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Regional Ventilation and Aerosol Deposition with Helium-Oxygen in Bronchoconstricted Asthmatic Lungs

机译:支气管狭窄性哮喘肺的局部通气和氦氧气溶胶沉积

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摘要

>Background: Theoretical models suggest that He-O2 as carrier gas may lead to more homogeneous ventilation and aerosol deposition than air. However, these effects have not been clinically consistent and it is unclear why subjects may or may not respond to the therapy. Here we present 3D-imaging data of aerosol deposition and ventilation distributions from subjects with asthma inhaling He-O2 as carrier gas. The data are compared with those that we previously obtained from a similar group of subjects inhaling air.>Methods: Subjects with mild-to-moderate asthma were bronchoconstricted with methacholine and imaged with PET-CT while inhaling aerosol carried with He-O2. Mean-normalized-values of lobar specific ventilation sV* and deposition sD* were derived and the factors affecting the distribution of sD* were evaluated along with the effects of breathing frequency (f) and regional expansion (FVOL).>Results: Lobar distributions of sD* and sV* with He-O2 were not statistically different from those previously measured with air. However, with He-O2 there was a larger number of lobes having sV* and sD* closer to unity and, in those subjects with uneven deposition distributions, the correlation of sD* with sV* was on average higher (p < 0.05) in He-O2 (0.84 ± 0.8) compared with air (0.55 ± 0.28). In contrast with air, where the frequency of breathing during nebulization was associated with the degree of sD*-sV* correlation, with He-O2 there was no association. Also, the modulation of f on the correlation between FVOL and sD*/sV* in air, was not observed in He-O2.>Conclusion: There were no differences in the inter-lobar heterogeneity of sD* or sV* in this group of mild asthmatic subjects breathing He-O2 compared with patients previously breathing air. Future studies, using these personalized 3D data sets as input to CFD models, are needed to understand if, and for whom, breathing He-O2 during aerosol inhalation may be beneficial.
机译:>背景:理论模型表明,作为载气的He-O2可能比空气导致更均匀的通风和气溶胶沉积。但是,这些作用在临床上并不一致,目前尚不清楚为什么受试者可能会对治疗产生反应。在这里,我们呈现哮喘患者吸入He-O2作为载气的气溶胶沉积和通气分布的3D成像数据。将这些数据与我们先前从相似的一组吸入空气的受试者中获得的数据进行比较。>方法:轻度至中度哮喘的受试者在吸入气雾剂的同时,用乙酰甲胆碱对支气管狭窄并用PET-CT成像与氦氧。得出大叶特定通气量sV *和沉积物sD *的平均归一化值,并评估影响sD *分布的因素以及呼吸频率(f)和区域扩展(FVOL)的影响。>结果: 含He-O2的sD *和sV *的大叶分布与以前使用空气测量的分布无统计学差异。但是,在He-O2的情况下,sV *和sD *接近统一的叶片数量更大,在那些沉积分布不均匀的受试者中,sD *与sV *的相关性平均更高(p <0.05)。 He-O2(0.84±±0.8)与空气(0.55±0.28)相比。与空气相反,雾化期间的呼吸频率与sD * -sV *的相关程度有关,而与He-O2则没有任何关系。另外,在He-O2中未观察到f对 FVOL sD * / sV * 之间的相关性的调制。 strong> 结论: 在这组轻度人群中, sD * sV * 的叶间异质性没有差异与先前呼吸空气的患者相比,呼吸He-O2的哮喘受试者。需要使用这些个性化的3D数据集作为CFD模型的输入进行进一步的研究,以了解在气雾吸入过程中呼吸He-O2是否有益,对谁有益。

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