Article

Aging of the respiratory system: impact on pulmonary function tests and adaptation to exertion.

Outpatient Section of the Division of Pulmonary Diseases, Geneva University Hospital, 1211 Geneva 14, Switzerland.
Clinics in Chest Medicine (Impact Factor: 2.17). 10/2005; 26(3):469-84, vi-vii. DOI: 10.1016/j.ccm.2005.05.004
Source: PubMed

ABSTRACT Normal aging of the respiratory system is associated with a decrease in static elastic recoil of the lung, in respiratory muscle performance, and in compliance of the chest wall and respiratory system, resulting in increased work of breathing compared with younger subjects and a diminished respiratory reserve in cases of acute illness, such as heart failure, infection, or airway obstruction. In spite of these changes, the respiratory system remains capable of maintaining adequate gas exchange at rest and during exertion during the entire lifespan, with only a slight decrease in Pa(O2) and no significant change in Pa(CO2).

4 Bookmarks
 · 
742 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Age-related anatomic, physiologic, and immunologic changes to the pulmonary system, as well as a high prevalence of chronic pulmonary diseases, puts the geriatric patient at an especially high risk for postoperative pulmonary complications. Successful perioperative respiratory care of the geriatric patient relies on careful risk assessment and optimization of pulmonary function and support. The success of such efforts aimed at preventing and/or mitigating pulmonary complications in the geriatric patient depends on a thorough, individualized, yet standardized and evidence-based approach to the care of every patient. Copyright © 2015 Elsevier Inc. All rights reserved.
    Surgical Clinics of North America 11/2014; 95(1). DOI:10.1016/j.suc.2014.09.009 · 1.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The longitudinal relationship between regional air trapping and emphysema remains unexplored. We have sought to demonstrate the utility of parametric response mapping (PRM), a computed tomography (CT)-based biomarker, for monitoring regional disease progression in chronic obstructive pulmonary disease (COPD) patients, linking expiratory- and inspiratory-based CT metrics over time. Inspiratory and expiratory lung CT scans were acquired from 89 COPD subjects with varying Global Initiative for Chronic Obstructive Lung Disease (GOLD) status at 30 days (n = 13) or 1 year (n = 76) from baseline as part of the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) clinical trial. PRMs of CT data were used to quantify the relative volumes of normal parenchyma (PRM(Normal)), emphysema (PRM(Emph)), and functional small airways disease (PRM(fSAD)). PRM measurement variability was assessed using the 30-day interval data. Changes in PRM metrics over a 1-year period were correlated to pulmonary function (forced expiratory volume at 1 second [FEV1]). A theoretical model that simulates PRM changes from COPD was compared to experimental findings. PRM metrics varied by ∼6.5% of total lung volume for PRM(Normal) and PRM(fSAD) and 1% for PRM(Emph) when testing 30-day repeatability. Over a 1-year interval, only PRM(Emph) in severe COPD subjects produced significant change (19%-21%). However, 11 of 76 subjects showed changes in PRM(fSAD) greater than variations observed from analysis of 30-day data. Mathematical model simulations agreed with experimental PRM results, suggesting fSAD is a transitional phase from normal parenchyma to emphysema. PRM of lung CT scans in COPD patients provides an opportunity to more precisely characterize underlying disease phenotypes, with the potential to monitor disease status and therapy response. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.
    Academic Radiology 11/2014; 22(2). DOI:10.1016/j.acra.2014.08.015 · 2.08 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We examined structural properties of the marine mammal respiratory system, and tested Scholander’s hypothesis that the chest is highly compliant by measuring the mechanical properties of the respiratory system in five species of pinniped under anesthesia (Pacific harbor seal, Phoca vitulina; northern elephant seal, Mirounga angustirostris; northern fur seal Callorhinus ursinus; California sea lion, Zalophus californianus; and Steller sea lion, Eumetopias jubatus). We found that the chest wall compliance (CCW) of all five species was greater than lung compliance (airways and alveoli, CL) as predicted by Scholander, which suggests that the chest provides little protection against alveolar collapse or lung squeeze. We also found that specific respiratory compliance was significantly greater in wild animals than in animals raised in an aquatic facility. While differences in ages between the two groups may affect this incidental finding, it is also possible that lung conditioning in free-living animals may increase pulmonary compliance and reduce the risk of lung squeeze during diving. Overall, our data indicate that compliance of excised pinniped lungs provide a good estimate of total respiratory compliance.
    Frontiers in Physiology 11/2014; 5(00433). DOI:10.3389/fphys.2014.00433

Preview

Download
31 Downloads
Available from