EFFECT OF PURSED LIPS EXPIRATION ON PULMONARY PRESSURE-FLOW RELATIONSHIP IN OBSTRUCTIVE LUNG DISEASE

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Abstract
Pressure, flow, and volume relationships during tidal respiration were defined in 15 patients with chronic obstructive pulmonary disease with and without the addition of an external expiratory obstruction designed to simulate pursed lips expiration. The patient group that clained benefit from pursed lips expiration had a greater decrease in nonelastic trans-pulmonary resistance with the added expiratory resistance than did the group who did not purse their lips. The difference between expiratory and inspiratory resistance as an index of airway collapsibility related linearly to the effectiveness of the added expiratory resistance in decreasing the nonelastic resistance across the lung and airways. More total pressure, however, was required for less flow and external volume displacement even in those patients who showed the greatest fall in transpulmonary resistance with added external resistance. Therefore, there is no mechanical advantage to an added expiratory resistance. The explanation for any subjective benefit may be related to a change in the length: tension relationship of the respiratory musculature or relief from any discomfort incurred because of narrowing or collapse of larger bronchi.

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