Name: combining volumetric capnography and barometric plethysmography to measure the lung structure-function relationship
Uploaded: 2019-01-08T13:00:00
Description: Watch this Scientific Journal Video about Combining Volumetric Capnography And Barometric Plethysmography To Measure The Lung Structure-function Relationship Video at JoVE.com

这项工作由爱荷华州大学卫生和人体生理和内科系资助。这项工作还得到了美国癌症协会的旧黄金研究金研究金研究金研究金研究金研究金研究金研究金研究金研究金 (b茨) 和美国癌症协会的 granga-176-40 的支持, 这些研究报告是通过爱荷华州大学 (贝茨) 的霍尔顿综合癌症中心管理的。

该议定书先前已得到爱荷华州大学机构审查委员会的批准, 并遵循了该委员会制定的准则。所显示的数据是作为爱荷华州大学机构审查委员会批准的项目的一部分收集的。与会者表示了知情同意, 并根据《赫尔辛基宣言》进行了研究。
1. 设备
<ol><li>检查设备表, 以验证所有必需的设备是否可用。使用图 2中设备的图形描述对配置进行仔细检查。</li>
</ol><p...

<ol>
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An old physiology experiment with new relevance to small airways diseases.</a> Annals of the American Thoracic Society. 11 (8), 1258-1266 (2014).</li><li>Taher, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chest+wall+strapping+increases+expiratory+airflow+and+detectable+airway+segments+in+computer+tomographic+scans+of+normal+and+obstructed+lungs.">Chest wall strapping increases expiratory airflow and detectable airway segments in computer tomographic scans of normal and obstructed lungs.</a> Journal of Applied Physiology. , (2017).</li><li>Verscheure, S., Massion, P. 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H., Tusman, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Volumetric+capnography:+the+time+has+come.">Volumetric capnography: the time has come.</a> Current Opinion in Critical Care. 20 (3), 333-339 (2014).</li><li>Wanger, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Standardisation+of+the+measurement+of+lung+volumes.">Standardisation of the measurement of lung volumes.</a> European Respiratory Journal. 26 (3), 511-522 (2005).</li><li>Culver, B. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recommendations+for+a+Standardized+Pulmonary+Function+Report.+An+Official+American+Thoracic+Society+Technical+Statement.">Recommendations for a Standardized Pulmonary Function Report. 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S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lumen+area+change+(Delta+Lumen)+between+inspiratory+and+expiratory+multidetector+computed+tomography+as+a+measure+of+severe+outcomes+in+asthmatic+patients.">Lumen area change (Delta Lumen) between inspiratory and expiratory multidetector computed tomography as a measure of severe outcomes in asthmatic patients.</a> J The Journal of Allergy and Clinical. , (2018).</li><li>Smith, B. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+airway+branch+variation+and+chronic+obstructive+pulmonary+disease.">Human airway branch variation and chronic obstructive pulmonary disease.</a> Proceedings of the National Academy of Sciences of the United States of America. 115 (5), E974-E981 (2018).</li><li>Farmery, A. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Volumetric+Capnography+and+Lung+Growth+in+Children+-+a+Simple-Model+Validated.">Volumetric Capnography and Lung Growth in Children - a Simple-Model Validated.</a> Anesthesiology. 83 (6), 1377-1379 (1995).</li><li>Scherer, P. W., Neufeld, G. R., Aukburg, S. J., Hess, G. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measurement+of+Effective+Peripheral+Bronchial+Cross-Section+from+Single-Breath+Gas+Washout.">Measurement of Effective Peripheral Bronchial Cross-Section from Single-Breath Gas Washout.</a> Journal of Biomechanical Engineering-Transactions of the Asme. 105 (3), 290-293 (1983).</li><li>Sinha, P., Soni, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+volumetric+capnography+and+mixed+expired+gas+methods+to+calculate+physiological+dead+space+in+mechanically+ventilated+ICU+patients.">Comparison of volumetric capnography and mixed expired gas methods to calculate physiological dead space in mechanically ventilated ICU patients.</a> Intensive Care Medicine. 38 (10), 1712-1717 (2012).</li><li>Bourgoin, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+Bohr+and+Enghoff+Dead+Space+Equations+in+Mechanically+Ventilated+Children.">Assessment of Bohr and Enghoff Dead Space Equations in Mechanically Ventilated Children.</a> Respiratory Care. 62 (4), 468-474 (2017).</li></ol>

本文给出了一种测量 v d 和气道均匀性 (斜率) 的协议。这些测量可以在 frc 进行, 也可以作为肺体积的函数。在实验开始前测量 frc, 在扰动之后测量frc , 使 v d 和斜率被绘制为肺体积的函数, 并可能提供有关未从仅在 frc 就有毛细血管造影。
航空的体积和高分辨率结构可以从计算机断层扫描成像 17,18 中获得, 但这需要?...

