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https://www.readbyqxmd.com/read/28617166/challenges-in-providing-timely-physiotherapy-and-opportunities-to-influence-outcomes-for-potential-lung-donors
#1
Cassandra Raios, Jenny L Keating, Nicola Stitt, Helen I Opdam, Elizabeth H Skinner
CONTEXT: There is a critical shortage of donor lungs however, considerable ethical considerations are associated with the conduct of research to optimize care of the potential organ donor. OBJECTIVE: To investigate pathways of consent, respiratory care by physiotherapists and donation rates to contextualize future research on physiotherapy effects on donor lung suitability for procurement. DESIGN: Retrospective audit. SETTING: Australian tertiary hospital...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28615308/mechanisms-measurement-and-management-of-exertional-dyspnoea-in-asthma-number-5-in-the-series-exertional-dyspnoea-edited-by-pierantonio-laveneziana-and-piergiuseppe-agostoni
#2
Jason Weatherald, M Diane Lougheed, Camille Taillé, Gilles Garcia
Asthma is a heterogeneous condition, with dyspnoea during exercise affecting individuals to a variable degree. This narrative review explores the mechanisms and measurement of exertional dyspnoea in asthma and summarises the available evidence for the efficacy of various interventions on exertional dyspnoea. Studies on the mechanisms of dyspnoea in asthma have largely utilised direct bronchoprovocation challenges, rather than exercise, which may invoke different physiological mechanisms. Thus, the description of dyspnoea during methacholine challenge can differ from what is experienced during daily activities, including exercise...
June 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28614400/emphysema-in-active-farmer-s-lung-disease
#3
Thibaud Soumagne, Marie-Laure Chardon, Gaël Dournes, Lucie Laurent, Bruno Degano, François Laurent, Jean Charles Dalphin
BACKGROUND: Farmer's lung (FL) is a common type of hypersensitivity pneumonitis. It is often considered that fibrosis is the most frequent finding in chronic FL. Nevertheless, three cohort studies have suggested that some patients with chronic FL may develop emphysema. We aimed to evaluate the current prevalence of emphysema in active FL, to describe the radiological and functional features of emphysema in active FL, and to identify risk factors associated with emphysema in this population...
2017: PloS One
https://www.readbyqxmd.com/read/28604095/anesthetic-management-using-a-laryngeal-mask-airway-in-a-child-with-congenital-bronchial-atresia
#4
Yuki Gomi, Asuka Taguchi, Sahoko Matsunari, Taisuke Iwamoto, Yui Kawamoto, Satoshi Tachikawa, Rikuo Masuda, Kinuko Gotoh, Takehiko Iijima
Congenital bronchial atresia is a relatively rare malformation that causes a segmental obstruction of the bronchus during the fetal period. The peripheral lung distal from the obstructed bronchus becomes hyperinflated because of the unidirectional flow through collateral check-valve entry. Positive pressure ventilation during general anesthesia may cause a rupture of the bulla, resulting in pneumothorax. An 8-year-old girl, who had to undergo oral surgery, was diagnosed as having congenital bronchial atresia and one-fifth of her lung was poorly ventilated...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28586146/locating-the-level-and-extent-of-congenital-high-airway-obstruction-fluid-in-the-airway-tract-as-reference-points
#5
Mamatha Gowda, Shilpa Gupta, Ashraf Ali, Shanthi Paranthaman
Described here are a series of four cases of congenital high airway obstruction in the fetus. All of the patients presented in the second trimester and all had hydrops fetalis. Three cases had bilateral hyperinflated lungs, midline shift of heart, flattening or inversion of the diaphragm, and fetal ascites. Autopsy was performed in one of these three and showed laryngeal atresia. In one fetus, there was only a unilateral huge enlargement of the lung with mediastinal shift. On autopsy, this fetus had atresia of right main bronchus...
June 6, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28583413/effect-of-pulmonary-hyperinflation-on-central-blood-volume-an-mri-study
#6
Tanja Mijacika, Kasper Kyhl, Daria Frestad, F Otto Barak, Ivan Drvis, Niels H Secher, Zeljko Dujic, Per Lav Madsen
Pulmonary hyperinflation attained by glossopharyngeal insufflation (GPI) challenges the circulation by compressing the heart and pulmonary vasculature. Our aim was to determine the amount of blood translocated from the central blood volume during GPI. Cardiac output and cardiac chamber volumes were assessed by magnetic resonance imaging in twelve breath-hold divers at rest and during apnea with GPI. Pulmonary blood volume was determined from pulmonary blood flow and transit times for gadolinium during first-pass perfusion after intravenous injection...
