Influence of changed gas media on acoustic parameters of human forced exhalation

In previous study it was shown that duration of tracheal forced expiratory noises is promising to reveal negative changes of lung function after dive. The objective is a study of parameters of tracheal forced expiratory noises in changed gas media. The first experiment involved 25 volunteers (22-60 years), performed forced exhalation under normal pressure with air, oxygen-helium and oxygen-krypton mixtures. The second experiment in the chamber involved 6 volunteers (25-46 years), which performed forced exhalation with air under normal pressure (0.1 MPa), and under elevated pressure 0.263 MPa with air and oxygen-helium mixture. In the first experiment the direct linear dependence on gas density was found for forced expiratory noises common duration in the band of 200-2000 Hz and for its durations in narrow 200-Hz bands, excluding high frequency range 1400-2000 Hz. In the second experiment a significant reversed dependence of high frequency durations and spectral energies in 200-Hz bands (1600-2000 Hz) on adiabatic gas compressibility. Individual dynamics of common duration of tracheal forced expiratory noises under model dive of 16.3 m (0.263 MPa) is more then the diagnostic threshold of this parameter for lung function decrease, previously obtained for divers under normal pressure.     

Regression simulation of the dependence of forced expiratory tracheal noises duration on human respiratory system biomechanical parameters

BACKGROUND: Estimating the duration of forced exhalation tracheal noises shows promise for recognizing bronchial obstruction. OBJECTIVE: Experimental simulation of an influence of biomechanical parameters on the duration of normal forced exhalation tracheal noises. METHOD AND MATERIALS: Thirty-two healthy non-smoking men aged 16-22 years were examined. The duration of noises, the parameters of computer spirometry, and the maximum static expiratory pressure are recorded. These data were analyzed by means of multiple linear regression simulation for logarithms of the elements of the proportionality relation obtained with the use of a one-component biomechanical model of forced exhalation and a linearized approximation of flow-volume curve. RESULTS: Dependence between duration of the forced expiratory noises recorded on human trachea and the product of forced volume capacity (in power of 1.05 +/- 0.27), maximum static expiratory pressure (in power of 0.46 +/- 0.23), equivalent expiratory resistance in the stage of functional expiratory stenosis (in power of 0.72 +/- 0.15 in healthy is an estimate of the equivalent expiratory resistance of human bronchial tree in the functional expiratory stenosis phase, whereas in patients with bronchial obstruction it is supposed to take into account an excess of noise generation time compared with the time predicted from normal individual value of this resistance.     

Acoustic estimation of the impact of a single dive using a closed-type breathing apparatus on the ventilatory function of the human lungs

Diving negatively affects the human respiratory system, especially if an oxygen breathing apparatus is used. The spirometry indices generally used to estimate the ventilatory function of the lung have a poor sensitivity to the toxic effect of hyperbaric hyperoxia. The goal of this study was to estimate the possibilities of using the forced expiratory (FE) tracheal noise duration. The study was done on 48 divers who had been tested before and after a single dive.     

Acoustical estimation of impact of single dive in closed-type breathing apparatus on human ventilatory lung function

Diving renders negative influence on human respiratory system especially when oxygen breathing apparatus is used. Spirometry indexes, traditionally used to estimate ventilator lung function, have poor sensitivity to toxic effect of hyperbaric hyperoxia. The objective is to study possibility of revealing minimum impairments of lung ventilator function in oxygen divers by analysis of forced expiratory tracheal noise duration. 48 divers were studied before and after single shallow water dive in oxygen closed-type breathing apparatus. A significant drop of FVC, FEV1 over the group as a whole was found after dive however being in the limits of norm. The significant increase of individual forced expiratory tracheal noise duration, exceeding the natural variability limit (19.6%, p < 0.05), was found in 10 subjects (20.8%). Three of them during dive had respiratory symptoms characteristic for initial manifestations of pulmonary oxygen poisoning. The asymptomatic reversible increase of forced expiratory tracheal noise duration in the rest 7 divers was interpreted as a sign of hidden phase of hyperbaric hyperoxia effect.     

