scholarly journals Flow-Volume Parameters in COPD Related to Extended Measurements of Lung Volume, Diffusion, and Resistance

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Linnea Jarenbäck ◽  
Jaro Ankerst ◽  
Leif Bjermer ◽  
Ellen Tufvesson
Keyword(s):  
Lung Function ◽  
Forced Expiratory Volume ◽  
Flow Volume ◽  
Impulse Oscillometry ◽  
Body Plethysmography ◽  
Additional Information ◽  
Single Breath ◽  
Gold Stage ◽  
Copd Patients ◽  
Helium Dilution

Classification of COPD into different GOLD stages is based on forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) but has shown to be of limited value. The aim of the study was to relate spirometry values to more advanced measures of lung function in COPD patients compared to healthy smokers. The lung function of 65 COPD patients and 34 healthy smokers was investigated using flow-volume spirometry, body plethysmography, single breath helium dilution with CO-diffusion, and impulse oscillometry. All lung function parameters, measured by body plethysmography, CO-diffusion, and impulse oscillometry, were increasingly affected through increasing GOLD stage but did not correlate with FEV1within any GOLD stage. In contrast, they correlated fairly well with FVC%p, FEV1/FVC, and inspiratory capacity. Residual volume (RV) measured by body plethysmography increased through GOLD stages, while RV measured by helium dilution decreased. The difference between these RV provided valuable additional information and correlated with most other lung function parameters measured by body plethysmography and CO-diffusion. Airway resistance measured by body plethysmography and impulse oscillometry correlated within COPD stages. Different lung function parameters are of importance in COPD, and a thorough patient characterization is important to understand the disease.

scholarly journals Can the single-breath helium dilution method predict lung volumes as measured by whole-body plethysmography?

2013 ◽  
Vol 39 (6) ◽  
pp. 675-685 ◽  
Author(s):  
Patrícia Chaves Coertjens ◽  
Marli Maria Knorst ◽  
Anelise Dumke ◽  
Adriane Schmidt Pasqualoto ◽  
João Riboldi ◽  
...  
Keyword(s):  
Lung Function ◽  
Whole Body ◽  
Normal Lung ◽  
Regression Equations ◽  
Body Plethysmography ◽  
Lung Volumes ◽  
Single Breath ◽  
Normal Lung Function ◽  
Helium Dilution ◽  
Whole Body Plethysmography

OBJECTIVE: To compare TLC and RV values obtained by the single-breath helium dilution (SBHD) method with those obtained by whole-body plethysmography (WBP) in patients with normal lung function, patients with obstructive lung disease (OLD), and patients with restrictive lung disease (RLD), varying in severity, and to devise equations to estimate the SBHD results.METHODS: This was a retrospective cross-sectional study involving 169 individuals, of whom 93 and 49 presented with OLD and RLD, respectively, the remaining 27 having normal lung function. All patients underwent spirometry and lung volume measurement by both methods.RESULTS: TLC and RV were higher by WBP than by SBHD. The discrepancy between the methods was more pronounced in the OLD group, correlating with the severity of airflow obstruction. In the OLD group, the correlation coefficient of the comparison between the two methods was 0.57 and 0.56 for TLC and RV, respectively (p < 0.001 for both). We used regression equations, adjusted for the groups studied, in order to predict the WBP values of TLC and RV, using the corresponding SBHD values. It was possible to create regression equations to predict differences in TLC and RV between the two methods only for the OLD group. The TLC and RV equations were, respectively, ∆TLCWBP-SBHD in L = 5.264 − 0.060 × FEV1/FVC (r2= 0.33; adjusted r2 = 0.32) and ∆RVWBP-SBHD in L = 4.862 − 0.055 × FEV1/FVC (r2= 0.31; adjusted r2 = 0.30).CONCLUSIONS: The correction of TLC and RV results obtained by SBHD can improve the accuracy of this method for assessing lung volumes in patients with OLD. However, additional studies are needed in order to validate these equations.

scholarly journals Effect of mesenchymal stromal cell infusions on lung function in COPD patients with high CRP levels

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Daniel J. Weiss ◽  
Karen Segal ◽  
Richard Casaburi ◽  
Jack Hayes ◽  
Donald Tashkin
Keyword(s):  
Lung Function ◽  
Time Course ◽  
Inflammatory Marker ◽  
Controlled Trial ◽  
Phase 1 ◽  
Forced Expiratory Volume ◽  
Allogeneic Mscs ◽  
Copd Exacerbations ◽  
Copd Patients ◽  
Patient Reported

