scholarly journals Airway dynamics in COPD patients by within-breath impedance tracking: effects of continuous positive airway pressure

2017 ◽  
Vol 49 (2) ◽  
pp. 1601270 ◽  
Author(s):  
András Lorx ◽  
Dorottya Czövek ◽  
Zoltán Gingl ◽  
Gergely Makan ◽  
Bence Radics ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Forced Oscillation Technique ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Large Variability ◽  
Normal Breathing ◽  
Copd Patients ◽  
Expiratory Flow

Tracking of the within-breath changes of respiratory mechanics using the forced oscillation technique may provide outcomes that characterise the dynamic behaviour of the airways during normal breathing.We measured respiratory resistance (Rrs) and reactance (Xrs) at 8 Hz in 55 chronic obstructive pulmonary disease (COPD) patients and 20 healthy controls, and evaluated Rrs and Xrs as functions of gas flow (V′) and volume (V) during normal breathing cycles. In 12 COPD patients, additional measurements were made at continuous positive airway pressure (CPAP) levels of 4, 8, 14 and 20 hPa.The Rrs and Xrsversus V′ and V relationships displayed a variety of loop patterns, allowing characterisation of physiological and pathological processes. The main outcomes emerging from the within-breath analysis were the Xrsversus V loop area (AXV) quantifying expiratory flow limitation, and the tidal change in Xrs during inspiration (ΔXI) reflecting alteration in lung inhomogeneity in COPD. With increasing CPAP, AXV and ΔXI approached the normal ranges, although with a large variability between individuals, whereas mean Rrs remained unchanged.Within-breath tracking of Rrs and Xrs allows an improved assessment of expiratory flow limitation and functional inhomogeneity in COPD; thereby it may help identify the physiological phenotypes of COPD and determine the optimal level of respiratory support.

Titration Efficacy of Two Auto-Adjustable Continuous Positive Airway Pressure Devices Using Different Flow Limitation-Based Algorithms

Respiration ◽  
2007 ◽  
Vol 75 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Katrien B. Hertegonne ◽  
Bart Rombaut ◽  
Philippe Houtmeyers ◽  
Georges Van Maele ◽  
Dirk A. Pevernagie
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Flow Limitation

Relative Occurrence of Flow Limitation and Snoring During Continuous Positive Airway Pressure Titration

CHEST Journal ◽  
1998 ◽  
Vol 114 (3) ◽  
pp. 685-690 ◽  
Author(s):  
Indu Ayappa ◽  
Robert G. Norman ◽  
Jean-Jacques Hosselet ◽  
Roger A. Gruenke ◽  
Joyce A. Walsleben ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Flow Limitation ◽  
Relative Occurrence

scholarly journals Clinical characteristics of COPD patients with tidal expiratory flow limitation

2017 ◽  
Vol Volume 12 ◽  
pp. 1503-1506 ◽  
Author(s):  
James Dean ◽  
Umme Kolsum ◽  
Paul Hitchen ◽  
Vanadana Gupta ◽  
Dave Singh
Keyword(s):  
Clinical Characteristics ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Copd Patients ◽  
Expiratory Flow

scholarly journals Effect of nocturnal EPAP titration to abolish tidal expiratory flow limitation in COPD patients with chronic hypercapnia: a randomized, cross-over pilot study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Emanuela Zannin ◽  
Ilaria Milesi ◽  
Roberto Porta ◽  
Simona Cacciatore ◽  
Luca Barbano ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Work Of Breathing ◽  
Lung Mechanics ◽  
Intrinsic Peep ◽  
Chronic Obstructive ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Copd Patients ◽  
Ineffective Efforts ◽  
Expiratory Flow

