Abstract
There is a common belief that respiratory mechanics are representative of the lung status and unaffected by the chest wall behaviour. In reality, altered mechanical properties of the chest wall may limit ventilation, influence the work of breathing [1], affect the interaction between the respiratory muscles [2], hasten the development of respiratory failure and interfere with gas exchange [3]. Despite this central role of the chest wall in respiratory function, the understanding of its behavior has evolved slowly due to difficulties in making direct measurements in humans. How-ever, recently several methods have been developed to evaluate chest wall mechanics, allowing better definition of the role of the chest wall in different clinical situations.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Agostoni E (1964) Action of respiratory muscle. In: Fenn WO, Rahn H (eds) Handbook of physiology, 2nd edn. American Physiological Society, Washington, pp 377–386
Zocchi L, Garzaniki N, Newman S, Macklem PT (1987) Effect of hyperventilation and equalization of abdominal pressure on diaphragmatic action. J Appl Physiol 62: 1655–1664
Liu S, Margulies SS, Wilson TA (1990) Deformation of the dog lung in the chest wall. J Appl Physiol 68: 1979–1987
Lai-Fook SJ, Rodarte JR (1991) Pleural pressure distribution and its relationship to lung volume and interstitial pressure. J Appl Physiol 70: 967–978
Milic-Emili J, Mead J, Turner JM (1964) Improved technique for estimating pressure from esophageal balloons. J Appl Physiol 19: 207–211
Agostoni E, Rhan H (1960) Abdominal and thoracic pressures at different lung volumes. J Appl Physiol 15: 1087–1092
Maxted KJ, Shaw A, Macdonald TH (1977) Choosing a catheter system for measuring intra- esophageal pressure. Med Biol Eng Comput 15: 398–401
Knowles JH, Hong SK, Rhan H (1959) Possible errors using esophageal balloon in determination of pressure-volume characteristics of the lung and thoracic cage. J Appl Physiol 14: 525–530
Baydur A, Behrakis PK, Zin WA, Jaeger M, Milic-Emili J (1982) A Simple method for assessing the validity of the esophageal balloon technique. Am Rev Respir Dis 126: 788–791
Higgs BD, Bherakis PK, Bevan DR, Milic-Emili J (1983) Measurement of pleural pressure with esophageal balloon in anesthetized humans. Anesthesiology 59: 349–343
Iberti TJ, Kelly KM, Gentili DR, Hirsch S (1987) A simple technique to accurately determine intra-abdominal pressure. Crit Care Med 15: 1140–1142
Collee GG, Lomax DM, Ferguson C, Hanson GC (1993) Bedside measurement of intraabdominal pressure (IAP) via an indwelling nasogastric tube: clinical validation of the technique. Intensive Care Med 19: 478–480
D’Angelo E, Robatto FM, Calderini E, Tavola M, Bono D, Milic-Emili J (1991) Pulmonary and chest wall mechanics in anesthetized and paralyzed humans. J Appl Physiol 70: 2602–2610
Pesenti A, Pelosi P, Foti G, D’Andera L, Rossi N (1992) An interrupter technique for measuring respiratory mechanics and the pressure generated by respiratory muscles during partial ventilatory support. Chest 102: 918–923
Bates JHT, Ludwig M, Sly PD, Brown K, Martin JG, Fredberg JJ (1988) Interrupter resistance elucidated by alveolar pressure measurement in open-chested normal dogs. J Appl Physiol 65: 408–414
D’Angelo E, Prandi E, Tavola M, Calderini E, Milic-Emili J (1994) Chest wall interrupter re-sistance in anesthetized paralyzed humans. J Appl Physiol 77: 883–887
DuBois AB, Brody AW, Lewis DH, Burgess BF (1956) Oscillation mechanics of lung and chest in man. J Appl Physiol 8: 587–594
Michaelson ED, Grassman ED, Peters WR (1975) Pulmonary mechanics by spectral analysis of forced random noise. J Clin Invest 56: 1210–1230
Peslin R, Papon J, Duvivier C, Richalet J (1975) Frequency response of the chest: modeling and parameter estimation. J Appl Physiol 39: 523–534
Lutchen KR, Everett JR, Jackson AC (1993) Influence of frequency range and input impedance on interpreting the airways tissue separation implied from transfer impedance. J Appl Physiol 73: 1089–1099
Milledge JS, Stott FD (1977) Inductive plethysmography - a new respiratory transducer. J Physiol 267: 4–5