June 3, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28579768/clinical-characteristics-of-copd-patients-with-tidal-expiratory-flow-limitation
#7
James Dean, Umme Kolsum, Paul Hitchen, Vandana Gupta, Dave Singh
We have used impulse oscillometry to identify COPD patients with tidal expiratory flow limitation (EFL), which is a measurement related to small airway disease. We report that 37.4% of COPD patients had EFL; these patients had multiple clinical characteristics of more severe disease including lower forced expiratory volume in 1 second values, greater hyperinflation, reduced exercise performance, and increased small airway impairment. We highlight that EFL can be used to identify a subgroup of COPD patients with distinct characteristics associated with small airway disease...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28579149/assessment-of-dyspnea-and-dynamic-hyperinflation-in-male-patients-with-chronic-obstructive-pulmonary-disease-during-a-six-minute-walk-test-and-an-incremental-treadmill-cardiorespiratory-exercise-test
#8
M Alfonso, V Bustamante, P Cebollero, M Antón, S Herrero, J B Gáldiz
The six minute walk test (6MWT) is a standardized test that provides information on exercise capacity in patients with COPD. It is considered a submaximal test in opposition to incremental cardiopulmonary exercise tests (CPET) that provide valuable information on all the systems involved in exercise. OBJECTIVES: 1. To compare the perceptive, physiological responses and degree of dynamic hyperinflation during two exercise tests: the 6MWT and the incremental CPET on a treadmill. 2. To evaluate how dyspnea is related to dynamic hyperinflation (DH) and other functional parameters in both tests...
June 1, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/28559470/flow-decay-a-novel-spirometric-index-to-quantify-dynamic-airway-resistance
#9
Anita Oh, Tessa A Morris, Isaac T Yoshii, Timothy A Morris
BACKGROUND: Dynamic airway resistance from obstructive disease causes a concavity in the mid-expiratory portion of the spirometric flow-volume loop. We developed a simple model to measure the exponential decay in air flow during forced exhalation to quantify the extent of dynamic airway obstruction and facilitate the detection of obstructive airway diseases clinically. METHODS: We calculated flow decay as the slope of volume versus ln(1/flow) in mid-exhalation. We derived the normal range in a derivation group of healthy volunteers in whom spirometry had been performed repeatedly...
May 30, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28537001/study-design-of-vesuto-%C3%A2-efficacy-of-tiotropium-olodaterol-on-lung-hyperinflation-exercise-capacity-and-physical-activity-in-japanese-patients-with-chronic-obstructive-pulmonary-disease
#10
Masakazu Ichinose, Yoshiaki Minakata, Takashi Motegi, Jun Ueki, Tetsuo Seki, Tatsuhiko Anzai, Ayako Takizawa, Lars Grönke, Kazuto Hirata
INTRODUCTION: The superiority of tiotropium/olodaterol is demonstrated in improvement of lung function, dyspnea, lung hyperinflation, and quality of life compared with either monotherapy in patients with chronic obstructive pulmonary disease (COPD). Japanese Respiratory Society Guidelines for COPD management include improvement of exercise tolerance and daily physical activity as the treatment goals; however, there is limited evidence in Japanese patients with COPD. METHODS: A protocol is developed for the VESUTO(®) study that investigates the efficacy of tiotropium/olodaterol fixed-dose combination (FDC) compared with tiotropium alone on inspiratory capacity (IC, volume from functional residual capacity to total lung capacity), exercise capacity, and daily physical activity in Japanese patients with COPD...
May 23, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28527920/emerging-bronchoscopic-treatments-for-chronic-obstructive-pulmonary-disease
#11
REVIEW
Wouter H van Geffen, Huib A M Kerstjens, Dirk-Jan Slebos
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by pathophysiological factors including airflow limitation, hyperinflation and reduced gas exchange. Treatment consists of lifestyle changes, lung rehabilitation and pharmacological therapies such as long acting beta-2-agonists (LABA) and long acting muscarinic antagonists (LAMA). More recently bronchoscopic treatments are emerging for COPD. Among them endobronchial valves(EBV) and endobronchial coils (EBC), next to endobronchial stents, sclerosing agents, targeted lung denervation and liquid nitrogen metered cryospray...
