco ; Filippelli, Mario ; Mancini, Marco ; Duranti, Roberto ; Gigliotti, Francesco ; Scano, Giorgio. / Chest wall hyperinflation during acute bronchoconstriction in asthma. In: American Journal of Respiratory and Critical Care Medicine. 1999 ; Vol. 160, No. 3. pp. 808-816.
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