Cohn MA, Rao AS, Broudy M, et al (1982) The respiratory inductive plethysmograph: a new non-invasive monitor of respiration. Bull Eur Physiopathol Respir 18: 643–658
Stagg D, Goldman M, Davis JN (1978) Computer aided measurement of breath volume and time components using magnetometers. J Appl Physiol 44: 623–633
Stadling JR, Chadwick GA, Quirk C, Phillips T (1985) Respiratory inductance plethysmography: calibration techniques, their validation and the effects of posture. Bull Eur Physiopathol Respir 21: 317–324
Smith JC, Mead J (1986) Three degree of freedom description of movement of the human chest wall. J Appl Physiol 60: 928–934
Ferrigno G, Carnevali P, Aliverti A, Molteni F, Beulke G, Pedotti A (1994) Three-dimensional optical analysis of chest wall motion. J Appl Physiol 77: 1224–1231
Cala SJ, Kenyon C, Ferrigno G, et al (1996) Chest wall and lung volume estimation by optical reflectance motion analysis. J Appl Physiol 81: 2680–2689
Ferrigno G, Pedotti A (1985) ELITE: a digital dedicated hardware system for movement analysis via real time TV signal processing. IEEE Trans Biomed Eng BME 32: 943–950
Mead J, Peterson N, Grimby G, et al (1967) Pulmonary ventilation measured from body surface movements. Science 156: 1383–1384
Morel DR, Forster A, Suter PM (1983) Noninvasive ventilatory monitoring with bellows pneumographs in supine subjects. J Appl Physiol 55: 598–606
Wade OL (1954) Movements of the thoracic cage and diaphragm in respiration. J Physiol 124: 193–197
Grenvik A, Ballou S, McGinley E, et al (1972) Impedance pneumography: comparison between chest impedance changes and respiratory volumes in 11 healthy volunteers. Chest 62: 439–443
Spier S, England S (1983) The respiratory inductive plethysmograph: bands vs jenkins. Am Rev Respir Dis 127: 784–785
Konno K, Mead J (1967) Measurement of the separate volume changes of rib cage and abdomen during breathing. J Appl Physiol 22: 407–422
Peacock AJ, Morgan MDL, Gourlay S, Tourton C, Denison DM (1984) Optical mapping of the thoraco-abdominal wall. Thorax 39: 93–100
Krayer S, Rehder K, Beck KC, Cameron PD, Didier EP, Hoffman EA (1987) Quantification of thoracic volumes by three-dimensional imaging. J Appl Physiol 62: 591–598
McCool FD, Hoppin FG (1995) Ultrasonography of the diaphragm. In: Roussos C (ed) The thorax, 2nd edn., Marcel Dekker Inc, New York, pp 1295–1311
Warner DO, Krayer S, Rehder K, Ritman EL (1989) Chest wall motion during spontaneous breathing and mechanical ventilation in dogs. J Appl Physiol 66:1179–1189,
Warner DO, Warner MA, Ritman EL (1995) Human chest wall function while awake and during halothane anesthesia. Anesthesiology 82: 6–19
McCool FD,Liu S,Mead J (1985) Rib cage distortion during voluntary and involuntary breathing acts. J Appl Physiol 58: 1703–1712
Jiang TX, Demedts M, Decramer M (1988) Mechanical coupling of upper and lower canine rib cages and its functional significance. J Appl Physiol 64: 620–626
Ward ME, Ward JW, Macklem PT (1992) Analysis of human chest wall motion using a two-compartment rib cage model. J Appl Physiol 72: 1338–1347
Aliverti A, Kenyon CM, Yan S, et al (1997) Human respiratory muscle actions and control during exercise. J Appl Physiol 83: 1256–1269
Kenyon CM, Cala SJ, Aliverti A, et al (1998) Rib cage mechanics during quiet breathing and exercise in humans. J Appl Physiol (in press)
De Troyer A, Sampson M, Sigrist S, et al (1981) The diaphragm: two muscles. Science 213: 237–241
Tokics L, Hedenstierna G, Strandberg A, Brismar B, Lunquist H, Hedenstierna G (1987) Lung collapse and gas exchange during general anesthesia: effects of spontaneous breathing, muscle paralysis, and positive end-expiratory pressure. Anesthesiology 66: 157–167
Rehder K, Mallow JE, Fibuch EE, Krabiii DR, Sessler AD (1974) Effects of isoflurane anes-thesia and muscle paralysis on respiratory mechanics in normal man. Anesthesiology 41: 477–485
Westbrook PR, Stubbs SE, Sessler AD, Rheder K, Hyatt RE (1973) Effects of anesthesia and muscle paralysis on respiratory mechanics in normal man. J Appl Physiol 44: 114–123
Froese AB, Bryan AC (1974) Effects of anesthesia and paralysis on diaphragmatic mechanics in man. Anesthesiology 41: 242–255
Krayer S, Rehder K, Vettermann J, Didier EP, Ritman EL (1989) Position and motion of the human diaphragm during anesthesia and paralysis. Anesthesiology 70: 891–898
