Box-wisker plots of the percentage changes of VA per litre of expired volume (Delta VA/VE) in healthy individuals and in COPD patients

<p><b>Copyright information:</b></p><p>Taken from "Assessment of the alveolar volume when sampling exhaled gas at different expired volumes in the single breath diffusion test"</p><p>http://www.biomedcentral.com/1471-2466/7/18</p><p>BMC Pulmonary Medicine 2007;7():18-18.</p><p>Published online 19 Dec 2007</p><p>PMCID:PMC2235885.</p><p></p> The horizontal lines represent the 50th percentile (median); limits of boxes are the 25th and 75th percentiles; the wiskers are the 10th and 90th percentiles. More than 90% of patients with COPD showed significant changes in alveolar volume when sampled at different intervals of lung volume. This suggests a different time constant of lung units coupled with a non-homogeneous distribution of ventilation

Graphic representation of the alveolar volume calculated by the two methods in COPD patients

<p><b>Copyright information:</b></p><p>Taken from "Assessment of the alveolar volume when sampling exhaled gas at different expired volumes in the single breath diffusion test"</p><p>http://www.biomedcentral.com/1471-2466/7/18</p><p>BMC Pulmonary Medicine 2007;7():18-18.</p><p>Published online 19 Dec 2007</p><p>PMCID:PMC2235885.</p><p></p> The bars represent the mean values and the lines above the bars represent one standard deviation from the mean values. The alveolar volume calculated by the quintile method appears significantly different from that calculated using the standard method for all quintiles, except for the second one. It is evident that the alveolar volume, measured on the instantaneous CH4 fraction of each quintile, progressively increases from the beginning to the end of exhalation from total lung capacity (TLC) to residual volume (RV)

Graphic representation of the relation between the mean values of alveolar volume, calculated by the quintile method, and those of the corresponding DLCO, in healthy individuals (panel A) and in COPD patients (panel B), at different expired volumes

<p><b>Copyright information:</b></p><p>Taken from "Assessment of the alveolar volume when sampling exhaled gas at different expired volumes in the single breath diffusion test"</p><p>http://www.biomedcentral.com/1471-2466/7/18</p><p>BMC Pulmonary Medicine 2007;7():18-18.</p><p>Published online 19 Dec 2007</p><p>PMCID:PMC2235885.</p><p></p> The alveolar volume does not show any remarkable change when related to the expired volume in healthy individuals (only 300 ml), at variance with those of COPD patients. In addition, DLCO decreases by 1.5 mmol/min/mmHg with respect to the slight changes of the alveolar volume in healthy individuals, whereas it increases by less than 1 mmol/min/mmHg for a total increase of 2.5 litres of alveolar volume in COPD patients from TLC to RV

Graphic representation of the alveolar volume calculated by the two methods in healthy individuals

<p><b>Copyright information:</b></p><p>Taken from "Assessment of the alveolar volume when sampling exhaled gas at different expired volumes in the single breath diffusion test"</p><p>http://www.biomedcentral.com/1471-2466/7/18</p><p>BMC Pulmonary Medicine 2007;7():18-18.</p><p>Published online 19 Dec 2007</p><p>PMCID:PMC2235885.</p><p></p> The bars represent the mean values and the lines above the bars represent one standard deviation from the mean values. The alveolar volume calculated by the quintile method appears significantly different from that calculated by the ERS-ATS standard (the left hand image is taken from reference 18) from the third quintile, corresponding to 40% of exhaled volume, to residual volume (RV) from total lung capacity (TLC)

Respiratory Training Late After Fontan Intervention: Impact on Cardiorespiratory Performance

Fontan palliation allows patients with â\u80\u9csingle ventricleâ\u80\u9d circulation to reach adulthood with an acceptable quality of life, although exercise tolerance is significantly reduced. To assess whether controlled respiratory training (CRT) increases cardiorespiratory performance. 16 Adolescent Fontan patients (age 17. 5 ± 3.8 years) were enrolled. Patients were divided into CRT group (n = 10) and control group (C group, n = 6). Maximal cardiopulmonary test (CPT) was repeated at the end of CRT in the CRT group and after an average time of 3 months in the C group. In the CRT group a CPT endurance was also performed before and after CRT. In the CRT group there was a significant improvement in cardiovascular and respiratory response to exercise after CRT. Actually, after accounting for baseline values, the CRT group had decreased breathing respiratory reserve (â\u88\u92 15, 95% CI â\u88\u9222.3 to â\u88\u92 8.0, p = 0.001) and increased RR peak (+ 4.8, 95% CI 0.7â\u80\u938.9, p = 0.03), VE peak (+ 13.7, 95% CI 5.6â\u80\u9321.7, p = 0.004), VO2of predicted (+ 8.5, 95% CI 0.1â\u80\u9317.0, p = 0.05), VO2peak (+ 4.3, 95% CI 0.3 to 8.2, p = 0.04), and VO2workslope (+ 1.7, 95% CI 0.3â\u80\u933.1, p = 0.02) as compared to the control group. Moreover, exercise endurance time increased from 8.45 to 17.7 min (p = 0.01). CRT improves cardiorespiratory performance in post-Fontan patients leading to a better aerobic capacity

Early subclinical increase in pulmonary water content in athletes performing sustained heavy exercise at sea level: ultrasound lung comet-tail evidence

Whether prolonged strenuous exercise performed by athletes at sea-level can produce interstitial pulmonary edema is under debate. Chest sonography allows to estimate extravascular lung water, creating ultrasound lung "comet-tail" (ULC) artifacts. Aim of the study was to determine whether pulmonary water content increases in Ironmen (n=31) during race at sea-level and its correlation with cardiopulmonary function, systemic pro-inflammatory and cardiac bio-humoral markers. . A Multiple Factor Analysis approach was used to determine the relations between systemic modifications and ULCs by assessing correlations among variables and groups of variables showing significant pre-post changes. All athletes were asymptomatic for cough and dyspnea at rest and after the race. Immediately after the race, a score of more than 5 comet tail artifacts, the threshold for a significant detection, was present in 23 athletes (74 %, 16.3 ± 11.2, p<0.01 ULC after the race vs. rest), but decreased 12 h after the end of the race (13 athletes, 42%, 6.3 ± 8.0, p<0.01 vs. soon after the race). Multiple Factor Analysis showed significant correlations between ULCs and cardiac related variables and N-Terminal pro-Brain Natriuretic Peptide (NTproBNP). Healthy athletes developed subclinical increase in pulmonary water content immediately after an ironman race at sea level, as shown by the increased number of ULCs related to cardiac changes occurring during exercise. Hemodynamic changes are one of several potential factors contributing to the mechanisms of ULCs