Abstract Background We previously reported a Phase 1/2 randomized placebo-controlled trial of systemic administration of bone marrow-derived allogeneic MSCs (remestemcel-L) in COPD. While safety profile was good, no functional efficacy was observed. However, in view of growing recognition of effects of inflammatory environments on MSC actions we conducted a post-hoc analysis with stratification by baseline levels of a circulating inflammatory marker, C-reactive protein (CRP) to determine the effects of MSC administration in COPD patients with varying circulating CRP levels. Methods Time course of lung function, exercise performance, patient reported responses, and exacerbation frequency following four monthly infusions of remestemcel-L vs. placebo were re-assessed in subgroups based on baseline circulating CRP levels. Results In COPD patients with baseline CRP ≥ 4 mg/L, compared to COPD patients receiving placebo (N = 17), those treated with remestemcel-L (N = 12), demonstrated significant improvements from baseline in forced expiratory volume in one second, forced vital capacity, and six minute walk distance at 120 days with treatment differences evident as early as 10 days after the first infusion. Significant although smaller benefits were also detected in those with CRP levels ≥ 2 or ≥ 3 mg/L. These improvements persisted variably over the 2-year observational period. No significant benefits were observed in patient reported responses or number of COPD exacerbations between treatment groups. Conclusion In an inflammatory environment, defined by elevated circulating CRP, remestemcel-L administration yielded at least transient meaningful pulmonary and functional improvements. These findings warrant further investigation of potential MSC-based therapies in COPD and other inflammatory pulmonary diseases. Trial registration: Clinicaltrials.gov NCT00683722.

scholarly journals Maintenance Negative Pressure Ventilation Improves Survival in COPD Patients with Exercise Desaturation

2019 ◽  
Vol 8 (4) ◽  
pp. 562
Author(s):  
Hung-Yu Huang ◽  
Chun-Yu Lo ◽  
Lan-Yan Yang ◽  
Fu-Tsai Chung ◽  
Te-Fang Sheng ◽  
...  
Keyword(s):  
Lung Function ◽  
Negative Pressure ◽  
Significant Risk ◽  
Forced Expiratory Volume ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Negative Pressure Ventilation ◽  
Risk Of Death ◽  
Copd Patients

Negative pressure ventilation (NPV), when used as an adjuvant to pulmonary rehabilitation, improves lung function, increases exercise capacity, and reduces exacerbations. The aim of this study was to determine whether maintenance NPV improves long-term clinical outcomes and reduces mortality in patients with chronic obstructive pulmonary disease (COPD). Between 2003 and 2009, 341 patients were treated for COPD either with or without hospital-based NPV. We measured forced expiratory volume in one second (FEV1), 6-min walking distance (6MWD), and oxygen saturation by pulse oximetry (SpO2) during a 6-min walk test (6MWT) every 3–6 months. Desaturation (D) during the 6MWT was defined as a reduction in SpO2 of ≥10% from baseline. The NPV group had a better survival outcome than the Non-NPV group. The 8-year survival probabilities for the NPV and Non-NPV groups were 60% and 20%, respectively (p < 0.01). Baseline desaturation was a significant risk factor for death, and the risk of death increased with desaturation severity (SpO2 80~89: hazard ratios (HR) 2.7, 95% confidence interval (CI) 1.4–5.3; SpO2 < 80: HR 3.1, 95% CI 1.3–7.4). The NPV group had a slower decline in lung function and 6MWD. The NPV + D and Non-NPV+D had a threefold and fourfold increase in the risks of all-cause mortality compared with the NPV-ND, respectively. Maintenance non-invasive NPV reduced long-term mortality in COPD patients. The desaturating COPD patients had an increased mortality risk compared with non-desaturating COPD patients.