Hedenstierna G, Lofstrom B, Lundh R (1981) Thoracic gas volume and chest-abdomen dimen¬sions during anesthesia and muscle paralysis. Anesthesiology 55: 499–506
Suter PM, Fairley HB, Isenberg MD (1978) Effect of tidal volume and positive end-expiratory pressure on compliance during mechanical ventilation. Chest 73: 158–162
Katz JA, Zinn SE, Ozanne GM, Fairley HB (1982) Pulmonary, chest wall and lung-thorax elastances in acute respiratory failure. Chest 80: 304–311
Jardin F, Genevray B, Brun-ney D, Bourdarias JP (1985) Influence of lung and chest wall compliances on transmission of airway pressure to the pleural space in critically ill patients. Chest 88: 653–658
Polese G, Rossi A, Appendini L, Brandi G, Bates JHT, Brandolese R (1991) Partitioning of respiratory mechanics in mechanically ventilated patients. J Appl Physiol 71: 2425–2433
Pelosi P, Cereda M, Foti G, Giacomini M, Pesenti A (1995) Alterations in lung and chest wall mechanics in patients with acute lung injury: effects of positive end-expiratory pressure. Am J Respir Crit Care Med 152: 531–537
Pelosi P, D’Andrea L, Vitale G, Pesenti A, Gattinoni L (1994) Vertical gradient of regional lung inflation in adult respiratory distress syndrome. Am J Respir Crit Care Med 149: 8–13
Mutoh T, Lamm WJE, Hildebrandt J, Albert RK (1991) Abdominal distension alters regional pleural pressures and chest wall mechanics in pigs in vivo. J Appl Physiol 70: 2611–2618
Pelosi P, Foti G, Cereda M, Vicardi P, Gattinoni L (1996) Effects of carbon dioxide insufflation for laparoscopic cholecystectomy on the respiratory system. Anaesthesia 51: 744–749
Schein M, Rucinski J, Wise L (1996) The abdominal compartment syndrome in the critically ill patients. Curr Opinion Crit Care 2: 287–294
Pelosi P, Croci M, Chiumello D, Pedoto A, Gattinoni L (1996) Direct or indirect lung injury differently affects respiratory mechanics during acute respiratory failure. Intensive Care Med 22: 105
Pelosi P, Tubiolo D, Mascheroni D, et al (1998) The effects of prone position on respiratory mechanics and gas exchange during acute lung injury. Am J Respir Crit Care Med (in press)
Guerin C,Coussa ML,Eissa NT, et al (1993) Lung and chest wall mechanics in mechanically ventilated COPD patients. J Appl Physiol 74: 1570–1580
Pepe PE, Marini JJ (1982) Occult positive end-expiratory pressure in mechanically ventilated patients with airflow obstruction: the auto-PEEP effect. Am Rev Respir Dis 126: 166–170
Coussa ML, Guerin C, Eissa NT, et al (1993) Partitioning of work of breathing in mechanically ventilated COPD patients. J Appl Physiol 75: 1711–1719
Ranieri VM, Giuliani R, Mascia L, et al (1996) Chest wall and lung contribution to the elastic properties of the respiratory system in patients with chronic obstructive pulmonary disease. Eur Respir J 9: 1232–1239
Ranieri VM, Giuliani R, Cinnella G, et al (1993) Physiologic effects of positive end-expiratory pressure in patients with chronic obstructive pulmonary disease during acute ventilatory failure and controlled mechanical ventilation. Am Rev Respir Dis 147: 5–13
Musch G, Foti G, Cereda M, Pelosi P, Poppi D, Pesenti A (1998) Lung and chest wall mechanics in normal anesthetized subjects and in patients with COPD at different PEEP levels. Eur Respir J (in press)
Bonmarchand G, Denis P, Weber J, Lerebours-Pigonierre G, Massari P, Leroy J (1989) Motor abnormalities of digestive and urinary tracts in patients on ventilator for acute exacerbation of chronic obstructive pulmonary disease. Digest Dis Sciences 34: 1231–1237
Slutsky AS (1993) Mechanical ventilation. Chest 104: 1833–1859
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Pelosi, P., Aliverti, A., Dellaca, R. (1998). Chest Wall Mechanics: Methods of Measurement and Physiopathologic Insights. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1998. Yearbook of Intensive Care and Emergency Medicine, vol 1998. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72038-3_32
Download citation
DOI: https://doi.org/10.1007/978-3-642-72038-3_32
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-63798-1
Online ISBN: 978-3-642-72038-3
eBook Packages: Springer Book Archive