几十年来, 气体冲洗技术一直被用来提供有关气道树结构和均匀性的重要信息。肺被经典地描述为有两个隔间--一个是由解剖死区和肺泡中发生气体交换的呼吸区组成的传导区。导电气道被称为 "死区", 因为它们不参与氧气和二氧化碳的交换。在单呼吸气体冲洗法中, 呼气的浓度分布可用于确定解剖死空间的体积, 并获得通风均匀性的信息。有些方法依靠惰性气体的呼吸来制定这些措施 (n2、氩、he、sf 6 等)。惰性气体的使用是公认的, 并得到科学共识声明1的支持, 有可用的商业设备与用户友好的界面。然而, 二氧化碳 (co2) 呼出的剖面可用于获得类似的信息。评估二氧化碳的轮廓作为呼出体积的函数, 或体积毛细血管造影, 不需要参与者呼吸特殊的气体混合物, 并允许调查人员灵活地收集有关新陈代谢和气体的其他信息以最小的调整技术进行交换。
在控制呼气过程中, 可根据呼出量总量绘制二氧化碳的浓度。呼气开始时, 死亡空间充满了大气气体。这反映在呼出的 co2 剖面的第一阶段 , 其中有一个无法检测到的 co2 量 (图 1, 上图)。第二阶段标志着向肺泡气体的过渡, 在肺泡中发生气体交换, 而二氧化碳是丰富的。第二阶段中点的体积是解剖死空间 (vd) 的体积。第三阶段含有肺泡气体。由于不同直径的气道在不同速率下呈空, 因此第三阶段的坡度 (s) 提供了有关气道均匀性的信息。第三阶段的陡峭坡度表明, 靠近末端细支气管的气道树不那么均匀, 或与对流有关的不均匀性2。在扰动可能改变二氧化碳产生率的情况下, 为了在个体之间进行比较, 可以将斜率除以曲线下的区域, 以使新陈代谢的差异 (ns 或归一化的坡度) 正常化。体积毛细管以前曾被用来评估空气污染物接触3、4、5、6后气道体积和均匀性的变化。
肺部的气体输送受对流和扩散的影响。单次呼气冲洗措施高度依赖于气流, vd的测量值发生在对流扩散边界。改变呼气或吸入前吸的流速会改变该边界的位置 7。光肺造影也高度依赖于紧接机动之前的肺体积。较大的肺体积使气道扩张, 从而产生更大的vd8值。一种解决方案是在相同的肺体积 (通常是功能剩余容量 (frc)) 下持续测量。这里描述的另一种方法是将体积毛细血管造影与气压胸透结合, 以获得 vd与肺体积之间的关系。然后, 参与者以恒定的流速进行机动, 同时改变肺体积。这仍然允许在 frc 采取经典的捕获措施, 也允许获得肺体积与死空间体积之间的关系以及肺体积与同质性之间的关系。事实上, 耦合毛细血管造影与胸透的附加价值来自于测试关于气道树的扩张性和肺的结构-功能关系的假设的能力。这可能是一个有价值的工具, 调查人员旨在量化气道力学与肺顺应性和弹性对健康和患病人群肺功能的影响9, 10,11.此外, 考虑到进行体积毛细血管测量的绝对肺体积, 调查人员可以描述肥胖、肺等可能改变肺部膨胀状态的疾病的影响移植, 或干预, 如胸壁捆绑。体积毛细血管造影可能最终有临床效用在重症监护室设置12,13。

