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1Department of Medical Informatics and Engineering, and 2Institute of Surgical Research, University of Szeged, H-6720 Szeged, Hungary; and 3Center for Polymer Studies and Department of Physics, and 4Department of Biomedical Engineering, Boston University, Boston, Massachussetts 02215
Submitted 29 December 2003 ; accepted in final form 8 April 2004
The aim of this study was to test the hypothesis that the mechanism of recruitment and the lower knee of the pressure-volume curve in the normal lung are primarily determined by airway reopenings via avalanches rather than simple alveolar recruitments. In isolated dog lung lobes, the pressure-volume loops were measured, and crackle sounds were recorded intrabronchially during both the first inflation from the collapsed state to total lobe capacity and a second inflation without prior degassing. The inflation flow contained transients that were accompanied by a series of crackles. Discrete volume increments were estimated from the flow transients, and the energy levels 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 pressure-volume curve. The values of volume increments were correlated with crackle energy during the flow transient for both the first and the second inflations (r2 = 0.290.73 and 0.680.82, respectively). Because the distribution of volume increments 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.
airway closure; pressure-volume curve; avalanches
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