Effects of Obesity on Respiratory Resistance

Zérah, Françoise; Harf, Alain; Perlemuter, Léon; Lorino, H.; Lorino, A. M.; Atlan, G

doi:10.1378/chest.103.5.1470

Cited by 389 publications

(331 citation statements)

References 24 publications

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“…Comparing end tidal CO 2 at zero time and 5 minutes intervals in groups I and II, group showed no significant difference in the mean values all over the first hour of surgery. This is in agreement with the results obtained by [21].…”

Section: Resultssupporting

confidence: 93%

Comparative Study between Continuous Thoracic Epidural vs. Thoracic Spinal Anaesthesia in Breast Surgery

Ahmed¹,

Ali²,

Helal³

et al. 2017

J Pain Relief

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Section: Resultssupporting

confidence: 93%

Comparative Study between Continuous Thoracic Epidural vs. Thoracic Spinal Anaesthesia in Breast Surgery

Ahmed¹,

Ali²,

Helal³

et al. 2017

J Pain Relief

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“…In addition, chest wall abnormalities could have infl uenced IOS measurement of respiratory system impedance, but physical examination and chest radiographs revealed normal chest wall structure. Last, obesity is associated with airway abnormality 59,60 ; however, IOS abnormality was noted in nonobese subjects, and no relationship was demonstrable between degree of obesity and TLC. Thus, primary airway dysfunction is more likely in the present study and is supported by bronchodilator responsiveness, nonuniformity of airfl ow distribution, and CT scan evidence for AT and bronchial wall thickening.…”

Section: Acknowledgmentsmentioning

confidence: 97%

Lessons From the World Trade Center Disaster

Berger

Reibman

Oppenheimer

et al. 2013

Chest

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Background: The present study (1) characterizes a physiologic phenotype of restrictive dysfunction due to airway injury and (2) compares this phenotype to the phenotype of interstitial lung disease (ILD). Methods: This is a retrospective study of 54 persistently symptomatic subjects following World Trade Center (WTC) dust exposure. Inclusion criteria were reduced vital capacity (VC), FEV 1 /VC . 77%, and normal chest roentgenogram. Measurements included spirometry, plethysmography, diffusing capacity of lung for carbon monoxide (D LCO ), impulse oscillometry (IOS), inspiratory/expiratory CT scan, and lung compliance (n 5 16). Results: VC was reduced (46% to 83% predicted) because of the reduction of expiratory reserve volume (43% Ϯ 26% predicted) with preservation of inspiratory capacity (IC) (85% Ϯ 16% predicted). Total lung capacity (TLC) was reduced, confi rming restriction (73%

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“…Low lung volumes reduce airway caliber and thus increase airway resistance in the obese. 15,16 The effects of increased body mass on airway closure and on the chest wall also increase the stiffness of the respiratory system. 15,17 Increased resistive and elastic loads are chronic effects of obesity, and are unlikely to cause the episodic symptoms that are typical of asthma, but they could increase the sensation of dyspnea associated with acute airway narrowing.…”

Section: Introductionmentioning

confidence: 99%

“…15,16 The effects of increased body mass on airway closure and on the chest wall also increase the stiffness of the respiratory system. 15,17 Increased resistive and elastic loads are chronic effects of obesity, and are unlikely to cause the episodic symptoms that are typical of asthma, but they could increase the sensation of dyspnea associated with acute airway narrowing. A better understanding of the contribution of resistive and elastic loads to dyspnea in the obese, particularly in the presence of acute airway narrowing, would clarify whether obesity could have a direct effect on the occurrence of asthma symptoms.…”

Section: Introductionmentioning

confidence: 99%

Effect of obesity on breathlessness and airway responsiveness to methacholine in non-asthmatic subjects

et al. 2007

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Background: Obesity is associated with increased prevalence and incidence of asthma, but the mechanism is unknown. Obesity reduces lung volumes, which can increase airway responsiveness, and increases resistive and elastic work of breathing, which can increase dyspnea. Objective: To determine if the intensity of dyspnea due to airway narrowing or if airway responsiveness is increased in obese, non-asthmatic subjects. Subjects: Twenty-three obese (BMI (body mass index) X30 kg m À2 ) and 26 non-obese (BMI o30 kg m À2 ) non-asthmatic subjects, aged between 18 and 70 years. Methods: High-dose methacholine challenge was used to determine the sensitivity and the maximal response to methacholine. Respiratory system resistance (Rrs) and reactance were measured, using the forced oscillation technique, as indicators of resistive and elastic loads during challenge. Perception of dyspnea was measured by the Borg score during challenge. Static lung volumes were measured by body plethysmography. Results: Static lung volumes were reduced in the obese subjects. There were no significant differences in the sensitivity or maximal response to methacholine between obese and non-obese subjects. The magnitude of change in Rrs was similar in both groups, but obese subjects had more negative reactance after challenge (P ¼ 0.002) indicating a greater elastic load. The intensity of dyspnea was greater in obese subjects (P ¼ 0.03). Conclusions: Obesity reduces lung volumes, but does not alter the sensitivity or maximal response to methacholine. However, obese subjects have enhanced perception of dyspnea, associated with greater apparent stiffness of the respiratory system, and may therefore be at greater risk of symptoms.

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Effects of Obesity on Respiratory Resistance

Cited by 389 publications

References 24 publications

Comparative Study between Continuous Thoracic Epidural vs. Thoracic Spinal Anaesthesia in Breast Surgery

Comparative Study between Continuous Thoracic Epidural vs. Thoracic Spinal Anaesthesia in Breast Surgery

Lessons From the World Trade Center Disaster

Effect of obesity on breathlessness and airway responsiveness to methacholine in non-asthmatic subjects

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