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1 Department of Medical Informatics, University of Szeged, Szeged, Hungary
2 Institute of Surgical Research, University of Szeged, Szeged, Hungary
3 Center for Polymer Studies and Department of Physics, Boston University, Boston, MA, USA; Department of Biomedical Engineering, Boston University, Boston, MA, USA
4 Department of Biomedical Engineering, Boston University, Boston, MA, USA
* To whom correspondence should be addressed. E-mail: hantos{at}dmi.u-szeged.hu.
The aim of this study was to test the hypothesis that the mechanism of recruitment and the lower knee of the pressure-volume (P-V) curve in the normal lung are primarily determined by airway reopenings via avalanches, rather than simple alveolar recruitments. In isolated dog lung lobes, the P-V loops were measured and crackle sounds were recorded intrabronchially during both the first inflation from the collapsed state to total lobe capacity (TLC) and a second inflation without prior degassing. The inflation flow contained transients which were accompanied by a series of crackles. Discrete volume increments (
V) were estimated from the flow transients and the energy (
E) of the corresponding crackles were calculated from the sound recordings. Crackles were concentrated in the early phase of inflation with the cumulative energy exceeding 90% of its final value by the lower knee of the P-V curve. The values of
V were correlated with
E during the flow transient for both the first and the second inflations (r2=0.29-0.73 and 0.68-0.82, respectively). Since the distribution of
V followed a power law, the correlation between crackle energy and discrete volume increments suggests that an avalanche-like airway opening process governs the recruitment of collapsed normal lungs.
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