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Cited by 226Obstructive Sleep Apnea ResearchNeuroscience of respiration and sleepRespiratory Support and Mechanisms

Fluid Shift by Lower Body Positive Pressure Increases Pharyngeal Resistance in Healthy Subjects

Chiu, Kuo-Liang, Ryan, Clodagh M., Shiota, Satomi, Ruttanaumpawan, Pimon, Arzt, Michael, Haight, James S., Chan, Christopher T., Floras, John S. +1 more·2006·American Journal of Respiratory and Critical Care Medicine
DOI 10.1164/rccm.200607-927oc
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Abstract

Introduction: Fluid displacement into nuchal and peripharyngeal soft tissues while recumbent may contribute to narrowing and increased airflow resistance of the pharynx (Rph), and predispose to pharyngeal collapse in patients at risk for obstructive sleep apnea. Objectives: To determine whether displacement of fluid from the lower body to the neck will increase both neck circumference and Rph in healthy subjects. Methods: In 11 healthy, nonobese subjects, studied while awake and supine, leg fluid volume, neck circumference, and Rph were measured at baseline. Subjects were then randomized to a control period or to application of lower body positive pressure (LBPP) of 40 mm Hg via antishock trousers to displace fluid from the legs, after which they crossed over to the other arm. Baseline measurements were repeated at 1 and 5 min during the control and LBPP periods. Results: Compared with the control period, application of LBPP caused a significant reduction in leg fluid volume (p < 0.001) and a significant increase in neck circumference (p = 0.004). Rph remained stable during the control period, but increased significantly from baseline after 1 and 5 min of LBPP (from 0.43 ± 0.10 to 0.60 ± 0.11 cm H2O/L/s, p = 0.034, and to 0.87 ± 0.19 cm H2O/L/s, p < 0.001, compared with baseline, respectively). Conclusions: Fluid displacement from the legs by LBPP increases neck circumference and Rph in healthy subjects. These findings suggest the hypothesis that fluid displacement to the upper body during recumbency may predispose to pharyngeal obstruction during sleep, especially in fluid overload states, such as heart and renal failure.

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Authors
Chiu, K.-L., Ryan, C. M., Shiota, S., Ruttanaumpawan, P., Arzt, M., Haight, J. S., Chan, C. T., Floras, J. S., & Bradley, T. D.
Affiliations
Mount Sinai Hospital (CA)
ORCID
Venue
American Journal of Respiratory and Critical Care Medicine
Publisher
Oxford University Press (OUP)
Published
2006-12
Volume
174
Issue
12
Pages
1378-1383
ISSN
  • 1073-449X (ISSN-L)
  • 1535-4970
DOI
10.1164/rccm.200607-927oc
OpenAlex
W2116187155
Cited by
226
References
48
Citations by year
2026: 3 · 2025: 5 · 2024: 1 · 2023: 7 · 2022: 7 · 2021: 6 · 2020: 8 · 2019: 10 · 2018: 14 · 2017: 12 · 2016: 10 · 2015: 19 · 2014: 14 · 2013: 10 · 2012: 20
FWCI
9.94
Type
journal article
Language
en
Open access
closed
Licence
academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations
  • American Journal of Respiratory and Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords
lower body positive pressure, fluid shifts, neck circumference, pharyngeal collapse, obstructive sleep apnea, supine position, fluid overload
MeSH terms
Adult, Airway Resistance, Female, Humans, Male, Middle Aged, Neck, Pharynx, Pressure, Fluid Shifts

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