The correlation between quadriceps muscle strength and endurance and exercise performance in patients with COPD

2021 ◽  
Author(s):  
Anouk W. Vaes ◽  
Maurice J.H. Sillen ◽  
Yvonne M.J. Goertz ◽  
Felip Machado ◽  
Maarten Van Herck ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Exercise Capacity ◽  
Quadriceps Muscle ◽  
Forced Expiratory Volume ◽  
Fat Free Mass ◽  
Quadriceps Muscle Strength ◽  
Single Breath ◽  
Copd Patients ◽  
Peak Aerobic Capacity ◽  
Explained Variance

Purpose To determine the association between quadriceps muscle strength (QMS) and endurance (QME) and exercise capacity in COPD patients after stratification for sex and resting lung function (LF). Methods Data were collected in 3246 COPD patients (60% men, 64±9 years), including measures of exercise capacity (peak aerobic capacity (peakVO2)), six-minute walk distance (6MWD)) and isokinetic QMS and QME. Patients were stratified for sex, forced expiratory volume in 1 s (>50/≤50% predicted), single breath carbon monoxide diffusing capacity (>50/≤50% predicted) and residual volume (>140/≤140% predicted). Results After stratification for resting LF, QMS and QME were significantly associated with peakVO2 (r range: 0.47-0.61 and 0.49-0.65 for men; and 0.53-0.66 and 0.48-0.67 for women, respectively)and 6MWD (r range: 0.29-0.42 and 0.44-0.55 for men; and 0.25-0.54 and 0.34-0.55 for women, respectively) (p<0.001). Regression models demonstrated that QMS and QME were significant determinants of peakVO2 (explained variance R2 range: 35.6-48.8% for men; and 36.8-49.0% for women) and 6MWD (R2 range: 24.3-43.3% for men; and 28.4-40.3% for women), independent of age and fat-free mass. Conclusion Quadriceps muscle function was significantly associated with peakVO2 and 6MWD in male and female COPD patients after stratification for resting LF, in which QME appear to be a more important determinant than QMS. This underlines the importance of systematically evaluating both quadriceps muscle strength and endurance in in all COPD patients.

scholarly journals Defining asthma–COPD overlap syndrome: a population-based study

2017 ◽  
Vol 49 (5) ◽  
pp. 1602008 ◽  
Author(s):  
Tobias N. Bonten ◽  
Marise J. Kasteleyn ◽  
Renee de Mutsert ◽  
Pieter S. Hiemstra ◽  
Frits R. Rosendaal ◽  
...  
Keyword(s):  
Lung Function ◽  
Patient Characteristics ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Overlap Syndrome ◽  
Self Report ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Adjusted Incidence Rate

Asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) seems an important clinical phenotype, but multiple definitions have been proposed. This study's objectives were to assess the effect of different ACOS definitions on prevalence, patient characteristics and exacerbations.5675 individuals aged 45–65 years, with 846 asthma/COPD patients, were included in the Netherlands Epidemiology of Obesity study between 2008 and 2012, and followed-up for a median of 1.8 years. ACOS was defined by recent consensus criteria and five other definitions, based on registry, questionnaires and lung function.Prevalence of ACOS in the asthma/COPD population ranged between 4.4% and 38.3%, depending on the definition used. Agreement between registry-based and self-reported ACOS was 0.04 and 0.41 when lung function (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.7) was added. With registry or self-report defined ACOS, only 51% and 33% had FEV1/FVC <0.7. Patient characteristics were similar, but asthma duration was longer with self-reported compared with registry-based ACOS (mean difference 22 years (95% CI 12–33)). Exacerbation risk was highest with registry-based ACOS compared with asthma (adjusted incidence rate ratio 1.6 (95% CI 1.2–2.1)).This study adds important knowledge about agreement between ACOS definitions and their relation with exacerbations. Given the low agreement, differences in prevalence, patient characteristics and risk of exacerbations, consensus about ACOS definition in different care settings is urgently needed.

scholarly journals Expiratory reactance abnormalities in patients with expiratory dynamic airway collapse: a new application of impulse oscillometry

2018 ◽  
Vol 4 (4) ◽  
pp. 00080-2018 ◽  
Author(s):  
David I. Fielding ◽  
Justin Travers ◽  
Phan Nguyen ◽  
Michael G. Brown ◽  
Gunter Hartel ◽  
...  
Keyword(s):  
Lung Function ◽  
Regression Tree ◽  
Classification And Regression Tree ◽  
Normal Lung ◽  
Chronic Obstructive ◽  
Stepwise Logistic Regression ◽  
Impulse Oscillometry ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Normal Lung Function