Effect of breathing an oxygen-helium mixture under positive pressure on biochemical parameters

In 35 subjects the effect of breathing an oxygen-helium mixture or oxygen during 10 minutes under positive pressure of 40 hPa was studied. Immediately before positive-pressure breathing, in the last minute of this breathing, and 30 minutes after its and blood samples were taken for investigations. Positive-pressure breathing caused in both groups a rise-in the haematocrit value, total protein, albumin and glucose levels. The level of lactic acid rose during breathing oxygen by 74% and that of pyruvic acid increased by 44%, while during the use of the oxygen-helium mixture both these compounds failed to rise during positive-pressure breathing and 30 minutes after its completion.     

Research on the physiological effect of heated heliox on human external respiration parameters

The goals and objectives of the study were to investigate and compare the physiological effects of a heated oxygen-helium mixture (heliox) and air on the human external breathing function. The study involved eight subjects aged 24 ± 4 years who breathed the gases heated up to a temperature of 58 ± 5°C and atmospheric air for 21 min. The effects were evaluated according to the parameters of spontaneous pneometry and forced expiration using the Master Screen VIASYS device. The effect of the heated gases (heliox and air) on humans caused a phase-by-phase increase in the values of the external breathing parameters. Apparently, the patency of airways at the level of tracheas and bronchi appeared to increase significantly during breathing heliox compared to air.     

Various mechanisms of regulation of lipid peroxidation in human erythrocytes after long-term exposure to hyperbaric oxygenation]

Intensity of lipid peroxidation and activity of antioxidant protection enzymes in erythrocytes were measured in three experiments with 10-24 days exposure of aquanauts under 4.6 and 5.1 MPa. It is established that there is no pathological intensification of lipid peroxidation when oxygen partial pressure in breathing gas mixture is optimal. This process is under reliable control by modulation of antioxidant enzymes activity. The high sensitivity of these research methods allows using them to determine exposure limitations under high pressure and optimal oxygen concentrations in breathing gas mixture.     

Dynamics of the duration of tracheal forced expiratory noises during long-term isolation in the Mars-500 experiment

The dynamics of the duration of tracheal forced expiratory noises in a group of volunteers were studied before, during, and after a 520-day confinement. The duration did not change in most volunteers. Two volunteers exhibited significant changes in the duration of tracheal sounds and some spirometric parameters. The increase in the duration of tracheal forced expiratory noises and the decrease in spirometric parameters reveal ventilation impairment of the obstructive type. Analysis of the duration of tracheal forced expiratory noise dynamics during prolonged confinement has proven to be a sensitive technique to test ventilation function changes.     

Probing the limits of human deep diving

Divers breathing compressed air are restricted to 45 m depth because of the narcotic effects of nitrogen and toxic action of oxygen at increased pressures. Substitution of oxygen-helium for compressed air has permitted divers to reach 600 m. However, at depths greater than 160 m, signs and symptoms of the high pressure nervous syndrome (h.p.n.s.) occur, with tremors, myoclonic jerking, nausea, vomiting, fatigue, somnolence, e.e.g. changes, dyspnoea, and poor sleep with nightmares. It has been the objective of this Laboratory to ameliorate the symptoms of pressure-induced h.p.n.s. by the addition of small amounts of 'narcotic' nitrogen to the oxygen-helium mixture to form the Trimix breathing gas. In 1973, comparative experiments with oxygen-helium and the same divers, during compressions in only 33 min to 219.5 m and 305 m, showed such Trimix to be effective with 10% (by volume) nitrogen. Simulated dives, termed ATLANTIS, have been made with Trimix over the last 4 years to depths in excess of 610 m for 11 days, 650 m for 4 days and 686 m for 1 day. The objectives were to determine the effects of either slow or rapid rates of compression, and either 5% or 10% (by volume) nitrogen in Heliox, on the presence of h.p.n.s. or nitrogen narcosis. Measurements were made of intellectual and psychomotor performance, electrophysiological function of the brain and reflexes, lung and cardiovascular function, including arterial gas analysis at rest and work, blood chemistry and psychiatric and psychological status. The results permit the conclusion that divers may be compressed safely to depths as great as 686 m. The technique requires a slow exponential compression over days, with frequent stages lasting 14 h or more, the use of 5-8% (by volume) nitrogen in Heliox and careful selection of the divers.     

