Exacerbations of chronic obstructive pulmonary disease (COPD) are natural events in the progression of the disease, and are characterised by acute worsening of symptoms, especially dyspnoea. These heterogeneous events follow increased airway inflammation, often due to infection, and lead to decreased airflow and increased lung hyperinflation relative to stable COPD. Although exacerbation freque...

Living-donor lobar lung transplantation seems to be best suited for children and small adults because only two lobes are transplanted. However, the amount of tolerable size discrepancy between donors and recipients is currently unknown. We report two cases of lymphangioleiomyomatosis with hyperinflation successfully treated with living-donor lobar lung transplantation in spite of large size dis...

Bronchial atresia is a rare pulmonary anomaly characterized by a blindly-terminating bronchus, mucoid impaction, and hyperinflation of the obstructed segment of the lung.1 Chest radiographic findings typically show mucoid impaction, segmental overinflation, and hypovascularity, although most patients do not have any respiratory symptoms.1,2 We herein present 2 cases of bronchial atresia with un...

To examine the relationship between end-expiratory lung volume and respiratory muscle work during acute bronchoconstriction, we measured the work of breathing in nine asthmatic subjects, in whom bronchoconstriction was induced with histamine aerosol. When the forced expiratory volume in one second (FEV1) fell below 60% of the control value, work was measured at the spontaneously hyperinflated l...

The optimal strategy for monitoring cystic fibrosis lung disease in infancy remains unclear. Our objective was to describe longitudinal associations between infant pulmonary function tests, chest radiograph scores and other characteristics. Cystic fibrosis patients aged ≤24 months were enrolled in a 10-centre study evaluating infant pulmonary function tests four times over a year. Chest radiogr...

To examine the effect of hyperinflation on the volume displaced by diaphragm motion (DeltaVdi), we compared nine subjects with emphysema and severe hyperinflation [residual volume (RV)/total lung capacity (TLC) 0.65 +/- 0.08; mean +/- SD] with 10 healthy controls. Posteroanterior and lateral chest X rays at RV, functional residual capacity, one-half inspiratory capacity, and TLC were used to me...

BACKGROUND Computer tomography (CT) densitometry is a potential tool for detecting the progression of emphysema but the optimum methodology is uncertain. The level of inspiration affects reproducibility but the ability to adjust for this variable is facilitated by whole lung scanning methods. However, emphysema is frequently localised to sub-regions of the lung and targeted densitometric sampli...

BACKGROUND Maintenance of spontaneous breathing is advocated in mechanical ventilation. This study evaluates the effect of spontaneous breathing on regional lung characteristics during high-frequency oscillatory (HFO) ventilation in an animal model of mild lung injury. METHODS Lung injury was induced by lavage with normal saline in eight pigs (weight range 47-64 kg). HFO ventilation was appli...

INTRODUCTION Cyclic recruitment-derecruitment and overdistension contribute to ventilator-induced lung injury. Tidal volume (Vt) may influence both, cyclic recruitment-derecruitment and overdistension. The goal of this study was to determine if decreasing Vt from 6 to 4 ml/kg reduces cyclic recruitment-derecruitment and hyperinflation, and if it is possible to avoid severe hypercapnia. METHOD...