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Pregled bibliografske jedinice broj: 646808

Reply to comment by Singh et al. about article untitled “Gastroesophageal reflux disease and pulmonary function : a potential role of the dead space extension by Bonacin et al.”

Fabijanić, Damir; Bonacin, Damir; Tocilj, Jadranka; Radić, Mislav
Reply to comment by Singh et al. about article untitled “Gastroesophageal reflux disease and pulmonary function : a potential role of the dead space extension by Bonacin et al.” // Medical science monitor, 18 (2012), 7; 6-7 doi:10.12659/MSM.883190 (podatak o recenziji nije dostupan, pismo uredniku, stručni)

Reply to comment by Singh et al. about article untitled “Gastroesophageal reflux disease and pulmonary function : a potential role of the dead space extension by Bonacin et al.”

Fabijanić, Damir ; Bonacin, Damir ; Tocilj, Jadranka ; Radić, Mislav

Medical science monitor (1234-1010) 18 (2012), 7; 6-7

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, pismo uredniku, stručni

Ključne riječi
Gastroesophageal reflux disease; pulmonary function

Dear Editor, We read with great interest comments from Indian group of authors related to our research published in your esteemed journal. The changing of dead space expansion in respiratory function is the fundament in our and Indian group study [1–3]. However, the pathophysiological mechanism responsible for its occurrence is quite different. Contrary to the studies from the Indian group in which changes in respiratory function are reversible, in our study observed changes are irreversible [1]. Also, our opinion is that changes in dead space observed in mentioned studies are dominantly results of inadequate ventilation, probably caused by high-frequency breathing [2, 3]. In physiological condition, parts of the alveoli which are closed during slow breathing are opening during aerobic exercise or during application of moderate exercise breathing [4]. Therefore, moderate aerobic activities results in opening of closed alveoli, reduction of alveolar dead space and increasing lung vital capacity. It is possible that high frequency yoga breathing (HFYB) reduces the percentage of ventilated alveoli which resulted in death space expansion. In that context it is important observation that termination of HFYB improved respiratory parameters and returned them to initial values.The other significant difference is duration of causal mechanisms.Contrary to our study in which mechanism responsible for impairment of respiratory function (gastroesophageal reflux and aspiration of gastric contents into the alveoli which causing microatelectasis and intrapulmonaly shunt increasing) was chronic and continuously present within several months or years, cause responsible for deterioration of respiratory parameters in studies from Indian group (increased carbondioxid washout) was acute, and stopped very quickly after termination of causal activity – HFYB. However, the question is whether the repetition of HFYB cause chronic impairment of lung function in healthy yoga practitioners, as well as, in which part chronic impairment of respiratory function participated in the displayed results. Namely, this study included participants which practiced yoga in a very wide range, from 3 to 180 months. Despite, we know very little about HFYB, based on the description given, the method seems very demanding and, therefore, to our own opinion, inappropriate and potentially dangerous for individuals with known respiratory dysfunction, especially for those with advanced breathing disorders.Finally, research from Indian group prompted us to one, potentially interesting, hypothesis. It is possible that in dead space extension during HFYB is participating pathophysiological mechanism described in our study. Namely, there is possibility that abdominal muscles straining during HFYB increases intra-abdominal pressure, resulting in emerging gastroesophageal reflux and repeated microaspiration of gastric contents into the alveoli, with consequent microatelectasis and intrapulmonary shunt increases. Certainly, in this case we expected a progressive respiratory impairment which correlates with the length and frequency of applying HFYB. Of course, before such research, it would be interesting to investigate the prevalence of Gastroesophageal Reflux Disease in yoga practitioners. Snicerelly, Damir Fabijanić1, Damir Bonacin2, Jadranka Tocilj3, Mislav Radić4 1 Department of Cardiology, University Hospital Split, Split, Croatia, 2 Department of Gastroenterology and Hepatology, University Hospital Split, Split, Croatia 3 Centre for Sport Medicine DIOMED, Split, Croatia 4 Department of Rheumatology and Clinical Immunology, University Hospital Split, Split, Croatia, e-mail: Bonacin D, Fabijanić D, Radić M et al: Gastroesophageal reflux disease and pulmonary function: A potential role of the dead space extension. Med Sci Monit, 2012 ; 18(5): CR271–75 2. Swami G, Singh S, Singh KP, Gupta M: Effect of yoga on pulmonary function tests of hypothyroid patients. Indian J Physiol Pharmacol, 2010 ; 54: 51–56 3. Telles S, Naveen KV, Gaur V, Balkrishna A: Effect of one week of yoga on function and severity in rheumatoid arthritis. BMC Res Notes, 2011 ; 4: 118 4. Steinacker JM, Dehnert C, Whipp BJ: Effect of exercise intensity on the changes in alveolar slopes of carbon dioxide and oxygen expiratory profiles in humans. Eur J Appl Physiol, 2001 ; 85: 56–61

Izvorni jezik

Znanstvena područja
Kliničke medicinske znanosti


KBC Split,
Medicinski fakultet, Split

Časopis indeksira:

  • Current Contents Connect (CCC)
  • Web of Science Core Collection (WoSCC)
    • SCI-EXP, SSCI i/ili A&HCI
  • Scopus

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