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Exploratory study into the effect of abdominal mass loading on airways resistance and ventilatory failure

Abstract:
Objective We hypothesised that the airway resistance during tidal breathing would correlate with a particular pattern of increasing obesity, particularly when supine, and would differ between participants with and without ventilatory failure. Methods In our cross-sectional cohort study, 72 morbidly obese patients (40 males, 32 females, mean body mass index (BMI) 47.2) had measurements of both airways resistance (by impulse oscillometry (IOS)) and adiposity (by dual-energy X-ray absorptiometry (DXA)). Results All measures of airways resistance increased in the supine position: total airways resistance (R5) +37% (p<0.0005); large airways resistance (R20) +29% (p<0.0005); and small airways resistance (R5–R20) +52% (p<0.0005). BMI was correlated with seated R5, seated R5–R20, supine R5 and supine R5–R20 (r=0.33 p<0.006, r=0.32 p<0.004, r=0.30 p<0.02 and r=0.36 p<0.04, respectively). Visceral adipose tissue mass was correlated with supine R5–20 (r=0.46 p<0.05). Supine measures of total airways resistance (R5) and large airways resistance (R20) differed between those with and without ventilatory failure, as did mean weight and BMI. Conclusions Our study identifies a potentially detrimental effect of the supine posture on tidal breathing airways resistance in obese patients. This change is correlated most with visceral adipose tissue mass and the small airways. We were able to demonstrate that supine increases in airways resistance during tidal breathing, within obese patients, are different between those with and without ventilatory failure.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/bmjresp-2016-000138

Authors


More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
NDM Experimental Medicine
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
NDM Experimental Medicine
Role:
Author
ORCID:
0000-0003-4971-5018
More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
NDM Experimental Medicine
Role:
Author
ORCID:
0000-0002-7092-1687


Publisher:
BMJ Publishing Group
Journal:
BMJ Open Respiratory Research More from this journal
Volume:
3
Pages:
e000138
Publication date:
2016-06-09
Acceptance date:
2016-05-13
DOI:
EISSN:
2052-4439
Pmid:
27335651


Language:
English
Keywords:
Pubs id:
pubs:632182
UUID:
uuid:a0f98b40-8b10-4da5-8fc5-832468d35669
Local pid:
pubs:632182
Source identifiers:
632182
Deposit date:
2018-07-24

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