Wall motion in expiratory flow limitation: choke and flutter.

Limitation of expiratory airflow from mammalian airways is currently understood to be due to choking at wave speed (S. V. Dawson and E. A. Elliott. J. Appl. Physiol. 43: 498-515, 1977). A critical weakness of the theory is the lack of a mechanism for the dissipation of energy when effort exceeds that needed for maximal flow. We have observed substantial wall motion with flow limitation in a physical model of a trachea. Therefore we have examined a simple two-dimensional mathematical model, designed to approximate the behavior of the physical model of the trachea, to try to identify a relationship between flow limitation and wall oscillation. The model matches wave-speed predictions when only long waves are considered. The model predicts that aerodynamic flutter will occur in the zone of supercritical flow described in wave-speed theory. Aerodynamic flutter in the zone of supercritical flow provides a potential mechanism for the energy dissipation necessary for transition from supercritical to subcritical flow and explains the high-frequency pure tone heard with flow limitation.