May 17, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28526483/effects-of-air-stacking-maneuver-on-cough-peak-flow-and-chest-wall-compartmental-volumes-of-amyotrophic-lateral-sclerosis-subjects
#12
Antonio Sarmento, Vanessa Regiane Resqueti, Mario Emílio Teixeira Dourado-Júnior, Lailane Saturnino, Andrea Aliverti, Guilherme Augusto de Freitas Fregonezi, Armele de Fátima Dornelas de Andrade
OBJECTIVES: To assess the acute effects of air stacking on cough peak flow (CPF) and chest wall compartmental volumes of persons with amyotrophic lateral sclerosis (ALS) versus healthy controls positioned at 45° body inclination. DESIGN: Cross-sectional study with a matched-pair design. SETTING: University hospital. PARTICIPANTS: Twelve persons with ALS and twelve age-matched healthy. MAIN OUTCOMES: CPF, chest wall compartmental inspiratory capacity (ICCW), vital capacity (VCCW), tidal volume (VTCW) and operational volumes, breathing pattern and percentage of contribution of the compartments to the inspired volume were measured by optoelectronic plethysmography...
May 16, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28510483/improvement-in-ventilation-perfusion-mismatch-after-bronchoscopic-lung-volume-reduction-quantitative-image-analysis
#13
Sei Won Lee, Sang Min Lee, So Youn Shin, Tai Sun Park, Sang Young Oh, Namkug Kim, Yoonki Hong, Jae Seung Lee, Yeon-Mok Oh, Sang-Do Lee, Joon Beom Seo
Purpose To evaluate whether bronchoscopic lung volume reduction (BLVR) increases ventilation and therefore improves ventilation-perfusion (V/Q) mismatch. Materials and Methods All patients provided written informed consent to be included in this study, which was approved by the Institutional Review Board (2013-0368) of Asan Medical Center. The physiologic changes that occurred after BLVR were measured by using xenon-enhanced ventilation and iodine-enhanced perfusion dual-energy computed tomography (CT). Patients with severe emphysema plus hyperinflation who did not respond to usual treatments were eligible...
May 16, 2017: Radiology
https://www.readbyqxmd.com/read/28505167/relationship-of-hyperlipidemia-to-comorbidities-and-lung-function-in-copd-results-of-the-cosyconet-cohort
#14
Kathrin Kahnert, Tanja Lucke, Rudolf M Huber, Jürgen Behr, Frank Biertz, Anja Vogt, Henrik Watz, Peter Alter, Sebastian Fähndrich, Robert Bals, Rolf Holle, Stefan Karrasch, Sandra Söhler, Margarethe Wacker, Joachim H Ficker, Klaus G Parhofer, Claus Vogelmeier, Rudolf A Jörres
Although hyperlipidemia is common in COPD, its relationship to comorbidities, risk factors and lung function in COPD has not been studied in detail. Using the baseline data of the COSYCONET cohort we addressed this question. Data from 1746 COPD patients (GOLD stage 1-4; mean age 64.6 y, mean FEV1%pred 57%) were evaluated, focusing on the comorbidities hyperlipidemia, diabetes and cardiovascular complex (CVC; including arterial hypertension, cardiac failure, ischemic heart disease). Risk factors comprised age, gender, BMI, and packyears of smoking...
2017: PloS One
https://www.readbyqxmd.com/read/28502420/cardiopulmonary-exercise-testing-and-second-line-pulmonary-function-tests-to-detect-obstructive-pattern-in-symptomatic-smokers-with-borderline-spirometry
#15
Fabiano Di Marco, Silvia Terraneo, Sara Job, Rocco Francesco Rinaldo, Giuseppe Francesco Sferrazza Papa, Maria Adelaide Roggi, Pierachille Santus, Stefano Centanni
BACKGROUND: The need for additional research on symptomatic smokers with normal spirometry has been recently emphasized. Albeit not meeting criteria for Chronic obstructive pulmonary disease (COPD) diagnosis, symptomatic smokers may experience activity limitation, evidence of airway disease, and exacerbations. We, therefore, evaluated whether symptomatic smokers with borderline spirometry (post-bronchodilator FEV1/FVC ratio between 5th to 20th percentile of predicted values) have pulmonary function abnormalities at rest and ventilatory constraints during exercise...
