Skip to main content
SpringerLink
Log in

Influence of end-expiratory level and tidal volume on gravitational ventilation distribution during tidal breathing in healthy adults

  • Original Article
  • Published:
European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

Our understanding of regional filling of the lung and regional ventilation distribution is based on studies using stepwise inhalation of radiolabelled tracer gases, magnetic resonance imaging and positron emission tomography. We aimed to investigate whether these differences in ventilation distribution at different end-expiratory levels (EELs) and tidal volumes (V Ts) held also true during tidal breathing. Electrical impedance tomography (EIT) measurements were performed in ten healthy adults in the right lateral position. Five different EELs with four different V Ts at each EEL were tested in random order, resulting in 19 combinations. There were no measurements for the combination of the highest EEL/highest V T. EEL and V T were controlled by visual feedback based on airflow. The fraction of ventilation directed to different slices of the lung (VENTRL1−VENTRL8) and the rate of the regional filling of each slice versus the total lung were analysed. With increasing EEL but normal tidal volume, ventilation was preferentially distributed to the dependent lung and the filling of the right and left lung was more homogeneous. With increasing V T and maintained normal EEL (FRC), ventilation was preferentially distributed to the dependent lung and regional filling became more inhomogeneous (p < 0.05). We could demonstrate that regional and temporal ventilation distribution during tidal breathing was highly influenced by EEL and V T.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Costa EL, Lima RG, Amato MB (2009) Electrical impedance tomography. Curr Opin Crit Care 15:18–24

    Article  PubMed  Google Scholar 

  • Dunlop S, Hough J, Riedel T, Fraser JF, Dunster K, Schibler A (2006) Electrical impedance tomography in extremely prematurely born infants and during high frequency oscillatory ventilation analyzed in the frequency domain. Physiol Meas 27:1151–1165

    Article  PubMed  Google Scholar 

  • Emami K, Kadlecek SJ, Woodburn JM, Zhu J, Yu J, Vahdat V, Pickup S, Ishii M, Rizi RR (2010) Improved technique for measurement of regional fractional ventilation by hyperpolarized 3He MRI. Magn Reson Med 63:137–150

    PubMed  Google Scholar 

  • Fixley MS, Roussos CS, Murphy B, Martin RR, Engel LA (1978) Flow dependence of gas distribution and the pattern of inspiratory muscle contraction. J Appl Physiol 45:733–741

    PubMed  CAS  Google Scholar 

  • Frerichs I (2000) Electrical impedance tomography (EIT) in applications related to lung and ventilation: a review of experimental and clinical activities. Physiol Meas 21:R1–R21

    Article  PubMed  CAS  Google Scholar 

  • Frerichs I, Hahn G, Hellige G (1996) Gravity-dependent phenomena in lung ventilation determined by functional EIT. Physiol Meas 17 Suppl 4A:A149–157

    Google Scholar 

  • Frerichs I, Dudykevych T, Hinz J, Bodenstein M, Hahn G, Hellige G (2001) Gravity effects on regional lung ventilation determined by functional EIT during parabolic flights. J Appl Physiol 91:39–50

    PubMed  CAS  Google Scholar 

  • Frerichs I, Braun P, Dudykevych T, Hahn G, Genee D, Hellige G (2004) Distribution of ventilation in young and elderly adults determined by electrical impedance tomography. Respir Physiol Neurobiol 143:63–75

    Article  PubMed  Google Scholar 

  • Grant BJ, Jones H, Hughes JM (1974a) Inspiratory flow rate and ventilation distribution. Scand J Respir Dis Suppl 85:23–27

    PubMed  CAS  Google Scholar 

  • Grant BJ, Jones HA, Hughes JM (1974b) Sequence of regional filling during a tidal breath in man. J Appl Physiol 37:158–165

    PubMed  CAS  Google Scholar 

  • Grant CA, Fraser JF, Dunster KR, Schibler A (2009) The assessment of regional lung mechanics with electrical impedance tomography: a pilot study during recruitment manoeuvres. Intensive Care Med 35:166–170

    Article  PubMed  Google Scholar 

  • Hahn G, Sipinkova I, Baisch F, Hellige G (1995) Changes in the thoracic impedance distribution under different ventilatory conditions. Physiol Meas 16:A161–A173

    Article  PubMed  CAS  Google Scholar 

  • Heinrich S, Schiffmann H, Frerichs A, Klockgether-Radke A, Frerichs I (2006) Body and head position effects on regional lung ventilation in infants: an electrical impedance tomography study. Intensive Care Med 32:1392–1398

    Article  PubMed  Google Scholar 

  • Kaneko K, Milic-Emili J, Dolovich MB, Dawson A, Bates DV (1966) Regional distribution of ventilation and perfusion as a function of body position. J Appl Physiol 21:767–777

    PubMed  CAS  Google Scholar 

  • Milic-Emili J, Henderson JA, Dolovich MB, Trop D, Kaneko K (1966) Regional distribution of inspired gas in the lung. J Appl Physiol 21:749–759

