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European Journal of Applied Physiology

Erschienen in:

01.04.2007 | Review Article

Closing volume: a reappraisal (1967–2007)

verfasst von: Joseph Milic-Emili, Roberto Torchio, Edgardo D’Angelo

Erschienen in: European Journal of Applied Physiology | Ausgabe 6/2007

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Abstract

Measurement of closing volume (CV) allows detection of presence or absence of tidal airway closure, i.e. cyclic opening and closure of peripheral airways with concurrent (1) inhomogeneity of distribution of ventilation and impaired gas exchange; and (2) risk of peripheral airway injury. Tidal airway closure, which can occur when the CV exceeds the end-expiratory lung volume (EELV), is commonly observed in diseases characterised by increased CV (e.g. chronic obstructive pulmonary disease, asthma) and/or decreased EELV (e.g. obesity, chronic heart failure). Risk of tidal airway closure is enhanced by ageing. In patients with tidal airway closure (CV > EELV) there is not only impairment of pulmonary gas exchange, but also peripheral airway disease due to injury of the peripheral airways. In view of this, the causes and consequences of tidal airway closure are reviewed, and further studies are suggested. In addition, assessment of the “open volume”, as opposed to the “closing volume”, is proposed because it is easier to perform and it requires less equipment.

Abernethy JD, Maurizi JJ, Farhi LE (1967) Diurnal variations in urinary-alveolar N2 difference and effects of recumbency. J Appl Physiol 23:875–879PubMed

Anthonisen NR, Bass H, Oriol A, Place RE, Bates DV (1968) Regional lung function in patients with chronic bronchitis. Clin Sci Dec 35:495–511

Anthonisen NR, Danson J, Robertson PC, Ross WR (1970) Airway closure as a function of age. Respir Physiol 8:58–65

Anthonisen NR, Engel L, Grassino A, Zidulka A, Bode F, Dosman J, Martin RR, Macklem PT (1974) The clinical significance of measurements of closing volume. Scand J Respir Dis 85:245–250

Bake B, Fugl-Meyer AR, Grimby G (1972) Breathing patterns and regional ventilation distribution in tetraplegic patients and in normal subjects. Clin Sci 42:117–128PubMed

Basch S von (1887) “Ueber eine Function des Capillardruckes in den Lungen Alveoli”. Wien Med Blatter 10:465–467

Bilek AM, Dee KC, Gaver DP III (2003) Mechanisms of surface-tension-induced epithelial cell damage in a model of pulmonary airway reopening. J Appl Physiol 94:770–783PubMed

Bjure J, Grimby G, Kasalicky J, Lindh M, Nachemson A (1970) Respiratory impairment and airway closure in patients with untreated idiopathic scoliosis. Thorax 25:451–456PubMed

Bouhuys A (1964) Distribution of inspired gas in the lungs. In: Fenn WO and Rahn H (eds) Handbook of physiology. Section 3. Respiration vol 1, American Physiological Society, Washington, pp 715–735

Buist SA, Ross BB (1973) Predicted values for closing volumes using a modified single breath test. Am Rev Respir Dis 107:744–752PubMed

Calverley PM, Koulouris NG (2004) Flow limitation and dynamic hyperinflation: key concepts in modern respiratory physiology. Eur Respir J 25:186–199

Carlin RE, Ferrario L, Boyd JT, Camporesi EM, McGraw DJ, Hakim TS (1997) Determinants of nitric oxide in exhaled gas in the isolated rabbit lung. Am J Respir Crit Care Med 155:922–927PubMed

Cavagna GA, Stemmler EJ, DuBois AB (1967) Alveolar resistance to atelectasis. J Appl Physiol 22:441–452PubMed

Cheng KC, Zeng H, Slutsky AS (2002) Ventilation with negative airway pressure induces a cytokine response in isolated mouse lung. Anesth Analg 94:1577–1582PubMed