Gender-specific characteristics of forced expiratory tracheal noise duration in humans aged 17–25 years

In a sample of 77 men and 53 women aged 17–25 years, it has been shown that the duration of tracheal forced expiratory noises is significantly shorter in women. However, normalizing the duration of tracheal forced expiratory noises to height, body mass, and chest circumference eliminates this difference.     

High density respiratory syndrome: I. Oscillations of flow-volume curves during forced respiration in dense gas media]

33 divers exposed to high pressure have been examined in three series. The dynamics of the forced breathing parameters has been studied: I--helio or neon-oxygen medium under pressure of 1.078-3.53 MPa (11-36 kg/m2) with density to 32.7 kg/m3; II--nitrogen-oxygen medium under 0.274-0.882 MPa (2.8-9.0 kg/m2) with density of 11.7 kg/m3; III--under the same conditions, as II, but using bronchospasmolytics (stimulators of 2-adrenoreceptors: astompent, salbutamol, berotec) under hyperbaria. A new phenomenon: high-density breathing syndrome is revealed. It includes appearance of oscillations of respiratory flows against the background of a decrease of forced breathing rate in dense gas medium and has a common mechanism of appearance both during inhale and exhale. High hydrostatic pressure and narcotic qualities of inert gases can have a modulating effect. Evidences are obtained that tremor phenomena observed during high pressure nervous syndrome can influence the biomechanics of forced breathing at hyperbaria. A high correlation between amplitude modulation of electromyograms of breathing muscles and pneumotachogram oscillations within the range, corresponding to the frequency of physiological tremor, allowed assuming that tremor of breathing muscles induced by high-density gas medium action is one of factors responsible for appearance of respiratory flows oscillations.     

Spontaneous phrenic nerve activity in the exteriorized fetal lamb.

Phrenic nerve activity and tracheal pressure changes were recorded in four exteriorized fetal lambs (120-135 days gestation) from lightly anesthetized ewes to study possible mechanisms involved in the establishment of rhythmical breathing patterns. Two types of spontaneous neural activity were found. The first consisted of high-frequency multiunit bursts (mean duration 820 ms; range 450-2,500 ms) that preceded a gasp. Individual units within these bursts reached peak discharge frequencies as high as 40 impulses/s. The second type of neural activity consisted of single-unit, low-frequency (1-14 impulses/s), irregular background discharges lasting up to several seconds without changes in tracheal pressure. Occasionally, higher frequency bursts of single-unit activity were detected that were also unassociated with tracheal pressure changes. The data indicate that the neural correlate of a fetal gasp includes high-frequency synchronized bursting activity in the phrenic nerve. In addition, background phrenic activity can be detected in the exteriorized fetal lamb that reflects central nervous activity in the absence of tracheal pressure changes.     

Effects of moderate hypoxia on fetal electrocortical activity, eye movements, and breathing activity in sheep

Isocapnic hypoxaemia (delta PaO2 = -8.0 +/- 0.5 mmHg; delta CaO2 = -2.86 +/- 0.20 ml/dl) was produced in fetal sheep by having the ewe breathe for one hour a gas mixture (v/v) of 10.5% O2 and 1.5% CO2 in N2. Mean fetal heart rate, blood pressure, and incidence of low voltage electrocortical activity were not affected. However, the incidence of rapid-eye-movements and breathing activity was reduced by about 40%. Breathing movements during hypoxaemia had a mean inspiratory time, breath interval, and tracheal pressure amplitude which did not differ significantly from those during control experiments in which the ewe breathed air from the plastic bag. These observations suggest that hypoxia decreases the incidence of breathing movements but does not affect the amplitude or pattern of breathing activity and that it may reduce the incidence of eye movements and breathing activity through a common mechanism.     

