Detection of expiratory flow limitation in COPD using the forced oscillation technique
Raffaele Dellaca,Pierachille Santus,Andrea Aliverti,N Stevenson,Stefano Centanni,Peter T. Macklem,Antonio Pedotti,P M A Calverley +7 more
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Within-breath respiratory system reactance provides an accurate, reliable and noninvasive technique to detect expiratory flow limitation in patients with chronic obstructive pulmonary disease.Abstract:
Expiratory flow limitation (EFL) during tidal breathing is a major determinant of dynamic hyperinflation and exercise limitation in chronic obstructive pulmonary disease (COPD). Current methods of detecting this are either invasive or unsuited to following changes breath-by-breath. It was hypothesised that tidal flow limitation would substantially reduce the total respiratory system reactance (Xrs) during expiration, and that this reduction could be used to reliably detect if EFL was present. To test this, 5-Hz forced oscillations were applied at the mouth in seven healthy subjects and 15 COPD patients (mean +/- sD forced expiratory volume in one second was 36.8 +/- 11.5% predicted) during quiet breathing. COPD breaths were analysed (n=206) and classified as flow-limited if flow decreased as alveolar pressure increased, indeterminate if flow decreased at constant alveolar pressure, or nonflow-limited. Of these, 85 breaths were flow-limited, 80 were not and 41 were indeterminate. Among other indices, mean inspiratory minus mean expiratory Xrs (deltaXrs) and minimum expiratory Xrs (Xexp,min) identified flow-limited breaths with 100% specificity and sensitivity using a threshold between 2.53-3.12 cmH2O x s x L(-1) (deltaXrs) and -7.38- -6.76 cmH2O x s x L(-1) (Xexp,min) representing 6.0% and 3.9% of the total range of values respectively. No flow-limited breaths were seen in the normal subjects by either method. Within-breath respiratory system reactance provides an accurate, reliable and noninvasive technique to detect expiratory flow limitation in patients with chronic obstructive pulmonary disease.read more
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Physiology of obesity and effects on lung function.
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TL;DR: Obesity has effects on lung function that can reduce respiratory well-being, even in the absence of specific respiratory disease, and may also exaggerate the effects of existing airway disease.
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Long-term air pollution exposure and living close to busy roads are associated with COPD in women.
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An official American Thoracic Society Workshop report: obesity and asthma.
Anne E. Dixon,Fernando Holguin,Akshay Sood,Cheryl M. Salome,Richard E. Pratley,David A. Beuther,Juan C. Celedón,Stephanie A. Shore +7 more
TL;DR: There is an urgent need for research to better understand the mechanisms of asthma in the obese, and to develop new therapies specifically targeted to this unique patient population.
Journal ArticleDOI
Technical Standards for Respiratory Oscillometry
Gregory G. King,Jason H. T. Bates,Kenneth I. Berger,Peter M.A. Calverley,Pedro Lopes de Melo,Raffaele Dellaca,Ramon Farré,Graham L. Hall,Iulia Ioan,Iulia Ioan,Charles G. Irvin,David W. Kaczka,David A. Kaminsky,Hajime Kurosawa,Enrico Lombardi,Geoffrey N. Maksym,François Marchal,François Marchal,Beno W. Oppenheimer,Shannon J. Simpson,Cindy Thamrin,Maarten van den Berge,Ellie Oostveen +22 more
TL;DR: An update to the 2003 European Respiratory Society technical standards document was developed by an ERS task force of international experts to provide technical recommendations regarding oscillometry measurement including hardware, software, testing protocols and quality control.
Journal ArticleDOI
Flow limitation and dynamic hyperinflation: key concepts in modern respiratory physiology
Pma Calverley,Nikolaos Koulouris +1 more
TL;DR: This review focuses on how the two related physiological concepts of expiratory flow limitation and dynamic hyperinflation are defined and assessed and what evidence there is that they might be important in lung disease.
References
More filters
Journal ArticleDOI
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.
Jørgen Vestbo,Suzanne S. Hurd,Alvar Agusti,Paul W. Jones,Claus Vogelmeier,Antonio Anzueto,Peter J. Barnes,Leonardo M. Fabbri,Fernando J. Martinez,Masaharu Nishimura,Robert A. Stockley,Don D. Sin,Roberto Rodriguez-Roisin +12 more
TL;DR: It is recommended that spirometry is required for the clinical diagnosis of COPD to avoid misdiagnosis and to ensure proper evaluation of severity of airflow limitation.
Journal ArticleDOI
Handbook of Physiology.
TL;DR: This is the first volume of the proposed many-sectioned "Handbook" in which the American Physiological Society intends to present comprehensively the entire field of physiology.
Journal ArticleDOI
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary.
TL;DR: List of participants (GOLD Scientific Committee): Nicholas Anthonisen, Winnipeg, Canada, William C. Bailey, Birmingham, US, Tim Clark, London, UK, Leonardo Fabbri, Modena, Italy, Yoshinosuke Fukuchi, Tokyo, Japan; Lawrence Grouse, Seattle, US; James C. Hogg, Vancouver, Canada; Dirkje S. Postma, Groningen, the Netherlands.
Journal ArticleDOI
Lung volumes and forced ventilatory flows
TL;DR: Assessing the total lung capacity is indispensable in establishing a restrictive ventilatory defect or in diagnosing abnormal lung distensibility, as may occur in patients …
Journal Article
Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society.
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