Chinn S (2005) Concurrent trends in asthma and obesity. Thorax 60:3–4PubMed

Chiumello D, Pristine G, Slutsky AS (1999) Mechanical ventilation affects local and systemic cytokines in an animal model of acute respiratory distress syndrome. Am J Respir Crit Care Med 160:109–116PubMed

Cremona G, Higenbottam T, Takao M, Hall L, Bower EA (1995) Exhaled nitric oxide in isolated pig lungs. J Appl Physiol 78:59–63PubMed

D’Angelo E (1972) Local alveolar size and transpulmonary pressure in situ and in isolated lungs. Respir Physiol l4:251–266

D’Angelo E, Pecchiari M, Baraggia P, Saetta M, Balestro E, Milic-Emili J (2002) Low-volume ventilation causes peripheral airway injury and increased airway resistance in normal rabbits. J Appl Physiol 92:949–956PubMed

D’Angelo E, Pecchiari M, Saetta M, Balestro E, Milic-Emili J (2004) Dependence of lung injury on inflation rate during low-volume ventilation in normal open-chest rabbits. J Appl Physiol 97:260–268PubMed

D’Angelo E, Pecchiari M, Della Valle P, Koutsoukou A, Milic-Emili J (2005) Effects of mechanical ventilation at low lung volume on respiratory mechanics and nitric oxide exhalation in normal rabbits. J Appl Physiol 99:433–444PubMed

D’Angelo E, Pecchiari M, Gentile G (2006) Dependence of lung injury on surface tension during low-volume ventilation in normal open-chest rabbits. J Appl Physiol

Delgado M, Munoz-Elias EJ, Gomariz RP, Ganea D (1999) Vasoactive intestinal peptide and pituitary adenylate cyclase-activating polypeptide prevent inducible nitric oxide synthase transcription in macrophages by inhibiting NF-kB and IFN regulatory factor 1 activation. J Immunol 162:4685–4696PubMed

De Troyer A, Estenne M (1995) The respiratory system in neuromuscular disorders. In: Roussos Ch (ed) The thorax. Marcel Dekker Inc., New York, pp 2177–2212

Dollfuss RE, Milic-Emili J, Bates DV (1967) Regional ventilation of the lung studied with boluses of 133 Xenon. Respir Physiol 2:234–246

Dos Santos CC, Slutsky AS (2000) Cellular responses to mechanical stress. Invited Review: Mechanisms of ventilator-induced lung injury: a perspective. J Appl Physiol 89:1645–1655PubMed

Dosman J, Bode F, Urbanetti J, Martin R, Macklem PT (1975) The use of a helium-oxygen mixture during maximum expiratory flow to demonstrate obstruction in small airways in smokers. J Clin Invest 55:1090–1099PubMed

Dreyfuss D, Saumon G (1998) Ventilator-induced lung injury: lessons from experimental studies. Am J Respir Crit Care Med 157:294–323PubMed

Eltayara L, Becklake MR, Volta CA, Milic-Emili J (1996) Relationship between chronic dyspnea and expiratory flow limitation in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 154:1726–1734PubMed

Faridy EE, Kidd R, Milic-Emili J (1967) Topographical distribution of inspired gas in excised lobes of dogs. J Appl Physiol 22:760–766PubMed

Ferretti A, Giampiccolo P, Cavalli A, Milic-Emili J, Tantucci C (2001) Expiratory flow limitation and orthopnea in massively obese subjects. Chest 119:1401–1408PubMed

Fowler WS (1952) Intrapulmonary distribution of inspired gas. Physiol Rev 32:1–20PubMed

Frank NR (1959) Influence of acute pulmonary congestion on recoiling force of excised cat’s lung. J Appl Physiol 14:905–908PubMed

Gaver DP III, Samsel RW, Solway J (1990) Effect of surface tension and viscosity on airway reopening. J Appl Physiol 69:74–85PubMed

Glaister DH, Schroter RC, Sudlow MF, Milic-Emili J (1973a) Bulk elastic properties of excised lungs and the effect of a transpulmonary pressure gradient. Respir Physiol 17:347–364

