What is it about?
Lung hyperinflation during asthma exacerbations, increases respiratory muscles mechanical load and reduces inspiratory capacity, leading to muscle fatigue and respiratory failure in severe cases. Presently it is unclear whether hyperinflation during airway obstruction is passively caused by reduced expiratory flow, or by an active mechanism aimed at preventing airway closure. Here we present a novel imaging approach to study the distension of individual airway by its surrounding parenchyma and evaluate non-invasively the relationship between individual airway closure and lung expansion.
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Why is it important?
The main findings of our study support the concept that the elevation of lung volume following bronchoconstriction is not caused by a passive mechanism but rather by an actively controlled process aimed at keeping open the least stable segmental airway of the lung. This novel mechanistic insight may lead to improved understanding of asthma symptoms and their management. Furthermore, the imaging method for assessing individual airway distensibility relative to that of its surrounding parenchyma presented for the first time in this paper could have other clinical applications on early diagnosis and/or treatment of other diseases affecting airways and parenchyma.
Perspectives
Excited that our work showed, for the first time, that the lung volume spontaneously chosen by a broncho-constricted subject during quiet breathing, could be predicted based on the behavior of a single segmental airway: that airway that would have closed first if the lung volume had not increased to that level. This finding points to the existence of a possible neurological mechanism to control the end of exhalation at a high enough volume to prevent the catastrophic closure of airways.
Juan Osorio
GEMEDCO
Read the Original
This page is a summary of: Elevation in lung volume and preventing catastrophic airway closure in asthmatics during bronchoconstriction, PLOS One, December 2018, PLOS,
DOI: 10.1371/journal.pone.0208337.
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