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Division of Pulmonary and Critical Care Medicine, University Hospitals of Cleveland, and Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106
To evaluate the influence of cold air hyperpnea on
integrated upper and lower airway behavior, 22 asthmatic volunteers
hyperventilated through their mouths (OHV) and noses (NHV) while
pulmonary and nasal function were determined individually and in
combination. In the isolated studies, OHV at a minute ventilation of 65 ± 3 l/min lowered the 1-s forced expiratory volume (FEV1)
24 ± 2% (P < 0.001) and NHV (40 l/min) induced a 31 ± 9% (P < 0.001) increase in nasal resistance (NR). In the
combined studies, oral hyperpnea reduced the FEV1
(
FEV1 26 ± 2%, P < 0.001) and evoked a
significant rise in NR (
NR 26 ± 9%, P = 0.01). In
contrast, NHV only affected the upper airway. NR rose 33 ± 9% (P = 0.01), but airway caliber did not change
(
FEV1 2%, P = 0.27). The results of this
investigation demonstrate that increasing the transfer of heat and
water in the lower respiratory tract alters bronchial and nasal
function in a linked fashion. Forcing the nose to augment its
heat-exchanging activity, however, reduces nasal caliber but has no
effect on the intrathoracic airways.
cold air; asthma; hyperpnea; nasal function; airway function
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