Glaister DH, Schroter RC, Sudlow MF, Milic-Emili J (1973b) Transpulmonary pressure gradient and ventilation distribution in excised lungs. Respir Physiol 17:365–385

Goerke J, Clements JA (1986) Alveolar surface tension and lung surfactant. In: Macklem PT, Mead J (eds) Handbook of physiology: the respiratory system; mechanics of breathing. Part 1, Am Physiol Soc, Bethesda, Maryland, pp 247–261

Hedenstierna G (2003) Alveolar collapse and closure of airways: regular effects of anaesthesia. Clin Physiol Funct Imaging 23:123–129PubMed

Hogg JC, Macklem PT, Thurlbeck WM (1968) Site and nature of airway obstruction in chronic obstructive lung disease. N Engl J Med 278:1355–1360PubMedCrossRef

Holland J, Milic-Emili J, Macklem PT, Bates DV (1968) Regional distribution of pulmonary ventilation and perfusion in elderly subjects. J Clin Invest 47:81–92PubMed

Holley HS, Milic-Emili J, Becklake MR, Bates DV (1967) Regional distribution of pulmonary ventilation and perfusion in obesity. J Clin Invest 46:475–481PubMed

Hoppin FG (1999) Sources of lung recoil. In: Milic Emili J (ed) Respiratory mechanics, vol 12. Eur Respir Monograph, pp 33–53

Hsu SH, Strohl KP, Jamieson AM (1994) Role of viscoelasticity in tube model of airway reopening I. Nonnewtonian sols. J Appl Physiol 76:2481–2489PubMed

Hughes JMB, Rosenzweig DY, Kivitz PB (1970) Site of airway closure in excised dog lungs: histologic demonstration. J Appl Physiol 29:340–344PubMed

Hughes JMB, Hoppin FG Jr, Mead J (1972) Effect of lung inflation on bronchial length and diameter in excised lungs. J Appl Physiol 32:25–35PubMed

Hunt JF, Fang K, Malik R, Snyder A, Malhotra N, Platts-Mills TAE, Gaston B (2000) Endogenous airway acidification. Am J Respir Crit Care Med 161:694–699PubMed

Hutchinson J (1846–1852) In: Thorax. Todd Encyclop Anat & Physiol, p 1059

Ingram RH, O’Cain CF, Fridy WW (1974) Simultaneous quasi-static lung pressure-volume curves and “closing volume” measurements. J Appl Physiol 36:135–141PubMed

Kaneko K, Milic-Emili J, Dolovich MB, Dawson A, Bates DV (1966) Regional distribution of ventilation and perfusion as a function of body position. J Appl Physiol 21:767–777PubMed

Katsura T, Rosenzwaig R, Sutherland PW, Hogg JC, Milic-Emili J (1970) Effect of external support on regional alveolar expansion in excised dog lungs. J Appl PhysioI 25:133–137

Kharitonov SA, Sapienza MM, Chung KF, Barnes PJ (1999) Prostaglandins mediate bradykinin-induced reduction of exhaled nitric oxide in asthma. Eur Respir J 14:1023–1027PubMed

Keith A (1909) The mechanisms of respiration in man. In: Hill L (eds) Further advances in physiology. Longmans, Green, and Co, New York, pp 182–207

Kleinmann LE, Puolos DA, Siebens AA (1964) Minimal air in dogs. J Appl Physiol 19:204–206

Knudson RJ, Lebowitz MD, Burton AP, Knudson DE (1977) The closing volume test: evaluation of nitrogen and bolus methods in a random population. Am Rev Respir Dis 115:423–434PubMed

Knudson RJ (1991) Physiology of the ageing lung. In: Crystal RG, West JB et al (eds) The lung: scientific foundations. Raven Press Ltd, New York, pp 1749–1759

Koutsoukou A, Koulouris N, Bekos B, Sotiropoulou C, Kosmas E, Papadima K, Roussos C (2004) Expiratory flow limitation in morbidly obese postoperative mechanically ventilated patients. Acta Anaesthesiol Scand 48:1080–1088PubMed

