A Unidirectional Breathing Pattern Improves Breathing Efficiency in Subjects With Severe COPD

Sülemanji, Demet; Bao, Feichao; Jiang, Yandong; Kacmarek, Robert M.

doi:10.4187/respcare.02899

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…A reduction of re-breathing with unidirectional flow was also described by Jiang et al ( 45 ), who found that the unidirectional flow during pursed-lip breathing attributes to a significant reduction in functional anatomical dead space and improvement in breathing efficiency. Later it was suggested that the improved breathing efficiency could be associated with benefits for patients with COPD ( 46 ).…”

Section: Discussionmentioning

confidence: 99%

Asymmetrical nasal high flow ventilation improves clearance of CO₂ from the anatomical dead space and increases positive airway pressure

Tatkov

Rees

Gulley

et al. 2023

Journal of Applied Physiology

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Positive airway pressure that dynamically changes with breathing, and clearance of anatomical dead space are the key mechanisms of noninvasive respiratory support with nasal high flow (NHF). Pressure mainly depends on flow rate and nare occlusion. The hypothesis is that an increase in asymmetrical occlusion of the nares leads to an improvement in dead-space clearance resulting in a reduction in re-breathing. Clearance was investigated with volumetric capnography in an adult upper-airway model, which was ventilated by a lung simulator with entrained carbon dioxide (CO2) at respiratory rates (RR) of 15-45min-1, and at 18min-1 with COPD breathing patterns. Clearance was assessed at NHF of 20-60L/min with a symmetrical interface (SI) and an asymmetrical interface (AI). CO2 kinetics visualized by infrared spectroscopy and mathematical modeling were used to study the mechanisms of clearance. At a higher RR(35 min-1) and NHF of 60L/min clearance in the upper airway was significantly higher with the AI when compared to the SI(29.64±9.96%,p < 0.001), as opposed to at a lower RR (15min-1) (1.40±6.25%,p > 0.05), (mean±SD). With COPD breathing, clearance by NHF was reduced, but significantly improved with the AI by 45.93% relative to the SI at NHF 20L/min (p < 0.0001). The maximum pressure achieved with the AI was 6.6cmH2O and NHF 60L/min at the end of expiration. Pressure differences between nasal cavities led to the reverse flow observed in the optical model. Asymmetrical NHF increases dead-space clearance by reverse flow through the choanae and accelerates purging of expired gas via the less occluded nare.

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Section: Discussionmentioning

confidence: 99%

Asymmetrical nasal high flow ventilation improves clearance of CO₂ from the anatomical dead space and increases positive airway pressure

Tatkov

Rees

Gulley

et al. 2023

Journal of Applied Physiology

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The physiology of singing and implications for ‘Singing for Lung Health’ as a therapy for individuals with chronic obstructive pulmonary disease

et al. 2021

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Singing is an increasingly popular activity for people with chronic obstructive pulmonary disease (COPD). Research to date suggests that ‘Singing for Lung Health’ may improve various health measures, including health-related quality-of-life. Singing and breathing are closely linked processes affecting one another. In this narrative review, we explore the physiological rationale for ‘Singing for Lung Health’ as an intervention, focusing on the abnormalities of pulmonary mechanics seen in COPD and how these might be impacted by singing. The potential beneficial physiological mechanisms outlined here require further in-depth evaluation.

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Loss of a Legend: Remembering Robert M. Kacmarek

Hess

2021

Respir Care

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Bob's first publications in the Journal were a 3-part series on the technical aspects PEEP. 1-3 A co-author on those papers was Barry Shapiro, a physician and long-term supporter of the respiratory care profession until his death in 2008. Bob had a career long interest in PEEP and that had its genesis in these papers. Of note, in the early 1980s the use of PEEP was not common, and its use was controversial. It was a big deal to set PEEP on the ventilator back then. For respiratory therapists and critical care physicians practicing today, it is unthinkable that the ventilator could be set without PEEP, but it was common at that time. These papers on PEEP published in 1982 are classics and of interest even today, almost 40 years later.

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A Unidirectional Breathing Pattern Improves Breathing Efficiency in Subjects With Severe COPD

Cited by 3 publications

References 20 publications

Asymmetrical nasal high flow ventilation improves clearance of CO₂ from the anatomical dead space and increases positive airway pressure

Asymmetrical nasal high flow ventilation improves clearance of CO₂ from the anatomical dead space and increases positive airway pressure

The physiology of singing and implications for ‘Singing for Lung Health’ as a therapy for individuals with chronic obstructive pulmonary disease

Loss of a Legend: Remembering Robert M. Kacmarek

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A Unidirectional Breathing Pattern Improves Breathing Efficiency in Subjects With Severe COPD

Cited by 3 publications

References 20 publications

Asymmetrical nasal high flow ventilation improves clearance of CO2 from the anatomical dead space and increases positive airway pressure

Asymmetrical nasal high flow ventilation improves clearance of CO2 from the anatomical dead space and increases positive airway pressure

The physiology of singing and implications for ‘Singing for Lung Health’ as a therapy for individuals with chronic obstructive pulmonary disease

Loss of a Legend: Remembering Robert M. Kacmarek

Contact Info

Product

Resources

About

Asymmetrical nasal high flow ventilation improves clearance of CO₂ from the anatomical dead space and increases positive airway pressure

Asymmetrical nasal high flow ventilation improves clearance of CO₂ from the anatomical dead space and increases positive airway pressure