The Response to Respiratory Resistance

Moore, Richmond L.; Binger, Carl A. L.

doi:10.1084/jem.45.6.1065

Cited by 70 publications

(21 citation statements)

References 2 publications

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“…Lorber [6] and Reichsman [2] both cite Moore and Binger [17]. L orber also cites Barach and E ckman [18] and Loeb [19], while Reichsman cites Auer and G ates [20] and Barach [21].…”

Section: The Effect O F Laryngeal Paralysis On the Lungmentioning

confidence: 99%

“…M oore and B in g e r describe dogs studied under large doses of barbital [17]. Despite severe obstructions, at no time did they achieve a fall in the negative pressure found in the trachea during inspiration.…”

Section: The Effect O F Laryngeal Paralysis On the Lungmentioning

confidence: 99%

“…Much of the more basic work on respiratory obstruction cited by L orber, Reichsman and others was also done under barbiturate anesthesia [2,3,6,17,18,21,36,38]. Auer and G ates used ether [20].…”

Section: The Effect O F Laryngeal Paralysis On the Lungmentioning

confidence: 99%

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The Effects of Components of Vagotomy on the Lung and the Effects of Anesthesia on Vagotomy Induced Lung Change

Shanklin¹,

Sotelo‐Avila²

1967

Neonatology

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“…Lorber [6] and Reichsman [2] both cite Moore and Binger [17]. L orber also cites Barach and E ckman [18] and Loeb [19], while Reichsman cites Auer and G ates [20] and Barach [21].…”

Section: The Effect O F Laryngeal Paralysis On the Lungmentioning

confidence: 99%

Section: The Effect O F Laryngeal Paralysis On the Lungmentioning

confidence: 99%

See 1 more Smart Citation

The Effects of Components of Vagotomy on the Lung and the Effects of Anesthesia on Vagotomy Induced Lung Change

Shanklin¹,

Sotelo‐Avila²

1967

Neonatology

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“…1 In 1977, Oswalt and colleagues reported a series of adult cases involving pulmonary edema associated with a laryngeal tumour, strangulation and interrupted hanging. 2 It has been reported following foreign-body aspiration and the relief of airway obstruction from croup and epiglottitis in children.…”

Section: Discussionmentioning

confidence: 99%

Postobstructive pulmonary edema associated with a substernal goitre

Liu

Shih

Chen

2012

CMAJ

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A 50-year-old woman had experienced 6 months of mild shortness of breath and noise while breathing. She was obese with a body mass index of 32. Her primary care physician found a neck mass; results of a serum thyroid function test were normal. Her symptoms remitted spontaneously, and she ignored advice to seek further evaluation. Six months later, she had her first episode of dyspnea with cyanosis, followed by decreased consciousness. When the ambulance arrived, her Glasgow Coma Scale score was 7 and her peripheral oxygen saturation was 60%. A nonrebreather oxygen mask was applied during transport.On arrival at the emergency department, the patient's respiratory rate was 30 breaths/min, pulse rate was 80 beats/min, blood pressure was 107/61 mm Hg and peripheral oxygen saturation was 76%; her Glasgow Coma Scale score had deteriorated to 6. Blood gas analysis revealed pH 6.7, PCO 2 99.1 mm Hg, PO 2 91.3 mm Hg and HCO 3 11.0 mmol/L, which was consistent with mixed respiratory acidosis and metabolic acidosis. Physical examination showed diffuse rales and some wheezing. After emergent endotracheal intubation, the patient regained consciousness. The endotracheal tube contained copious amounts of a pink frothy secretion. Brain computed tomography scans were normal. Chest radiography done after intubation showed ground-glass opacities bilaterally, suggestive of pulmonary edema ( Figure 1A).Laboratory test results revealed d-dimer levels up to 10.5 (normal < 0.5) µg/mL. Computed tomography of the chest with contrast indicated no filling defect in the pulmonary arteries. There was a nodule visualized that measured 4.0 × 4.5 × 7.0 cm in the right thyroid lobe, with intrathoracic extension (Figure 2). Electrocardiography showed ST segment depressions in leads II, III, aVF, V5 and V6. Further laboratory results were as follows: creatine phosphokinase 527 (normal 26-192) U/L; creatine phosphokinasemyocardial band 40 (normal < 25) U/L and troponin I 1.73 (normal < 0.50) µg/L. Echocardiography showed hypokinesia over the anterolateral and basal septum with an ejection fraction of 40%. Coronary arteriography was normal. Results of thyroid function and virus serologic tests were negative.Subsequent chest radiography, 29 hours after intubation, showed resolution of the interstitial, patchy infiltrations ( Figure 1B). A second echocardiogram showed normal systolic function with an ejection fraction of 62%. The endotracheal tube was removed after weaning criteria were met and after a successful spontaneous breathing trial with a T-piece circuit. Two hours after extubation, the patient had a second episode of respiratory distress accompanied by stridor with hypoxemia and altered consciousness. Her condition was unresponsive to intravenous hydro cortisone and bilevel positive airway pressure ventilation. After reintubation, she recovered immediately. The patient underwent a tracheostomy and was transferred to the regular ward. She had a third episode of respiratory distress with desaturation 12 hours after the tracheostomy tube was re...

