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Expiratory flow pattern and respiratory mechanics.

J P Mortola, A M Lauzon, B Mott

    Canadian Journal of Physiology and Pharmacology
    |June 1, 1987
    PubMed
    Summary
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    Expiratory vocal fold narrowing, common in newborns, minimally impacts respiratory system impedance. This suggests expiratory patterns regulate airway pressure for lung fluid balance and gas exchange, not to reduce breathing effort.

    Area of Science:

    • Physiology
    • Respiratory Mechanics
    • Neonatal Physiology

    Background:

    • Expiration involves vocal fold narrowing, increasing expiratory resistance, lung volume, and airway pressure.
    • Neonatal expirations often feature short, complete airway closures, amplifying these effects.
    • The functional significance of expiratory flow patterns on inspiratory respiratory system impedance is not fully understood.

    Purpose of the Study:

    • To investigate how different expiratory flow patterns affect the inspiratory impedance of the respiratory system.
    • To determine if expiratory loading influences respiratory system compliance and impedance in newborn and adult animals.

    Main Methods:

    • Anesthetized, paralyzed, and mechanically ventilated newborn puppies, piglets, and adult rats.
    • Ventilation with three distinct expiratory patterns: no expiratory load, expiratory resistive load, and end-inspiratory pause.

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  • Measurements of mean inspiratory impedance and compliance after 1 minute of each ventilatory pattern, ensuring consistent starting lung volumes.
  • Main Results:

    • Changes in expiratory flow patterns (no load, resistive load, end-inspiratory pause) resulted in unchanged or minimally altered inspiratory impedance and compliance.
    • The type of expiratory ventilation did not significantly impact the measured respiratory parameters.

    Conclusions:

    • Expiratory laryngeal loading does not primarily serve to decrease the work of breathing.
    • Expiratory patterns likely play a role in increasing and controlling mean airway pressure.
    • This control of mean airway pressure may be crucial for regulating pulmonary fluid reabsorption, ventilation distribution, and gas diffusion.