    PubMed  CAS  Google Scholar 

  • Musch G, Layfield JD, Harris RS, Melo MF, Winkler T, Callahan RJ, Fischman AJ, Venegas JG (2002) Topographical distribution of pulmonary perfusion and ventilation, assessed by PET in supine and prone humans. J Appl Physiol 93:1841–1851

    PubMed  Google Scholar 

  • Pham TM, Yuill M, Dakin C, Schibler A (2010) Regional ventilation distribution in the first 6 months of life. Eur Respir J

  • Pulletz S, van Genderingen HR, Schmitz G, Zick G, Schadler D, Scholz J, Weiler N, Frerichs I (2006) Comparison of different methods to define regions of interest for evaluation of regional lung ventilation by EIT. Physiol Meas 27:S115–S127

    Article  PubMed  Google Scholar 

  • Rehder K, Sessler AD, Rodarte JR (1977) Regional intrapulmonary gas distribution in awake and anesthetized-paralyzed man. J Appl Physiol 42:391–402

    PubMed  CAS  Google Scholar 

  • Riedel T, Richards T, Schibler A (2005) The value of electrical impedance tomography in assessing the effect of body position and positive airway pressures on regional lung ventilation in spontaneously breathing subjects. Intensive Care Med 31:1522–1528

    Article  PubMed  Google Scholar 

  • Riedel T, Kyburz M, Latzin P, Thamrin C, Frey U (2009) Regional and overall ventilation inhomogeneities in preterm and term-born infants. Intensive Care Med 35:144–151

    Article  PubMed  Google Scholar 

  • Robertson PC, Anthonisen NR, Ross D (1969) Effect of inspiratory flow rate on regional distribution of inspired gas. J Appl Physiol 26:438–443

    PubMed  CAS  Google Scholar 

  • Robinson PD, Goldman MD, Gustafsson PM (2009) Inert gas washout: theoretical background and clinical utility in respiratory disease. Respiration 78:339–355

    Article  PubMed  Google Scholar 

  • Rooney D, Friese M, Fraser JF, Dunster KR, Schibler A (2009) Gravity-dependent ventilation distribution in rats measured with electrical impedance tomography. Physiol Meas 30:1075–1085

    Article  PubMed  Google Scholar 

  • Roussos CS, Fixley M, Genest J, Cosio M, Kelly S, Martin RR, Engel LA (1977) Voluntary factors influencing the distribution of inspired gas. Am Rev Respir Dis 116:457–467

    PubMed  CAS  Google Scholar 

  • Sa RC, Cronin MV, Henderson AC, Holverda S, Theilmann RJ, Arai TJ, Dubowitz DJ, Hopkins SR, Buxton RB, Prisk GK (2010) Vertical distribution of specific ventilation in normal supine humans measured by oxygen-enhanced proton MRI. J Appl Physiol 109:1950–1959

    Article  PubMed  Google Scholar 

  • Schibler A, Yuill M, Parsley C, Pham T, Gilshenan K, Dakin C (2009) Regional ventilation distribution in non-sedated spontaneously breathing newborns and adults is not different. Pediatr Pulmonol 44:851–858

    Article  PubMed  Google Scholar 

  • Tingay DG, Copnell B, Grant CA, Dargaville PA, Dunster KR, Schibler A (2010) The effect of endotracheal suction on regional tidal ventilation and end-expiratory lung volume. Intensive Care Med 36:888–896

    Article  PubMed  CAS  Google Scholar 

  • West JB (1966) Distribution of pulmonary blood flow and ventilation measured with radioactive gases. Scand J Respir Dis Suppl 62:9–13

    PubMed  CAS  Google Scholar 

  • Wrigge H, Zinserling J, Muders T, Varelmann D, Gunther U, von der Groeben C, Magnusson A, Hedenstierna G, Putensen C (2008) Electrical impedance tomography compared with thoracic computed tomography during a slow inflation maneuver in experimental models of lung injury. Crit Care Med 36:903–909

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

No conflicts of interest, financial or otherwise, are declared by the authors.

Author information

Authors and Affiliations

  1. Division of Paediatric and Neonatal Intensive Care Medicine, Department of Paediatrics, Inselspital, University Children’s Hospital and University of Bern, 3010, Bern, Switzerland

    Silvia Schnidrig & Thomas Riedel

  2. Division of Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, University Children’s Hospital and University of Bern, Bern, Switzerland

    Carmen Casaulta

  3. Paediatric Critical Care Research Group, Paediatric Intensive Care Unit, Mater Children’s Hospital, South Brisbane, QLD, Australia

    Andreas Schibler & Thomas Riedel

Authors
  1. Silvia Schnidrig
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carmen Casaulta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andreas Schibler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas Riedel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas Riedel.

Additional information

Communicated by Susan A. Ward.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schnidrig, S., Casaulta, C., Schibler, A. et al. Influence of end-expiratory level and tidal volume on gravitational ventilation distribution during tidal breathing in healthy adults. Eur J Appl Physiol 113, 591–598 (2013). https://doi.org/10.1007/s00421-012-2469-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00421-012-2469-7

Keywords

Search

Navigation