<table>
	<tbody>
		<tr>
			<td>Computer with dual monitor</td>
			<td>Dell Instruments</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>PowerLab 8/35*</td>
			<td>AD Instruments</td>
			<td>PL3508</td>
			<td></td>
		</tr>
		<tr>
			<td>LabChart Data Acquisition Software*</td>
			<td>AD Instruments</td>
			<td>Version 8</td>
			<td></td>
		</tr>
		<tr>
			<td>Gemini Respiratory Gas Analyzer* (upgraded option)</td>
			<td>CWE, Inc</td>
			<td>GEMINI 14-10000</td>
			<td>*indicates that part is available in the Exercise Physiology package from AD Instruments</td>
		</tr>
		<tr>
			<td>Heated Pneumotach with Heater Controller* (upgraded option)</td>
			<td>Hans Rudolph, Inc</td>
			<td>MLT3813H-V</td>
			<td></td>
		</tr>
		<tr>
			<td>3L Calibration Syringe</td>
			<td>Vitalograph</td>
			<td>36020</td>
			<td></td>
		</tr>
		<tr>
			<td>Nose Clip*</td>
			<td>VacuMed</td>
			<td>Snuffer 1008</td>
			<td></td>
		</tr>
		<tr>
			<td>Pulse Transducer*</td>
			<td>AD Instruments</td>
			<td>TN1012/ST</td>
			<td></td>
		</tr>
		<tr>
			<td>Barometer</td>
			<td>Fischer Scientific</td>
			<td>15-078-198</td>
			<td></td>
		</tr>
		<tr>
			<td>Flanged Mouthpiece*</td>
			<td>AD Instruments</td>
			<td>MLA1026</td>
			<td></td>
		</tr>
		<tr>
			<td>Nafion drying tube with three-way stopcock*</td>
			<td>AD Instruments</td>
			<td>MLA0343</td>
			<td></td>
		</tr>
		<tr>
			<td>Desiccant cartridge (optional for humid environments)*</td>
			<td>AD Instruments</td>
			<td>MLA6024</td>
			<td></td>
		</tr>
		<tr>
			<td>Resistor</td>
			<td>Hans Rudolph, Inc</td>
			<td>7100 R5</td>
			<td></td>
		</tr>
		<tr>
			<td>Flow head adapters*</td>
			<td>AD Instruments</td>
			<td>MLA1081</td>
			<td></td>
		</tr>
		<tr>
			<td>Modified Tubing Adapter (optional)</td>
			<td>AD Instruments</td>
			<td>SP0145</td>
			<td></td>
		</tr>
		<tr>
			<td>Two way non-rebreather valve (optional)*</td>
			<td>AD Instruments</td>
			<td>SP0146</td>
			<td></td>
		</tr>
		<tr>
			<td>Plethysmograph</td>
			<td>Vyaire</td>
			<td>V62J</td>
			<td></td>
		</tr>
		<tr>
			<td>High Purity Helium Gas</td>
			<td>Praxair</td>
			<td>He 4.8</td>
			<td></td>
		</tr>
		<tr>
			<td>6% CO2 and 16% O2 Calibration Gas</td>
			<td>Praxair</td>
			<td>Custom</td>
			<td></td>
		</tr>
		<tr>
			<td>Microsoft Excel</td>
			<td>Microsoft</td>
			<td>Office 365</td>
			<td></td>
		</tr>
	</tbody>
</table>

combining volumetric capnography and barometric plethysmography to measure the lung structure-function relationship

测量肺和气道体积的工具对于有兴趣评估疾病或新疗法对肺影响的肺研究人员来说至关重要。气压胸透造影是一种经典的技术, 以评估肺体积具有悠久的临床使用历史。体积毛细管利用呼出的二氧化碳的轮廓来确定导电气道的体积, 或死的空间, 并提供了气道均匀性的指数。这些技术可以单独使用, 也可以结合使用, 以评估气道体积和同质性对肺体积的依赖性。本文提供了复制这些技术的详细技术说明, 我们的代表性数据表明, 气道体积和均匀性与肺体积高度相关。我们还提供了一个用于分析 capnox-sp衣数据的宏, 可以对其进行修改或调整, 以适应不同的实验设计。这些措施的优点是, 几十年的实验数据支持了它们的优点和局限性, 在没有昂贵的成像设备或技术先进的分析算法的情况下, 它们可以在同一主题中反复制造。这些方法可能对对改变肺和气道体积的功能残余能力的扰动感兴趣的研究人员特别有用。

图 4给出了代表性的超声检查结果。这个参与者需要四次尝试, 以收集三个 frc 值 & lt;5% 的变异性从平均值.% ref 反映了预测值的百分比为每个变量基于人口回归方程, 考虑到性别, 年龄, 种族,身高和体重
图 1(上图) 显示了分析中使用的具有代表性的单个毛细管图,图 1</st...