Koutsoukou A, Perraki H, Raftopoulo A, Koulouris N, Sotiropoulou C, Kotanidou A, Stylianos O, Roussos C (2006) Respiratory mechanics in brain damaged patients. Intensive Care Med 32:1947–1954PubMed

Leblanc P, Ruff F, Milic-Emili J (1970) Effects of age and body position on “airway closure” in man. J Appl Physiol 28:448–451PubMed

Linn WS, Hackney JD (1973) Nitrogen and helium “closing volumes”: simultaneous measurement and reproducibility. J Appl Physiol 34:396–399PubMed

Maniscalco M, Vatrella A, Cremona G, Carratù L, Sofia M (2001) Exhaled nitric oxide after inhalation of isotonic and hypotonic solutions in healthy subjects. Clin Sci 101:645–650PubMed

McCarthy D, Milic-Emili J (1973) Closing volume in asymptomatic asthma. Am Rev Respir Dis 107:559–570PubMed

McCarthy DS, Spencer R, Creene R, Milic-Emili J (1972) Measurement of “closing volume” as a simple and sensitive test for early detection of small airway disease. Am J Med 52:747–753PubMed

McClean MA, Matheson MJ, McKay K, Johnson PR, Rynell AC, Ammit AJ, Black JL, Berend N (2003) Low lung volume alters contractile properties of airway smooth muscle in sheep. Eur Respir J 22:50–56PubMed

Mcculloch PR, Forkert PG, Froese A (1988) Lung volume maintenance prevents lung injury during high frequency oscillatory ventilation in surfactant-deficient rabbits. Am Rev Respir Dis 137:1185–1192PubMed

Mead J, Takishima T, Leith D (1970) Stress distribution in lungs: a model of pulmonary elasticity. J Appl Physiol. 28:596–608PubMed

Mellemgard K. (1966) The alveolar-arterial oxygen difference: its size and components in normal man. Acta Physiol Scand 67:10–20

Milic-Emili (1974) Pulmonary statics. In: Widdicombe J (ed) Respiration Physiology, vol. 1, University Park Press, Baltimore, pp 105–137

Milic-Emili J (2004) Does mechanical injury of the peripheral airways play a role in the genesis of COPD in smokers? COPD 1:85–92PubMedCrossRef

Milic-Emili J (2005) Ventilation distribution. In: Hamid Q, Shannon J, Martin J (eds) Physiologic basis of respiratory disease. BC Decker Inc., Hamilton, pp 133–141

Milic-Emili J, Mead J, Turner JM, Glauser EM (1964a) Improved technique for estimating pleural pressure from esophageal balloons. J Appl Physiol 19:207–211

Milic-Emili J, Mead J, Turner JM (1964b) Topography of esophageal pressure as a function of posture in man. J Appl Physiol 19:212–226

Milic-Emili J, Henderson JA, Dolovich MB, Trop D, Kaneko KMB (1966) Regional distribution of inspired gas in the lung. J Appl Physiol 21:749–759PubMed

Milic-Emili J, Koulouris N, Tantucci C (2005) Spirometric prediction of exercise limitation in patients with chronic obstructive pulmonary disease. In: Hamid Q, Shannon J, Martin J (eds) Physiologic basis of respiratory disease. BC Decker Inc., Hamilton, pp 671–687

Moncada S, Vane JR (1979) Pharmacology and endogenous roles of prostaglandin endoperoxides, thromboxane A₂ and prostacyclin. Pharmacol Rev 30:293–331

Muscedere JG, Mullen JBM, Gan K, Bryan AC, Slutsky AS (1994) Tidal ventilation at low airway pressure can augment lung injury. Am J Respir Crit Care Med 149:1327–1334PubMed

Nadel JA (1990) Decreased neutral endopeptidases: possible role in inflammatory diseases of airways. Lung 168:123–127PubMed