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“…Furthermore, a lower or more negative intrapleural pressure develops during the inspiratory phase when breathing against a resistance. The pathological consequences of obstructed breathing, namely pulmonary congestion, have been demonstrated in animals by Moore and Binger (4,5) and Barach and his associates (6)(7)(8).…”

mentioning

confidence: 99%

Physiological Effects of Mechanical Exsufflation on Experimental Obstructive Breathing in Human Subjects 1

Cherniack¹,

Gordon²,

Drimmer³

1952

J. Clin. Invest.

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The increased physical effort necessary to breathe through a constricted orifice results in an instantaneous and uncomfortable sensation of dyspnea. The immediate sensation of difficulty in breathing is aroused by proprioceptive reflexes. The duration of inspiration and expiration becomes markedly prolonged, (1, 2) and in spite of the increased work entailed, the peak volume flow rates diminish. The minute ventilation has been shown by Cain and Otis (1) to decrease. Haldane and Priestley (3) and others (1, 4) also noted that hypoxia and retention of carbon dioxide develops due to the prolonged duration of the respiratory cycle and reduced alveolar ventilation, resulting from obstructed breathing. Furthermore, a lower or more negative intrapleural pressure develops during the inspiratory phase when breathing against a resistance. The pathological consequences of obstructed breathing, namely pulmonary congestion, have been demonstrated in animals by Moore and Binger (4, 5) and Barach and his associates (6)(7)(8).During the initial studies on the physiological effects of exsufflation, the principle of which is described in Methods, it was noted that the physical effort required to breathe against a resistance introduced at the mouth was markedly diminished (9, 10). Since exsufflation appeared subjectively to relieve dyspnea it was of interest to study its physiological effect on experimentally produced obstructed breathing in normal human subjects. METHODSTwo mechanical methods of simulating a cough in man were originally devised by Barach and his coworkers (9-11) as a means of eliminating secretions in patients who are unable to cough effectively. One of these methods, exsufflation, i.e., rapid movement of air from the lungs, is accomplished by enclosing the body of the patient in a conventional tank respirator. A negative intra-tank pressure of 40 mm. Hg, developed over a two-second period by a motor blower unit attached to the respirator, is followed by a rapid return to atmospheric pressure in 0.06 seconds by means of a swift-opening

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The Response to Respiratory Resistance

Cited by 70 publications

References 2 publications

The Effects of Components of Vagotomy on the Lung and the Effects of Anesthesia on Vagotomy Induced Lung Change

The Effects of Components of Vagotomy on the Lung and the Effects of Anesthesia on Vagotomy Induced Lung Change

Postobstructive pulmonary edema associated with a substernal goitre

Physiological Effects of Mechanical Exsufflation on Experimental Obstructive Breathing in Human Subjects 1

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