scholarly journals Distinct Mechanical Properties of the Respiratory System Evaluated by Forced Oscillation Technique in Acute Exacerbation of COPD and Acute Decompensated Heart Failure

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 554
Author(s):  
Silvia Terraneo ◽  
Rocco Francesco Rinaldo ◽  
Giuseppe Francesco Sferrazza Papa ◽  
Fulvia Ribolla ◽  
Carlo Gulotta ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mechanical Properties ◽  
Acute Exacerbation ◽  
Respiratory System ◽  
Forced Oscillation ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Forced Oscillation Technique ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd

Discriminating between cardiac and pulmonary dyspnea is essential for patients’ management. We investigated the feasibility and ability of forced oscillation techniques (FOT) in distinguishing between acute exacerbation of COPD (AECOPD), and acute decompensated heart failure (ADHF) in a clinical emergency setting. We enrolled 49 patients admitted to the emergency department (ED) for dyspnea and acute respiratory failure for AECOPD, or ADHF, and 11 healthy subjects. All patients were able to perform bedside FOT measurement. Patients with AECOPD showed a significantly higher inspiratory resistance at 5 Hz, Xrs5 (179% of predicted, interquartile range, IQR 94–224 vs. 100 IQR 67–149; p = 0.019), and a higher inspiratory reactance at 5 Hz (151%, IQR 74–231 vs. 57 IQR 49–99; p = 0.005) than patients with ADHF. Moreover, AECOPD showed higher heterogeneity of ventilation (respiratory system resistance difference at 5 and 19 Hz, Rrs5-19: 1.49 cmH2O/(L/s), IQR 1.03–2.16 vs. 0.44 IQR 0.22–0.76; p = 0.030), and a higher percentage of flow limited breaths compared to ADHF (10%, IQR 0–100 vs. 0 IQR 0–12; p = 0.030). FOT, which resulted in a suitable tool to be used in the ED setting, has the ability to identify distinct mechanical properties of the respiratory system in AECOPD and ADHF.

Mechanical properties of the upper airway

1983 ◽  
Vol 55 (2) ◽  
pp. 335-342 ◽  
Author(s):  
M. Cauberghs ◽  
K. P. Van de Woestijne
Keyword(s):  
Mechanical Properties ◽  
Lung Disease ◽  
Frequency Dependence ◽  
Respiratory System ◽  
Obstructive Lung Disease ◽  
Forced Oscillation ◽  
Valsalva Maneuver ◽  
Upper Airway ◽  
Forced Oscillations ◽  
Forced Oscillation Technique

The series and shunt components of the impedance of the upper airway (Zuaw) were evaluated from measurements obtained during a Valsalva maneuver by means of a modified forced oscillation technique. When the cheeks are supported, the upper airway can be represented by a single distributed transmission line. The homogeneity of this line was confirmed by measuring separately Zuaw and the impedance of the mouth. Correction of the impedance of the respiratory system, determined by means of the forced oscillations technique, for the shunt properties of Zuaw results in some modifications of the frequency dependence of resistance (Rrs) in healthy adults and in marked changes of the absolute values of Rrs in children and in patients with obstructive lung disease.

N-TERMINAL PRO BRAIN NATRIURETIC PEPTIDE: A POTENTIAL PREDICTOR FOR INTENSIVE CARE ADMISSIONS IN PATIENTS WITH ACUTE EXACERBATION OF COPD.

2021 ◽  
pp. 22-24
Author(s):  
Ikbal Ali ◽  
Ajith Kumar M S ◽  
Mahendra Kumar Meena ◽  
Agnihotri SP
Keyword(s):  
Heart Failure ◽  
Intensive Care ◽  
Brain Natriuretic Peptide ◽  
Hospital Stay ◽  
Acute Exacerbation ◽  
Natriuretic Peptide ◽  
Acute Exacerbation Of Copd ◽  
Arterial Blood ◽  
Copd Patients ◽  
Exacerbation Of Copd

BACKGROUND: Cardiovascular disease is one of the major causes of mortality and is frequently unrecognized in COPD patients. Serum N-terminal pro-brain natriuretic peptide (NT-pro BNP) is an established risk factor in patients with Heart failure. However NT-pro BNP levels may also be elevated during acute exacerbation of COPD(AECOPD) even without heart failure. Objectives of the study are-(a)To nd the levels of Serum NT-pro BNP in AECOPD patients. (b) To nd out the association of Serum NT-pro BNP with clinical and physiological parameters in AECOPD patients. METHODS: This cross-sectional study was carried out on 60 AECOPD patients admitted in department of Respiratory Medicine, Institute of Respiratory Diseases, SMS Medical College, Jaipur during July 2019–June 2020. Clinical data including vitals, Electrocardiogram (ECG), arterial blood gas analysis (ABG), Serum NT-pro BNP levels were assessed. Previous ECG and spirometry details were also recorded. RESULTS: The mean levels of Serum NT-pro BNP were higher in very severe COPD patients. The association of Serum NT-pro BNP were signicantly higher with AECOPD patients having increased exacerbations per year, longer hospital stay duration, decreasing Spo2 levels and decreasing blood pH levels. CONCLUSION: Patients with AECOPD who had elevated Serum NT-pro BNP levels had higher likelihood of ICU admission and longer hospital stay. Thus elevated NT-pro BNP levels warrants the need of Intensive care for early and better management of COPD patients.

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