Lung hyperinflation in isolated dog lungs during high-frequency oscillation

To study the phenomenon of lung hyperinflation (LHI), i.e., an increase in lung volume without a concomitant rise in airway pressure, we measured lung volume changes in isolated dog lungs during high-frequency oscillation (HFO) with air, He, and SF6 and with mean tracheal pressure controlled at 2.5, 5.0, and 7.5 cmH2O. The tidal volume and frequency used were 1.5 ml/kg body wt and 20 Hz, respectively. LHI was observed during HFO in all cases except for a few trials with He. The degree of LHI was inversely related to mean tracheal pressure and varied directly with gas density. Maximum expiratory flow rate (Vmax) was measured during forced expiration induced by a vacuum source (-150 cmH2O) at the trachea. Vmax was consistently higher than the peak oscillatory flow rate (Vosc) during HFO, demonstrating that overall expiratory flow limitation did not cause LHI in isolated dog lungs. Asymmetry of inspiratory and expiratory impedances seems to be one cause of LHI, although other factors are involved.     

Changes in cardiac rhythm in humans during breathing compressed air under pressure up to 1.1 MPa (results of the rhythmo-cardiographic study)]

Dynamics of cardiac rhythm has been considered according to rhythmocardiographic characteristics of heart rate under orthostatic test and one-stage step-test in four altitude chamber experiments where air under pressure of 0.4-1.1 MPa is used as a breathing mixture. It is shown that these characteristics linearly depend on the partial nitrogen and oxygen pressure and hyperbaric bradycardia essentially decreases in the final period of isopression due to toxic oxygen effect. Cytochrome C decreases hyperbaric bradycardia. Under hyperbaric conditions the regulation of cardiac rhythm proceeds with altered central vegetative effects provided a direct effect of higher nitrogen and oxygen pressure on the sinusal node cells.     

The influence of the bronchodilatation test on the duration of forced expiratory tracheal noises in young men

The diagnostic efficiency of estimating the duration of forced expiratory noises under the conditions of bronchial obstruction has been shown. The objective of this study was to analyze the response of the forced expiratory noise duration to the bronchodilatation test with the β₂-agonist in the age- and genderhomogenous group of healthy volunteers and bronchial asthma patients selected as a model of variable bronchial obstruction. Two hundred and sixty young men (16–25 years old) were examined. It was shown that the prevailing type of response in bronchial asthma patients with spirometry confirmed bronchial obstruction was shortened forced expiratory noises. Furthermore, the degree of the shortening considerably depended on the severity of the background bronchial obstruction. The absence of a statistically significant response of the forced expiratory noise duration dominated among healthy volunteers (nonsmokers as well as smokers) and bronchial asthma patients without a spirometry confirmed bronchial obstruction. However, the shortened response occurred much more frequently in bronchial asthma patients than in healthy volunteers. The high specificity (86%) of the response as shortened forced expiratory noises to the β₂-agonist may be useful for diagnostics.     

Oxygen or carbogen breathing before simulated submarine escape.