Naire S, Jensen OE (2005) Epithelial cell deformation during surfactant-mediated airway reopening: a theoretical model. J Appl Physiol 99:458–471PubMed

Niewoehner DE, Kleinerman J, Rice DB (1974) Pathologic changes in the peripheral airways of young cigarette smokers. N Engl J Med 291:755–758PubMedCrossRef

Nucci G, Suki B, Lutchen K (2003) Modeling airflow related shear stress during heterogeneous constriction and mechanical ventilation. J Appl Physiol 95:348–356PubMed

Olofsson J, Bake B, Svärdsudd K, Skoogh BE (1986) The single breath N₂-test predicts the rate of decline in FEV₁. The study of men born in 1913 and 1923. Eur J Respir Dis 69:46–56PubMed

Otis DR Jr, Petak F, Hantos Z, Fredberg JJ, Kamm R (1996) Airway closure and reopening assessed by the alveolar capsule oscillation technique. J Appl Physiol 80:2077–2084PubMed

Pankow W, Podszus T, Gutheil T, Penzel T, Peter J, Von Wichert P (1998) Expiratory flow limitation and intrinsic positive end-expiratory pressure in obesity. J Appl Physiol 85:1236–1243PubMed

Persson MG, Wiklund NP, Gustafsson LE (1993) Endogenous nitric oxide in single exhalations and the change during exercise. Am J Respir Crit Care Med 148:1210–1214

Proud D (1997) Kinins as mediators of lung disease. In: Crystal RG, West JB, Weibel ER, Barnes PJ (eds) The lung. Lippincott-Raven, Philadelphia, Chap 7, pp 89–101

Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC (1993) Lung volumes and forced ventilatory flows. Report Working Party “Standardization of Lung Function Tests”. European Coal and Steel Community. Eur Resp J 6:5–40

Radford EP (1964) Static mechanical properties of mammalian lungs. In: Fenn WO, Rahn H (eds) Handbook of physiology. Respiration, vol II. Am Physiol Soc Washington, pp 429–449

Robertson B (1984) Lung surfactant. In: Robertson B, Van Calde L, Batenburgh J (eds) Pulmonary surfactant. Elsevier, Amsterdam

Rodarte JR, Hyatt RE, Cortese DA (1975) Influence of expiratory flow on closing capacity at low expiratory flow rates. J Appl Physiol 39:60–65PubMed

Ruff F, Wood L, Bryan AC, Milic-Emili J (1970) Effects of the augmentation of air output and of inspired gas density on the regional distribution of ventilation. J Physiol 62(s3):443

Sanderson RJ, Paul GW, Vatter AE, Filley GF (1976) Morphological and physical basis for lung surfactant action. Respir Physiol 27:379–392PubMed

Sandhar BK, Niblett DJ, Argiras EP, Dunnill MS, Sykes MK (1988) Effect of positive end-expiratory pressure on hyaline membrane formation in a rabbit model of neonatal respiratory distress syndrome. Int Care Med 14:538–546

Sorbini CA, Grassi V, Solinas E, Muiesan G (1968) Arterial oxygen tension in relation to age in healthy subjects. Respiration 25:3–13PubMedCrossRef

Stanescu D, Sanna A, Veriter C, Robert A (1998) Identification of smokers susceptible to development of chronic airflow limitation: a 13-year follow-up. Chest 114:416–425PubMed

Stigol Lc, Vawter GF, Mead J (1972) Studies on elastic recoil of the lung in pediatric population. Am Rev Respir Dis 105:552–563PubMed

Strömberg S, Lönnqvist PA, Persson MG, Gustafsson LE (1997) Lung distension and carbon dioxide affect pulmonary nitric oxide formation in the anaesthetized rabbit. Acta Physiol Scand 159:59–67PubMed

Sutherland PW, Katsura T, Milic-Emili J (1968) Previous volume history of the lung and regional distribution of gas. J Appl Physiol 25:566–574PubMed

