Effect of lung volume on lung resistance and elastance in awake subjects measured during sinusoidal forcing

• Published in: Anesthesiology (Philadelphia) Vol. 78; no. 6; pp. 1082 - 1090
• Main Authors: BARNAS, G. M, SPRUNG, J, CRAFT, T. M, WILLIAMS, J.E, RYDER, I. G, YUN, J. A, MACKENZIE, C. F
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01.06.1993
• Subjects: Adult; Airway Resistance - physiology; Biological and medical sciences; Female; Functional Residual Capacity - physiology; Humans; Investigative techniques of respiratory function; Investigative techniques, diagnostic techniques (general aspects); Lung - physiology; Lung Compliance - physiology; Lung Volume Measurements; Male; Medical sciences; Middle Aged; Respiratory Mechanics - physiology; Human; Lung volume; Mechanic of breathing; Lung function; Compliance(volume pressure)
• ISSN: 0003-3022; 1528-1175
• DOI: 10.1097/00000542-199306000-00010

Although lung volume may be changed by certain procedures during anesthesia and mechanical ventilation, dependence of the dynamic mechanical properties of the lungs on lung volume are not clear. Based on studies in dogs, the authors hypothesized that changes in lung mechanics caused by anesthesia in healthy humans could be accounted for by immediate changes in lung volume and that lung resistance will not be decreased by positive end-expiratory airway pressure if tidal volume and respiratory frequency are in the normal ranges. Lung resistance and dynamic lung elastance were measured in six healthy, relaxed, seated subjects during sinusoidal volume oscillations at the mouth (5 mL/kg; 0.4 Hz) delivered at mean airway pressure from -9 to +25 cmH2O. Changes in lung volume from functional residual capacity were measured with inductance plethysmographic belts. Decreases in mean mean airway pressure that caused decreases in lung volume from functional residual capacity comparable to those typically observed during anesthesia were associated with significant increases in both dynamic lung elastance and lung resistance. Increases in mean mean airway pressure that caused increases in lung volume from functional residual capacity did not increase lung resistance and increased dynamic lung elastance only above about 15 cmH2O. Increases in dynamic lung elastance and lung resistance with anesthesia can be explained by the accompanying, acute decreases in lung volume, although other factors may be involved. Increasing lung volume by increasing mean airway pressure with positive end-expiratory pressure will decrease lung resistance only if the original lung volume is low compared to awake, seated functional residual capacity.