Mechanism of production of crackles after atelectasis during low-volume breathing. 1982

Y Ploysongsang, and S A Schonfeld

We compared the effects of shallow breathing of air (LVB-air) and oxygen (LVB-O2) at low lung volumes (below closing capacity) and tidal breathing at FRC (FRC-air, FRC-O2) on the production of crackles in 5 normal volunteers. Two microphones were attached on the right posterior chest wall in the midclavicular line 10 and 20 cm from the apex of the right lung, respectively (M10 and M20), to record crackles during various breathing maneuvers. We found that after LVB-air and LVB-O2, there were changes in residual volume as measured by the body plethysmograph. Both inspiratory and expiratory limbs of the quasi-static pressure volume curve were shifted to the right. Occasionally, some subjects coughed after LVB-air and/or LVB-O2. Inspiratory crackles occurred mostly at the upper third of vital capacity (VC) after LVB-air and LVB-O2 and were confined almost exclusively to the dependent lung zones (M20). The inspiratory transpulmonary pressure at 25% (PL25) and 50% (PL50) of VC correlated with the volume of trapped gas that was absorbed (delta Vtg) (p less than 0.001 and p less than 0.001, respectively). The quantity of crackles correlated with delta Vtg (p less than 0.01). We conclude that during low lung volume breathing airways in the dependent lung regions are closed. There is absorption of trapped oxygen which causes reversible atelectasis. Upon reinflation, inspired air will go to the lung regions with open airways first and subsequently to the closed dependent regions, producing crackles recorded by the M20 microphone at the upper third of VC. The crackles are produced by inflation of atelectatic lung.

UI MeSH Term Description Entries
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D010993 Plethysmography, Whole Body Measurement of the volume of gas in the lungs, including that which is trapped in poorly communicating air spaces. It is of particular use in chronic obstructive pulmonary disease and emphysema. (Segen, Dictionary of Modern Medicine, 1992) Whole Body Plethysmography,Body Plethysmographies, Whole,Body Plethysmography, Whole,Plethysmographies, Whole Body,Whole Body Plethysmographies
D012123 Pulmonary Ventilation The total volume of gas inspired or expired per unit of time, usually measured in liters per minute. Respiratory Airflow,Ventilation Tests,Ventilation, Pulmonary,Expiratory Airflow,Airflow, Expiratory,Airflow, Respiratory,Test, Ventilation,Tests, Ventilation,Ventilation Test
D012135 Respiratory Sounds Noises, normal and abnormal, heard on auscultation over any part of the RESPIRATORY TRACT. Breathing Sounds,Crackles,Lung Sounds,Pleural Rub,Rales,Rhonchi,Stridor,Wheezing,Breathing Sound,Crackle,Lung Sound,Pleural Rubs,Rale,Respiratory Sound,Rhonchus,Rub, Pleural,Sound, Breathing,Sound, Lung,Sound, Respiratory,Sounds, Breathing,Sounds, Lung,Stridors,Wheezings
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000388 Air The mixture of gases present in the earth's atmosphere consisting of oxygen, nitrogen, carbon dioxide, and small amounts of other gases.
D001314 Auscultation Act of listening for sounds within the body. Auscultations
D013990 Tidal Volume The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. Tidal Volumes,Volume, Tidal,Volumes, Tidal
D014797 Vital Capacity The volume of air that is exhaled by a maximal expiration following a maximal inspiration. Forced Vital Capacity,Capacities, Forced Vital,Capacities, Vital,Capacity, Forced Vital,Capacity, Vital,Forced Vital Capacities,Vital Capacities,Vital Capacities, Forced,Vital Capacity, Forced

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