Taskar V, John J, Evander E, Robertson B, Jonson B (1997) Surfactant dysfunction makes lungs vulnerable to repetitive collapse and reexpansion. Am J Respir Crit Care Med 155:313–320PubMed

Teculescu DB, Damel MC, Costantino E, Buhler O, Bohadana AB, Marchand M, Pham QT (1996) Computerized single-breath nitrogen washout: predicted values in a rural French community. Lung 174:43–55PubMed

Torchio R, Gulotta C, Greco-Lucchina P, Perboni A, Montagna L, Guglielmo M, Milic-Emili J (2006a) Closing capacity and gas exchange in chronic heart failure. Chest 129:1330–1336

Torchio R, Gulotta C, Greco-Lucchina P, Perboni A, Avonto L, Ghezzo H, Milic-Emili J (2006b) Orthopnea and tidal expiratory flow-limitation in chronic heart failure. Chest 130:472–479

Torchio R, Gulotta C, Ciacco C, Perboni A, Guglielmo M, Crosa F, Zerbini M, Brusasco V, Hyatt RE, Pellegrino R (2006c) Effects of chest wall strapping on mechanical response to methacholine in humans. J Appl Physiol 101:430–438

Tremblay L, Valenza F, Ribeiro S, Li J, Slutsky AS (1997) Injurious ventilatory strategies increase cytokines and c-fos m-RNA expression in an isolated rat lung model. J Clin Invest 99:944–952PubMed

Tschumperlin DJ, Oswari J, Marguleis AS (2000) Deformation-induced injury of alveolar epithelial cells. Effect of frequency, duration, and amplitude. Am J Respir Crit Care Med 162:357–362PubMed

Turner JM, Mead J, Wohl ME (1968) Elasticity of human lung in relation to age. J Appl Physiol 25:664–671PubMed

Uddman R, Sundler F, Cardell LO, Luts A (1997) Neuropeptides in the lung. In: Crystal RG, West JB, Weibel ER, Barnes PJ (eds) The lung. Lippincott-Raven, Philadelphia, Chap 8, pp 103–115

Verbanck S, Paiva M (2002) Gas washout and aerosol bolus techniques: noninvasive measures of lung structure and ventilation heterogeneity. In: Aliverti A, BrusascoV, Macklem PT, Pedotti A (eds) Mechanics of breathing. Springer, Milan, pp 129–145

Viegi G, Paoletti P, Di Pede F, Prediletto R, Carrozzi L, Pistelli G, Giuntini C (1988) Single breath nitrogen test in an epidemiologic survey in North Italy. Reliability, reference values and relationships with symptoms. Chest 93:1213–1220PubMed

Von Neergaard K (1929) Neue Auffassungen über einen Grundbegriff der Atemmechanik. Z Gesamte Exp Med 66:373–394

Ward RJ, Tolas AG, Benveniste J, Hansey M, Bonica JJ (1966) Effect of posture on normal arterial blood gas tensions in the aged. Geriatrics 21:139–143

Woolcock AJ, Vincent NJ, Macklem PT (1969) Frequency dependence of compliance as a test for obstruction in the small airways. J Clin Invest 48:1097–1106PubMedCrossRef

Wyszogrodski I, Kyei-Aboagye E, Taeusch HW, Avery ME (1975) Surfactant inactivation by hyperventilation: conservation by end-expiratory pressure. J Appl Physiol 83:461–466

Young SL, Tierney DF, Clements JA (1970) Mechanisms of compliance change in excised rat lungs at low transpulmonary pressure. J Appl Physiol 29:780–785PubMed

Titel: Closing volume: a reappraisal (1967–2007)
verfasst von: Joseph Milic-Emili
Roberto Torchio
Edgardo D’Angelo
Publikationsdatum: 01.04.2007
Verlag: Springer-Verlag
Erschienen in: European Journal of Applied Physiology / Ausgabe 6/2007
Print ISSN: 1439-6319
Elektronische ISSN: 1439-6327
DOI: https://doi.org/10.1007/s00421-006-0389-0

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