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Expiratory flow limitation relates to symptoms during COPD exacerbations requiring hospital admission.
Jetmalani, Kanika; Timmins, Sophie; Brown, Nathan J; Diba, Chantale; Berend, Norbert; Salome, Cheryl M; Wen, Fu-Qiang; Chen, Peng; King, Gregory G; Farah, Claude S.
Afiliación
  • Jetmalani K; Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia ; Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
  • Timmins S; Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia ; Department of Respiratory Medicine, Royal North Shore Hospital, Sydney, NSW, Australia ; Cooperative Research Centre for Asthma and Airways, George Institute of Global Health, Sydney, NSW, Australia.
  • Brown NJ; Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia ; Cooperative Research Centre for Asthma and Airways, George Institute of Global Health, Sydney, NSW, Australia.
  • Diba C; Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia ; Cooperative Research Centre for Asthma and Airways, George Institute of Global Health, Sydney, NSW, Australia.
  • Berend N; Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia ; Cooperative Research Centre for Asthma and Airways, George Institute of Global Health, Sydney, NSW, Australia ; Department of Respiratory Research, George Institute of Global Health, Sydney, NSW, Australia.
  • Salome CM; Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia ; Sydney Medical School, University of Sydney, Sydney, NSW, Australia ; Cooperative Research Centre for Asthma and Airways, George Institute of Global Health, Sydney, NSW, Australia.
  • Wen FQ; Department of Medicine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, People's Republic of China.
  • Chen P; Department of Medicine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, People's Republic of China.
  • King GG; Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia ; Sydney Medical School, University of Sydney, Sydney, NSW, Australia ; Department of Respiratory Medicine, Royal North Shore Hospital, Sydney, NSW, Australia ; Cooperative Research Centre for Asthma and Airways, Ge
  • Farah CS; Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia ; Sydney Medical School, University of Sydney, Sydney, NSW, Australia ; Department of Respiratory Medicine, Concord Hospital, Sydney, NSW, Australia.
Int J Chron Obstruct Pulmon Dis ; 10: 939-45, 2015.
Article en En | MEDLINE | ID: mdl-25999709
ABSTRACT

BACKGROUND:

Expiratory flow limitation (EFL) is seen in some patients presenting with a COPD exacerbation; however, it is unclear how EFL relates to the clinical features of the exacerbation. We hypothesized that EFL when present contributes to symptoms and duration of recovery during a COPD exacerbation. Our aim was to compare changes in EFL with symptoms in subjects with and without flow-limited breathing admitted for a COPD exacerbation. SUBJECTS AND

METHODS:

A total of 29 subjects with COPD were recruited within 48 hours of admission to West China Hospital for an acute exacerbation. Daily measurements of post-bronchodilator spirometry, resistance, and reactance using the forced oscillation technique and symptom (Borg) scores until discharge were made. Flow-limited breathing was defined as the difference between inspiratory and expiratory respiratory system reactance (EFL index) greater than 2.8 cmH2O·s·L(-1). The physiological predictors of symptoms during recovery were determined by mixed-effect analysis.

RESULTS:

Nine subjects (31%) had flow-limited breathing on admission despite similar spirometry compared to subjects without flow-limited breathing. Spirometry and resistance measures did not change between enrolment and discharge. EFL index values improved in subjects with flow-limited breathing on admission, with resolution in four patients. In subjects with flow-limited breathing on admission, symptoms were related to inspiratory resistance and EFL index values. In subjects without flow-limited breathing, symptoms related to forced expiratory volume in 1 second/forced vital capacity. In the whole cohort, EFL index values at admission was related to duration of stay (Rs=0.4, P=0.03).

CONCLUSION:

The presence of flow-limited breathing as well as abnormal respiratory system mechanics contribute independently to symptoms during COPD exacerbations.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Admisión del Paciente / Enfermedad Pulmonar Obstructiva Crónica / Espiración / Pulmón Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Int J Chron Obstruct Pulmon Dis Año: 2015 Tipo del documento: Article País de afiliación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Admisión del Paciente / Enfermedad Pulmonar Obstructiva Crónica / Espiración / Pulmón Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Int J Chron Obstruct Pulmon Dis Año: 2015 Tipo del documento: Article País de afiliación: Australia