Research Topic

Impaired Function of the Respiratory Pump

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Effective gas exchange depends on the transfer of air to the distal airways followed by the exhalation of gases containing expired carbon dioxide and a reduced oxygen content. In the healthy state this process is remarkably energy efficient with considerable reserve to cope with intense ...

Effective gas exchange depends on the transfer of air to the distal airways followed by the exhalation of gases containing expired carbon dioxide and a reduced oxygen content. In the healthy state this process is remarkably energy efficient with considerable reserve to cope with intense exercise.

Effective function can be impaired by diseases affecting the airways, chest wall or control of function. As with most conditions, dysfunction can be caused by congenital abnormalities, infectious agents, loss of homeostatic control, the impact of psychophysiological changes and trauma.

The impact on functional abilities and quality of life of those affected are frequently significant though the high levels of morbidity are rarely recognized beyond the impact of acute exacerbations. As the clinical manifestations of many of these conditions are often remarkably similar, misdiagnosis is common - leading to failure to address the accompanying morbidity effectively.

This Topic will include revisiting asthma in order to consider alternative approaches to finding a cure to the current obsession with allergies and the desire to sell biological agents. Acute lower respiratory tract infections in infants and pre-school children can induce wheeze and differentiating those with a wheezy bronchitis (wheezing with a viral bronchitis without significant bronchospasm) from those with asthma can be difficult. but not impossible. Tracheomalacia amplifies the impact of a viral bronchitis and is a frequent cause of ‘recurrent bronchiolitis’. These issues together with others, such as the impact of chronic lung disease of prematurity and cerebral palsy, which often have their greatest impact in preschool children, will be discussed.

Structural chest wall abnormalities continue to challenge surgeons and respiratory physicians, and the issues of when and how to intervene will be also discussed in this Research Topic. The role of dysfunctional breathing in causing inefficient ventilation and hence a variety of symptoms will be explored, together with associated conditions such as pVCD and exercised induced laryngomalacia. Persistent bacterial bronchitis has been covered in a previous issue and will not be discussed particularly.


Keywords: dysfunction of conducting airways, dysfunctional breathing, structural abnormalities, imaging


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