Watch this Scientific Journal Video about Combining Volumetric Capnography And Barometric Plethysmography To Measure The Lung Structure-function Relationship Video at JoVE.com

Combining Volumetric Capnography And Barometric Plethysmography To Measure The Lung Structure-function Relationship Video (Video) | JoVE

体积摄影与气压面学相结合测量肺结构-功能关系

在这里, 我们描述了肺功能的两个度量--允许测量肺体积的气压胸透和体积毛细血管造影, 这是测量解剖死空和气道均匀性的工具。这些技术可以单独使用, 也可以结合使用, 以评估不同肺体积的气道功能。

Tools to measure lung and airways volume are critical for pulmonary researchers interested in evaluating the impact of disease or novel therapies on the ...

这种方法可以帮助回答肺生理学中的关键问题，特别是关于肺的结构-功能关系如何有助于疾病病理学。该技术的主要优点是，它允许在同一主题内重复测量，而无需昂贵的成像设备或技术先进的分析算法。测量肺结构-功能关系的影响延伸到了解肺疾病的发展，使用经典，成熟的生理工具来评估新的干预措施。虽然这种方法提供了人类肺生理学的见解，但它也可以应用于肺病的动物模型。通常，对此方法的新鲜人士可能难以正确指导学员遵循概述的策略。对于首次参加者，通常需要进行几次练习。这种方法的视觉演示至关重要，因为表顶操作可能难以学习，并且必须仔细控制操作的流量和体积。爱荷华大学机构审查委员会批准了涉及人类主体的程序。在开始校准之前，使用标准气压计测量温度、气压和相对湿度，并在大量测光软件中输入这些值作为校正系数。要校准流量传感器，请使用经过校准的三升注射器在可变流量下，并使用 50 毫升泵校准箱压力。在进行全体造影测量之前，请参与者进入全身的光谱仪并关闭门。经过30到60秒的热平衡后，指示参与者将嘴放在喉舌上，戴上鼻夹，并把手放在脸颊上。指示参与者正常呼吸，允许至少获得四次潮汐呼吸，并建立功能残余能力。在正常呼气结束时，关闭快门并指导学员以 0.5 到 1 次呼吸/秒的速度轻轻喘气三到四秒钟。评估口腔压力和多声测量压力之间的关系，以确保它是一系列重叠的直线，没有热漂移，并打开快门，让参与者正常呼吸。然后指导学员呼气到剩余体积。其次是最大吸气动作，以总肺活量。在学员到达之前，根据需要解决和修改表中的变量。要校准气体分析仪，请将干燥管连接到混合室，然后以每分钟至少 10 升的速度用惰性气体冲洗袋子，同时注意不要给系统加压。一旦显示的二氧化碳和氧气浓度稳定下来，调整零旋钮，直到它们都读零。接下来，重复用6%二氧化碳和含有20.93%氧气的房间空气作为校准气体冲洗，当气体浓度稳定时，校准气体的浓度与跨度旋钮相匹配。然后，重新检查惰性气体并校准气体浓度，并调整零和跨度旋钮，直到两者精确到正负 0.1% 校准加热的气肺，让气管加热到 37 摄氏度至少 20 分钟，并在系统软件中打开流通道菜单。选择螺旋计，然后单击"零"到"零"。然后选择"确定"。使用流量头适配器将三升注射器连接到气管，并突出显示校准呼吸。在"流量通道"菜单下，选择"螺旋计流量"并校准，然后输入三升。单击"确定"。并使用注射器以不同的流速将三升室内空气注入肺气。与三升的差值应小于 5%当系统准备就绪时，指导参与者执行由两对呼吸组成的单次操作：教练呼吸和呼吸进行分析。因为我们有灵感和过期，有灵感。在操作过程中，指导学员遵循计算机监视器上的流量指南。考虑添加与喉舌一样一些的电阻器，使呼出的流量更易于控制。要测量功能剩余容量，请指示学员用双脚直坐在地板上，戴上鼻夹，并将嘴放在喉舌上。指导参与者完成至少一分钟的潮汐呼吸，以测量代谢功能，并允许参与者熟悉喉舌。一分钟后停止数据收集。在开始演习之前，参与者应改变潮汐体积，采取正常、较小或大于正常潮汐呼吸，以确保在不同的肺量获得封顶图。指导学员在流量跟踪出现在屏幕上时立即过渡到执行封盖图操作，并在参与者呼吸循环的随机点恢复数据收集，以便以不同的肺体积获得测量。最后，教练在每一次动作结束时都进行一声叹息，使呼吸的肌肉完全放松，让功能呼吸能力得到确定。最重要的一步是正确测量和完成用体积封顶进行操作。然后，停止数据收集，让参与者重复至少 6 到 8 次的封盖图操作，以获得 12 到 16 对呼吸进行分析。此处显示了分析中使用的代表性单帽图，以及整个操作序列的原始数据。在原始数据中，上限图和流跟踪未对齐以考虑时间延迟。在这些代表性的情况下，死空间和坡度与肺体积显著相关，表明死区和气道同质性随着肺体积的增加而增加。在尝试此过程时，重要的是要记住，它高度依赖于参与者的呼出流速以及分析仪和呼吸仪之间的延迟。应仔细检查这些谷的精度。该技术开发后，为肺科领域的研究人员探索不同患者群体肺的结构-体积关系铺平了道路，并有可能纳入呼吸系统疾病的标准床边护理。

