Effect of regional chest wall restriction on regional lung function.

The effect of impeding regional chest wall excursion on regional lung function was assessed. Fourteen subjects were studied while seated in a volume-displacement plethysmography. The lower rib cage and epigastrium were restricted with an inextensible binder. Because such restriction increases lung recoil and diminishes functional residual capacity (FRC), all measurements were made at the unstrapped FRC (FRCus). Regional excursion of the chest wall was measured with magnetometers placed anteroposteriorly at the sternomanubrial angle, the xyphoid, and umbilicus and transversely at the level of the xyphoid at the midaxillary line. Regional lung function was assessed by measuring the distribution of inspired boluses and washout of 133Xe with scintillation detectors positioned against the subject's back at the apical, middle, and basal regions. Restriction of the lower chest wall impeded expansion of the lower rib cage and diminished the distribution of inspired gas to and washout of the lung bases. The upper rib cage expanded normally and was associated with an increased distribution of inspired gas and normal distribution of washout to the apices. These results suggest that regional lung function was dependent on regional rib cage excursion.