Abstract Background Tidal expiratory flow limitation (EFLT) promotes intrinsic PEEP (PEEPi) in patients with chronic obstructive pulmonary disease (COPD). Applying non-invasive ventilation (NIV) with an expiratory positive airway pressure (EPAP) matching PEEPi improves gas exchange, reduces work of breathing and ineffective efforts. We aimed to evaluate the effects of a novel NIV mode that continuously adjusts EPAP to the minimum level that abolishes EFLT. Methods This prospective, cross-over, open-label study randomized patients to one night of fixed-EPAP and one night of EFLT-abolishing-EPAP. The primary outcome was transcutaneous carbon dioxide pressure (PtcCO2). Secondary outcomes were: peripheral oxygen saturation (SpO2), frequency of ineffective efforts, breathing patterns and oscillatory mechanics. Results We screened 36 patients and included 12 in the analysis (age 72 ± 8 years, FEV1 38 ± 14%Pred). The median EPAP did not differ between the EFLT-abolishing-EPAP and the fixed-EPAP night (median (IQR) = 7.0 (6.0, 8.8) cmH2O during night vs 7.5 (6.5, 10.5) cmH2O, p = 0.365). We found no differences in mean PtcCO2 (44.9 (41.6, 57.2) mmHg vs 54.5 (51.1, 59.0), p = 0.365), the percentage of night time with PtcCO2 > 45 mm Hg was lower (62(8,100)% vs 98(94,100)%, p = 0.031) and ineffective efforts were fewer (126(93,205) vs 261(205,351) events/hour, p = 0.003) during the EFLT-abolishing-EPAP than during the fixed-EPAP night. We found no differences in oxygen saturation and lung mechanics between nights. Conclusion An adaptive ventilation mode targeted to abolish EFLT has the potential to reduce hypercapnia and ineffective efforts in stable COPD patients receiving nocturnal NIV. Trial registration: ClicalTrials.gov, NCT04497090. Registered 29 July 2020—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04497090.

Exacerbation History In COPD Patients With And Without Expiratory Flow Limitation (EFL)

2012 ◽  
Author(s):  
Bernt B. Aarli ◽  
Peter M. Calverley ◽  
Per Bakke ◽  
Tomas M.L. Eagan ◽  
Jon A. Hardie
Keyword(s):  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Copd Patients ◽  
Expiratory Flow

scholarly journals Tidal expiratory flow limitation induces expiratory looping of the alveolar pressure-flow relation in COPD patients

2020 ◽  
Vol 129 (1) ◽  
pp. 75-83
Author(s):  
Matteo Pecchiari ◽  
Dejan Radovanovic ◽  
Camilla Zilianti ◽  
Laura Saderi ◽  
Giovanni Sotgiu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Flow Limitation ◽  
Alveolar Pressure ◽  
Expiratory Flow Limitation ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Expiratory Flow ◽  
Spontaneously Breathing

In stable chronic obstructive pulmonary disease (COPD) patients spontaneously breathing at rest, tidal expiratory flow limitation is the major determinant of the occurrence of expiratory looping in the plethysmographic flow-alveolar pressure diagram. In these patients the magnitude and the characteristics of the loop can be used as predictors of the presence of tidal expiratory flow limitation.

scholarly journals Noninvasive detection of expiratory flow limitation in COPD patients during nasal CPAP

2006 ◽  
Vol 27 (5) ◽  
pp. 983-991 ◽  
Author(s):  
R. L. Dellacà ◽  
M. Rotger ◽  
A. Aliverti ◽  
D. Navajas ◽  
A. Pedotti ◽  
...  
Keyword(s):  
Noninvasive Detection ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Nasal Cpap ◽  
Copd Patients ◽  
Expiratory Flow

Effects of arm bracing on expiratory flow limitation and lung volume in elderly COPD patients

Physiotherapy ◽  
2015 ◽  
Vol 101 ◽  
pp. e1121-e1122
Author(s):  
T. Ogino ◽  
K. Mase ◽  
M. Nozoe ◽  
T. Wada ◽  
Y. Uchiyama ◽  
...  
Keyword(s):  
Lung Volume ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Copd Patients ◽  
Expiratory Flow
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