Raised internal pressure in a distressed submarine increases the risk of bubble formation and decompression illness after submarine escape. The hypothesis that short periods of oxygen breathing before submarine escape would reduce decompression stress was tested, using Doppler-detectable venous gas emboli as a measure. Twelve goats breathed oxygen for 15 min at 0.1 MPa before exposure to a simulated submarine escape profile to and from 2.5 MPa (240 m/seawater), whereas 28 control animals underwent the same dive without oxygen prebreathe. No decompression sickness (DCS) occurred in either of these two groups. Time with high bubble scores (Kisman-Masurel >or=3) was significantly (P < 0.001) shorter in the prebreathe group. In a second series, 30 goats breathed air at 0.2 MPa for 6 h. Fifteen minutes before escape from 2.5 MPa, animals were provided with either air (n = 10), oxygen (n = 12), or carbogen (97.5% O(2) and 2.5% CO(2)) gas (n = 8) as breathing gas. Animals breathed a hyperoxic gas (60% O(2)-40% N(2)) during the escape. Two animals (carbogen group) suffered oxygen convulsions during the escape but recovered on surfacing. Only one case of DCS occurred (carbogen group). The initial bubble score was reduced in the oxygen group (P < 0.001). The period with bubble score of Kisman-Masurel >or=3 was also significantly reduced in the oxygen group (P < 0.001). Oxygen breathing before submarine escape reduces initial bubble scores, although its significance in reducing central nervous system DCS needs to be investigated further.     

Effect of combined recompression and air, oxygen, or heliox breathing on air bubbles in rat tissues.

The fate of bubbles formed in tissues during the ascent from a real or simulated air dive and subjected to therapeutic recompression has only been indirectly inferred from theoretical modeling and clinical observations. We visually followed the resolution of micro air bubbles injected into adipose tissue, spinal white matter, muscle, and tendon of anesthetized rats recompressed to and held at 284 kPa while rats breathed air, oxygen, heliox 80:20, or heliox 50:50. The rats underwent a prolonged hyperbaric air exposure before bubble injection and recompression. In all tissues, bubbles disappeared faster during breathing of oxygen or heliox mixtures than during air breathing. In some of the experiments, oxygen breathing caused a transient growth of the bubbles. In spinal white matter, heliox 50:50 or oxygen breathing resulted in significantly faster bubble resolution than did heliox 80:20 breathing. In conclusion, air bubbles in lipid and aqueous tissues shrink and disappear faster during recompression during breathing of heliox mixtures or oxygen compared with air breathing. The clinical implication of these findings might be that heliox 50:50 is the mixture of choice for the treatment of decompression sickness.     

The mechanism of mucus clearance in cough

An instability resembling an avalanche is proposed as the mechanism by which mucus is expelled from the respiratory tract during cough. The cough event was simulated in a model airway. In these experiments, air was forced through a channel whose walls were lined with a non-Newtonian material rheologically similar to tracheal mucus. Frames from high-speed cine photographs showed an unstable event which began as an undulation of the free surface and progressed to a catastrophic clearance of the channel. Measurements of the longitudinal pressure gradient support the hypothesis that the clearance event is initiated when the total stress applied to the mucus analog exceeds its finite yield stress. A continuum model predicts that yielding occurs within the bottom layers of the mucus analog. Calculations based upon estimates of tracheal geometry and air flow show that the clearance event studied here would be expected to occur during a cough but not during normal breathing. Experiments also show that a lubricant introduced between the channel walls and the mucus blanket can reduce the air flow rate required to precipitate the clearance.     

The effect of changing the gaseous diffusion coefficient on the mass loss pattern of Hyalophora cecropia pupae

The importance of gas phase diffusion in insect gas exchange remains unclear. The role of diffusion in gas exchange of developing Hyalophora cecropia pupae was examined by altering the gaseous diffusion coefficient in the breathing mixture. Gaseous diffusion coefficients were manipulated by substituting helium or sulfur hexafluoride for the nitrogen usually present in air. Sensitive mass loss recordings were employed to monitor gas exchange activity. Mass loss recordings showed a two-phase cycle, open and closed-flutter. Mass loss rates during the open and closed-flutter periods were not altered in proportion to the changes induced in the rate of diffusion. Open-phase duration was inversely and proportionally related to the diffusion coefficient. These results are consistent with changes in spiracle resistance or convective flow during the open period in response to a change in the diffusion coefficient. In addition, they indicate a significant gas phase diffusive resistance within the pupal tracheal system. This previously unreported gas phase resistance appears to be a major determinant of the duration of the open period and thus of overall water loss rates in these pupae.