A thin liquid layer coating the airway can be unstable and forms a plug. Airway closure usually happens at the small airways near the end of expiration, often accompanied with hypersecretion or/and surfactant deficiency in the airway in a variety of lung diseases, such as chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome (ARDS). Modeling work by Halpern and Grotberg  has shown that several forces could contribute to airway closure, such as the surface tension instability and the wall compliance. Experiments in a capillary tube were conducted by Cassidy et al.  who found that adding surfactant increased the airway closure time and the critical film thickness. In vitro studies   illustrated that exposure of primary human airway epithelial cells to plug propagation and rupture led to significant cell injury. Experimental studies   on excised lungs or in vivo animal models have shown that severe tissue damage was found in surfactant-deficient lungs due to the repetitive airway reopening. However, mechanical forces induced by airway closure have not been experimentally evaluated.
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Micro-PIV Measurements of an Airway Closure Model
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Bian, S, Zheng, Y, Takayama, S, & Grotberg, JB. "Micro-PIV Measurements of an Airway Closure Model." Proceedings of the ASME 2009 Summer Bioengineering Conference. ASME 2009 Summer Bioengineering Conference, Parts A and B. Lake Tahoe, California, USA. June 17–21, 2009. pp. 141-142. ASME. https://doi.org/10.1115/SBC2009-206831
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