June 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28481631/peak-inspiratory-flow-rate-as-a-criterion-for-dry-powder-inhaler-use-in-chronic-obstructive-pulmonary-disease
#16
Donald A Mahler
Dry powder bronchodilator devices have an internal resistance. Effective use depends on the patient generating an adequate inspiratory flow to break up the powder packets into particles less than five micron in diameter that can be inhaled into the loser respiratory tract. This de-aggregation takes place inside the device before the dose leaves the inhaler; this process is increased if the acceleration is fast at the start of inhalation. Peak inspiratory flow depends on an individual's effort along with strength of the respiratory muscles, which may be compromised in those with chronic obstructive pulmonary disease due to lung hyperinflation, hypoxemia, and muscle wasting...
May 8, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28463971/pulmonary-hyperinflation-due-to-gas-trapping-and-pulmonary-artery-size-the-mesa-copd-study
#17
Hooman D Poor, Steven M Kawut, Chia-Ying Liu, Benjamin M Smith, Eric A Hoffman, João A Lima, Bharath Ambale-Venkatesh, Erin D Michos, Martin R Prince, R Graham Barr
BACKGROUND: Pulmonary hypertension is associated with increased morbidity and mortality in chronic obstructive pulmonary disease (COPD). Since pulmonary artery (PA) size increases in pulmonary hypertension, we measured PA cross-sectional area using magnetic resonance imaging (MRI) to test the hypothesis that pulmonary hyperinflation due to gas trapping is associated with PA cross-sectional area in COPD. METHODS: The MESA COPD Study recruited participants with COPD and controls from two population-based cohort studies ages 50-79 years with 10 or more pack-years and free of clinical cardiovascular disease...
2017: PloS One
https://www.readbyqxmd.com/read/28436723/asymptomatic-peripheral-artery-disease-can-limit-maximal-exercise-capacity-in-chronic-obstructive-pulmonary-disease-patients-regardless-of-airflow-obstruction-and-lung-hyperinflation
#18
Ernesto Crisafulli, Chiara Scelfo, Panagiota Tzani, Marina Aiello, Giuseppina Bertorelli, Alfredo Chetta
Background Silent/asymptomatic peripheral artery disease may occur in patients with chronic obstructive pulmonary disease, but it is poorly investigated. The primary aim of this study was to evaluate in chronic obstructive pulmonary disease patients the impact of asymptomatic/silent peripheral artery disease on maximal exercise capacity; the secondary aim was to search for predictors of peripheral artery disease. Methods We prospectively enrolled chronic obstructive pulmonary disease outpatients. Data on anthropometric characteristics, lung function, cardiopulmonary exercise test and ankle-brachial index were recorded...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28424359/effects-of-combined-tiotropium-olodaterol-on-inspiratory-capacity-and-exercise-endurance-in-copd
#19
Denis E O'Donnell, Richard Casaburi, Peter Frith, Anne Kirsten, Dorothy De Sousa, Alan Hamilton, Wenqiong Xue, François Maltais
Two replicate, double-blind, 6-week, incomplete-crossover studies (MORACTO 1 and 2) assessed the effects of tiotropium/olodaterol on inspiratory capacity and exercise endurance time in patients with moderate to severe chronic obstructive pulmonary disease.For each patient, four of five treatments were administered once daily for 6 weeks, with a 21-day washout between treatments: tiotropium/olodaterol 2.5/5 µg or 5/5 µg, tiotropium 5 µg, olodaterol 5 µg or placebo, all via the Respimat inhaler...
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28418337/a-simple-measure-to-assess-hyperinflation-and-air-trapping-1-forced-expiratory-volume-in-three-second-forced-vital-capacity
#20
Sermin Börekçi, Tunçalp Demir, Aslı Görek Dilektaşlı, Melahat Uygun, Nurhayat Yıldırım
BACKGROUND: Several recent studies have suggested that 1 minus-forced expiratory volume expired in 3 seconds / forced vital capacity (1-FEV3/FVC) may be an indicator of distal airway obstruction and a promising measure to evaluate small airways dysfunction. AIMS: To investigate the associations of 1-FEV3/FVC with the spirometric measures and lung volumes that assess small airways dysfunction and reflects hyperinflation and air trapping. STUDY DESIGN: Retrospective cross-sectional study...
April 5, 2017: Balkan Medical Journal
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