ArticleEuropean journal of applied physiology2025
Inspiratory effort increases blood volume in the thoracic cavity and decreases end-expiratory lung impedance: a preliminary prospective study.
Article in European journal of applied physiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePassive leg raising (PLR) increases intrathoracic blood volume by redistributing blood from the lower to the upper body area. While inspiratory effort is hypothesized to have a similar effect due to pressure differences between the intrathoracic and extrathoracic cavities, direct evidence is scarce. Therefore, this study evaluated whether excessive inspiratory effort increases intrathoracic blood volume using end-expiratory lung impedance (EELI).
methodsVolunteers, fitted with electrical impedance tomography (EIT) belts, underwent a spontaneous breathing procedure in the supine position (control step). They breathed through a specialized face mask with separated inspiration and expiration routes (one-way valves) and their EELI was continuously recorded. First, PLR was performed. Subsequently, resistors (3-mm and 2-mm) were sequentially added to the mask's inspiration route, requiring volunteers to increase inspiratory effort. A reference EELI was established during spontaneous breathing, and changes in EELI (ΔEELI) were calculated for each step (control, PLR, 3-mm, and 2-mm). ΔEELI values were compared using the Friedman test and Wilcoxon signed-rank test with Holm's P value adjustment.
resultsAcross 11 participants, the mean ΔEELI decreased by 13, 18, and 19 units for PLR, 3-mm, and 2-mm resistors, respectively. The Friedman test and Wilcoxon signed-rank test revealed significant differences between the control and each aforementioned intervention.
conclusionPLR and increased inspiratory effort augment thoracic blood volume, thereby reducing EELI. REGISTRATION: UMIN000054238. April/23/2024.
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