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About the Authors:
Beno W. Oppenheimer
* E-mail: [email protected]
Affiliation: André Cournand Pulmonary Physiology Laboratory, Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Bellevue Hospital/New York University School of Medicine, New York, New York, United States of America
Kenneth I. Berger
Affiliation: André Cournand Pulmonary Physiology Laboratory, Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Bellevue Hospital/New York University School of Medicine, New York, New York, United States of America
Leopoldo N. Segal
Affiliation: André Cournand Pulmonary Physiology Laboratory, Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Bellevue Hospital/New York University School of Medicine, New York, New York, United States of America
Alexandra Stabile
Affiliation: André Cournand Pulmonary Physiology Laboratory, Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Bellevue Hospital/New York University School of Medicine, New York, New York, United States of America
Katherine D. Coles
Affiliation: André Cournand Pulmonary Physiology Laboratory, Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Bellevue Hospital/New York University School of Medicine, New York, New York, United States of America
Manish Parikh
Affiliation: Bellevue Hospital Bariatric Center, Department of Surgery, New York University School of Medicine, New York, New York, United States of America
Roberta M. Goldring
Affiliation: André Cournand Pulmonary Physiology Laboratory, Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Bellevue Hospital/New York University School of Medicine, New York, New York, United States of America
Introduction
Recently there has been increased awareness of the interaction between obesity and intrinsic airway diseases such as asthma. However, objective assessment of lung function in obese patients is confounded by functional abnormalities that are attributable to increased body weight. Airway dysfunction will occur in obese subjects due to reduction in resting lung volume with associated airway compression; however, airway inflammation, vascular congestion and/or concomitant intrinsic airway disease may also be present.[1]–[5] Distinguishing the contribution of airway compression due to mass loading from these other mechanisms [6], [7] is clinically important and may not be identified by standard physiologic testing.
In obesity, mass loading shifts the balance of forces between chest wall/abdomen and lung and produces a decrease in functional residual capacity (FRC). [3], [8] The resulting decreased airway diameter is manifest as reduction in expiratory reserve volume (ERV). [8] Assessment of...