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Combining Volumetric Capnography And Barometric Plethysmography To Measure The Lung Structure-function Relationship

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High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart

High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart (

高频超声心动图：非侵入性的反复测量小鼠心脏缺血再灌注心肌劳损，收缩力，二尖瓣关闭不全的第一个证据

Ischemia-reperfusion (IR) was surgically performed in murine hearts which were then subjected to repeated imaging to monitor temporal changes in ...

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医学

Bronchial Thermoplasty:  A Novel Therapeutic Approach to Severe Asthma

Bronchial Thermoplasty:  A Novel Therapeutic Approach to Severe Asthma Video (Video) | JoVE

支气管Thermoplasty：严重哮喘的一种新的治疗方法

Bronchial thermoplasty is a non-drug procedure for severe persistent asthma that delivers thermal energy to the airway wall in a precisely controlled ...

The Measurement and Treatment of Suppression in Amblyopia

The Measurement and Treatment of Suppression in Amblyopia Video (Video) | JoVE

测量和制止在弱视治疗

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current ...

Angiogenesis in the Ischemic Rat Lung

Angiogenesis in the Ischemic Rat Lung Video (Video) | JoVE

在缺血大鼠肺的血管生成

The  adult lung is perfused by both the systemic bronchial artery and the entire  venous return flowing through the pulmonary arteries. In most lung ...

Noninvasive Intratracheal Intubation to Study the Pathology and Physiology of Mouse Lung

Noninvasive Intratracheal Intubation to Study the Pathology and Physiology of Mouse Lung Video (Video) | JoVE

无创性气管内插管，以研究小鼠肺的病理生理

The use of a model that mimics the condition of lung diseases in humans is critical for studying the pathophysiology and/or etiology of a particular ...

A Murine Model of Myocardial Ischemia-reperfusion Injury through Ligation of the Left Anterior Descending Artery

A Murine Model of Myocardial Ischemia-reperfusion Injury through Ligation of the Left Anterior Descending Artery Video (Video) | JoVE

心肌缺血再灌注损伤的通过左前降支结扎小鼠模型

Acute or chronic myocardial infarction (MI) are cardiovascular events resulting in high morbidity and mortality. Establishing the pathological mechanisms ...

Implantation of Fibrin Gel on Mouse Lung to Study Lung-specific Angiogenesis

Implantation of Fibrin Gel on Mouse Lung to Study Lung-specific Angiogenesis Video (Video) | JoVE

纤维蛋白胶对小鼠肺移植研究肺特异性血管生成

Recent significant advances in stem cell research and bioengineering techniques have made great progress in utilizing biomaterials to regenerate and ...

Cardiac Catheterization in Mice to Measure the Pressure Volume Relationship: Investigating the Bowditch Effect

Cardiac Catheterization in Mice to Measure the Pressure Volume Relationship: Investigating the Bowditch Effect Video (Video) | JoVE

心导​​管在小鼠测量压力体积的关系：调查的影响鲍迪奇

Animal models that mimic human cardiac disorders have been created to test potential therapeutic strategies. A key component to evaluating these ...

Combining Augmented Reality and 3D Printing to Display Patient Models on a Smartphone

Combining Augmented Reality and 3D Printing to Display Patient Models on a Smartphone Video (Video) | JoVE

结合增强现实和 3D 打印，在智能手机上显示患者模型

Augmented reality (AR) has great potential in education, training, and surgical guidance in the medical field. Its combination with three-dimensional (3D) ...

Evaluation of Capnography Sampling Line Compatibility and Accuracy when Used with a Portable Capnography Monitor

Evaluation of Capnography Sampling Line Compatibility and Accuracy when Used with a Portable Capnography Monitor Video (Video) | JoVE

与便携式刻度学监视器一起使用时，评估卡光采样线兼容性和准确性

Capnography is commonly used to monitor patient&#8217;s ventilatory status. While sidestream capnography has been shown to provide a reliable assessment ...