In Vivo Human Tracheal Pressure-Area Curves Using Computerized Tomographic Scans

In order to develop a simple technique to measure in vivo pressure-area (P-A) curves of the extrathoracic trachea in humans, we studied 14 normal male subjects. Valsalva and Mueller maneuvers were performed at FRC, and tracheal cross-sectional area (TXSA) was measured using computed tomography. Extrathoracic tracheal transmural pressure (TMP) was obtained as airway opening minus atmospheric pressure (Pat). Tracheal “compliance” (TC) was measured on the “inflation” limb of the P-A curve. Tracheal compliance was not a significant predictor of maximal expiratory flow rates, and TXSA at zero TMP was a significant predictor of peak expiratory flow rate but not of FEV1 or Vmax50. P-A curves showed an unexpected configuration characterized by a plateau or an increase in TXSA with TMP lower than -15 cm H2O. P-A curves obtained in 5 subjects using extrathoracic esophageal pressure as tracheal external pressure instead of atmospheric pressure did not show a plateau or an increase in TXSA with Mueller maneuvers. In ...