The cardiopulmonary effects of physical restraint in subjects with chronic obstructive pulmonary disease

Meredith, Carolyn; Taslaq, Samer; Kon, Onn Min; Henry, John

doi:10.1016/j.jcfm.2004.10.013

Cited by 13 publications

(10 citation statements)

References 8 publications

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“…The ability of the BIT index to assess respiratory impairment in each cohort was depicted by iso-BIT index graphs (similar to the iso-diaphragmatic tension-time plot of Bellemare and Grassino [1]) in which Ti/Ttot was plotted against Vt/FVC, with BIT isopleths ranging from 0.04 to 0.16 in seated and supine postures (Figures 9(a) and (b), respectively). We assumed there was no significant postural change in FVC, as reported by others in healthy subjects [6][7][8] and in patients with obesity [9) and COPD [10]. As can be seen, obese and COPD patients tended towards higher BIT index values, suggesting a greater tendency to respiratory fatigue, although, differences amongst cohorts were ot statistically significant.…”

Section: Anthropometric and Pulmonary Function Datamentioning

confidence: 67%

“…The higher values of BIT index in seated posture can be attributed to greater values of Vt and Ti/Ttot in this posture as compared to the supine position. For purposes of computing BIT index in both postures, we assumed there was no significant postural change in FVC, as reported by others in healthy subjects [6][7][8] and in patients with obesity [9] and COPD [10]. Supine decline in FVC amounts to about 200 mL, or about 5% in both obese and control subjects [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…The purpose of this study was to compare control of ventilation and the BIT index in individuals with obesity, chronic obstructive pulmonary disease (COPD), and control subjects free of cardiorespiratory disorders. Because change in posture alters respiratory mechanics and control of ventilation [6][7][8][9][10][11][12][13][14], variables were assessed in seated and supine posture. We considered that assuming the supine posture increases respiratory load and may reduce respiratory reserve, thereby increasing the BIT index.…”

Section: Introductionmentioning

confidence: 99%

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Breathing Intolerance Index in COPD and Obesity: A Comparative Observational Study

Baydur¹,

Chen²

2013

OJRD

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Background: The breathing intolerance index, BIT, a noninvasive derivation of the tension-time index of respiratory muscles, has been recently used to evaluate patients with respect to their need for noninvasive ventilation. Comparing the BIT index in different disorders with mild to moderate respiratory impairment, such as COPD and obesity, would be useful in determining differences in threshold for respiratory muscle fatigue amongst cohorts. Objectives: The purpose of this study was to compare control of ventilation and BIT in individuals with obesity, chronic obstructive pulmonary disease (COPD), and control subjects free of cardiorespiratory disorders. Because change in posture can alter respiratory load and control of ventilation, variables were assessed in two postures. Methods: We assessed 142 subjects consisting of 81 with obesity, 42 with COPD, and 19 non-smoking healthy adults. All subjects underwent evaluation of pulmonary function, control of ventilation and BIT index [(Ti/Ttot) × (Vt/FVC)] in seated and supine postures. Findings: BIT index was significantly greater in seated posture in all 3 cohorts due primarily to an increase in Vt in this position. BIT index was similar in value amongst cohorts in both postures, but tended to be higher in patients with obesity and COPD. Conclusion: While BIT index is higher in seated posture, and tends to be higher in patients with obesity and COPD as compared to control subjects, discrimination between cohorts is not found in our study because of small inter-group variations of respiratory function amongst cohorts. Thus, in clinically stable patients whose vital capacities are mild to moderately reduced, the BIT index alone cannot be recommended as a predictive guide for initiating assisted ventilation for respiratory failure. Nevertheless, because it is easy to perform, and is comfortably tolerated by patients, its potential usefulness may be in periodic measurements to monitor its increase as respiratory reserve declines.

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Section: Anthropometric and Pulmonary Function Datamentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Breathing Intolerance Index in COPD and Obesity: A Comparative Observational Study

Baydur¹,

Chen²

2013

OJRD

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“…A thorough autopsy will uncover these potential confounders: • Pulmonary: ○ Chronic obstructive pulmonary disease (Meredith et al 2005). In some instances, they may be solely causal, contributory to, or wholly unrelated to death.…”

Section: Restraint Asphyxiamentioning

confidence: 99%

Death in Abnormal Positions: Physical Restraint

Hunsaker¹

2014

Handbook of Forensic Medicine

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“…In 2004, Meredith et al measured the effects of prone positioning on subjects with a history of COPD. 29 Interestingly, of the eight subjects that were recruited to the study, only five were able to tolerate the prone position. Three subjects could not tolerate the prone position for 10 min and were removed from the study due to breathlessness, wheezing, and desaturation, respectively.…”

Section: Introductionmentioning

confidence: 99%

Restraint physiology: A review of the literature

Vilke

2020

Journal of Forensic and Legal Medicine

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Law-enforcement often uses forensic restraints to control individuals and often these individuals are placed in positions and with various amounts of weight used to hold them in place. There has been a moderate amount of research performed on humans in this field of study to assess the physiologic impact of the positions and weight on ventilatory and cardiovascular parameters. This review discusses the scientific medical literature on the use of restraints and restraint position including the use of weight force and aggregates the findings in specific physiologic areas, such as impact on blood pressure, heart rate, and ventilatory parameters.

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The cardiopulmonary effects of physical restraint in subjects with chronic obstructive pulmonary disease

Cited by 13 publications

References 8 publications

Breathing Intolerance Index in COPD and Obesity: A Comparative Observational Study

Breathing Intolerance Index in COPD and Obesity: A Comparative Observational Study

Death in Abnormal Positions: Physical Restraint

Restraint physiology: A review of the literature

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