Expiratory dynamic airways collapse (EDAC) is a condition that affects the central airways; it is not well characterised physiologically, with relatively few studies. We sought to characterise impulse oscillometry (IOS) features of EDAC in patients with normal spirometry. Expiratory data were hypothesised to be the most revealing. In addition, we compared IOS findings in chronic obstructive pulmonary disease (COPD) patients with and without EDAC.EDAC was identified at bronchoscopy as 75–100% expiratory closure at the carina or bilateral main bronchi. Four patient groups were compared: controls with no EDAC and normal lung function; lone EDAC with normal lung function; COPD-only patients; and COPD patients with EDAC.38 patients were studied. Mean IOS data z-scores for EDAC compared to controls showed significantly higher reactance (X) values including X at 5 Hz, resonance frequency and area under the reactance curve (AX). EDAC showed significantly greater expiratory/inspiratory differences in all IOS data compared to controls. Stepwise logistic regression showed that resonant frequency best discriminated between EDAC and normal control, whereas classification and regression tree analysis found AX ≥3.523 to be highly predictive for EDAC in cases with normal lung function (14 out of 15 cases, and none out of eight controls).These data show a new utility of IOS: detecting EDAC in patients with normal lung function.

scholarly journals Effect of TRPM8 and TRPA1 Polymorphisms on COPD Predisposition and Lung Function in COPD Patients

2021 ◽  
Vol 11 (2) ◽  
pp. 108
Author(s):  
Denis E. Naumov ◽  
Olesya O. Kotova ◽  
Dina A. Gassan ◽  
Ivana Y. Sugaylo ◽  
Evgeniya Y. Afanas’eva ◽  
...  
Keyword(s):  
Lung Function ◽  
Multiple Testing ◽  
Transient Receptor Potential ◽  
Trp Channels ◽  
Receptor Potential ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Bronchodilator Response ◽  
Copd Patients

Certain transient receptor potential (TRP) channels including TRPM8 and TRPA1 are widely expressed in the respiratory tract and have been shown to be the receptors of cigarette smoke and particulate matter—the main causative factors of chronic obstructive pulmonary disease (COPD). The aim of the study was to investigate the effect of TRPM8 and TRPA1 polymorphisms on COPD predisposition and lung function in COPD patients. The study enrolled 143 COPD patients and 104 smokers with post-bronchodilator forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) > 70%. Lung function was measured by spirometry. TRPM8 and TRPA1 polymorphisms were genotyped by LATE-PCR. None of the polymorphisms significantly influenced COPD predisposition after correction for covariates and multiple testing. Among COPD patients, the TT genotype of TRPA1 rs7819749 was significantly associated with higher degree of bronchial obstruction. In addition, we established that carriers of the C allele of TRPM8 rs11562975 more commonly had post-bronchodilator FEV1 < 60% (OR 3.2, 95%CI (1.14–8.94), p = 0.03) and revealed the effect of TRPA1 rs959976 and TRPM8 rs17865682 on bronchodilator response in COPD. Thus, the obtained results suggest possible involvement of TRPM8 and TRPA1 in COPD pathogenesis, indicating the necessity to further investigate their functional role in this pathology.

scholarly journals Effects of Side Lying on Lung Function in Older Individuals

1999 ◽  
Vol 79 (5) ◽  
pp. 456-466 ◽  
Author(s):  
Fiona Manning ◽  
Elizabeth Dean ◽  
Jocelyn Ross ◽  
Raja T Abboud
Keyword(s):  
Lung Function ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Phase Iii ◽  
Diffusing Capacity ◽  
Older Individuals ◽  
Transport Pathway ◽  
Single Breath ◽  
History Of ◽  
Body Positioning

Abstract Background and Purpose. Body positioning exerts a strong effect on pulmonary function, but its effect on other components of the oxygen transport pathway are less well understood, especially the effects of side-lying positions. This study investigated the interrelationships between side-lying positions and indexes of lung function such as spirometry, alveolar diffusing capacity, and inhomogeneity of ventilation in older individuals. Subjects and Methods. Nineteen nonsmoking subjects (mean age=62.8 years, SD=6.8, range=50–74) with no history of cardiac or pulmonary disease were tested over 2 sessions. The test positions were sitting and left side lying in one session and sitting and right side lying in the other session. In each of the positions, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), single-breath pulmonary diffusing capacity (DLCO/VA), and the slope of phase III (DN2%/L) of the single-breath nitrogen washout test to determine inhomogeneity of ventilation were measured. Results. Compared with measurements obtained in the sitting position, FVC and FEV1 were decreased equally in the side-lying positions, but no change was observed in DLCO/VA or DN2%/L. Conclusion and Discussion. Side-lying positions resulted in decreases in FVC and FEV1, which is consistent with the well-documented effects of the supine position. These findings further support the need for prescriptive rather than routine body positioning of patients with risks of cardiopulmonary compromise and the need to use upright positions in which lung volumes and capacities are maximized.

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