title: Lung hyperinflation: foe or friend?
abstract: Breath-hold divers employ glossopharyngeal insufflation (GI) in order to prevent the lungs from compressing at great depth and to increase intrapulmonary oxygen stores, thus increasing breath-hold time. The presented case study shows the physiological data and dynamic magnetic resonance imaging (dMRI) findings of acute hyperinflation, deliberately induced by GI, in a breath-hold diver and discusses the current state of knowledge regarding the associated hazards of this unique competitive sport. Static and dynamic lung volumes and expiratory flows were within the normal range, with vital capacity and peak expiratory flow being higher than the predicted values. Airway resistance and diffusing capacity of the lung for carbon monoxide were normal. Static compliance was normal and increased five-fold with hyperinflation. dMRI revealed a preserved shape of the thorax and diaphragm with hyperinflation. A herniation of the lung beneath the sternum and enlargement of the costodiaphragmatic angle were additional findings during the GI manoeuvre. After expiration, complete resolution to baseline was demonstrated. Hyperinflation can be physiological and even protective under abnormal physical conditions in the sense of acute adaptation to deep breath-hold diving. Dynamic magnetic resonance imaging is adequate for visualisation of the sequence of the glossopharyngeal insufflation manoeuvre and the complete reversibility of deliberate hyperinflation.
authors.affiliation: Dept of Radiology, German Cancer Research CentreHeidelberg, Germany. m.eichinger@dkfz.de
authors.forename: M
authors.initials: M
authors.lastname: Eichinger
authors.forename: S
authors.initials: S
authors.lastname: Walterspacher
authors.forename: T
authors.initials: T
authors.lastname: Scholz
authors.forename: K
authors.initials: K
authors.lastname: Tetzlaff
authors.forename: K
authors.initials: K
authors.lastname: Röcker
authors.forename: C-M
authors.initials: CM
authors.lastname: Muth
authors.forename: M
authors.initials: M
authors.lastname: Puderbach
authors.forename: H-U
authors.initials: HU
authors.lastname: Kauczor
authors.forename: S
authors.initials: S
authors.lastname: Sorichter
mesh_terms: D000328:Adult; D000403:Airway Resistance; D002248:Carbon Monoxide / Q000378:metabolism; D004242:Diving / Q000502:physiology; D006801:Humans; D008168:Lung / Q000473:pathology*; D008171:Lung Diseases / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D012115:Residual Volume / Q000502:physiology; D015656:Respiratory Mechanics / Q000502:physiology; D014109:Total Lung Capacity / Q000502:physiology; D014797:Vital Capacity / Q000502:physiology
chemical_list: D002248:Carbon Monoxide