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Ventilation in COPD

Daniel Langer, Casey E Ciavaglia, Azmy Faisal, Katherine A Webb, J Alberto Neder, Rik Gosselink, Sauwaluk Dacha, Marko Topalovic, Anna Ivanova, Denis E O'Donnell
Among patients with COPD, those with the lowest maximal inspiratory pressures experience greater breathing discomfort (dyspnea) during exercise. In such individuals, inspiratory muscle training (IMT) may be associated with improvement of dyspnea but the mechanisms for this are poorly understood. Therefore, we aimed to identify physiological mechanisms of improvement in dyspnea and exercise endurance following inspiratory muscle training (IMT) in patients with COPD and low maximal inspiratory pressure (Pi,max)...
March 15, 2018: Journal of Applied Physiology
Heather M Young, Fumin Guo, Rachel L Eddy, Geoffrey Maksym, Grace Parraga
Ventilation heterogeneity is a hallmark finding in obstructive lung disease and may be evaluated using a variety of methods including multiple-breath gas-washout and pulmonary imaging. Such methods provide an opportunity to better understand the relationships between structural and functional abnormalities in the lungs, and their relationships with important clinical outcomes. We measured ventilation heterogeneity and respiratory impedance in 100 subjects (50 asthmatics, 22 ex-smokers and 28 COPD), using oscillometry and hyperpolarized3 He magnetic resonance imaging (MRI) and determined their relationships with quality-of-life scores and disease control/exacerbations...
March 15, 2018: Journal of Applied Physiology
Christian Viniol, Claus F Vogelmeier
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. While COPD is a mainly chronic disease, a substantial number of patients suffer from exacerbations. Severe exacerbations are related to a significantly worse survival outcome. This review summarises the current knowledge on the different aspects of COPD exacerbations. The impact of risk factors and triggers such as smoking, severe airflow limitation, bronchiectasis, bacterial and viral infections and comorbidities is discussed...
March 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
Jan Hendrik Storre, Jens Callegari, Friederike Sophie Magnet, Sarah Bettina Schwarz, Marieke Leontine Duiverman, Peter Jan Wijkstra, Wolfram Windisch
Long-term or home mechanical noninvasive ventilation (Home-NIV) has become a well-established form of therapy over the last few decades for chronic hypercapnic COPD patients in European countries. However, meta-analyses and clinical guidelines do not recommend Home-NIV for COPD patients on a routine basis. In particular, there is ongoing debate about Home-NIV in chronic hypercapnic COPD regarding the overall effects, the most favorable treatment strategy, the selection of eligible patients, and the time point at which it is prescribed...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Qi Chen, Weidong Tang, Xuebo Shao, Lijun Zhu
OBJECTIVE: To analyze the difference between indirect calorimetry (IC) and predicted energy estimation in patients with chronic obstructive pulmonary disease (COPD), and its possible factors affecting the difference, to provide reasonable energy supply basis for COPD patients. METHODS: A prospective cohort study was conducted. Twenty-six patients with COPD undergoing mechanical ventilation (MV) admitted to intensive care unit (ICU) of Hangzhou City Fuyang District First People's Hospital in Zhejiang Province from January to December in 2016 were enrolled...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Katrine Bredahl Buggeskov

During conventional cardiopulmonary bypass (CPB) there is no active perfusion of the pulmonary circulation and the mechanical ventilation is ceased leaving the lungs exposed to warm ischemia.
Pulmonary dysfunction is seen in varying degrees after major surgery, but more severe in cardiac surgery patients probably due to the effects of CPB. The evidence for effect and safety are limited, but active pulmonary artery perfusion during CPB could be beneficial for the patients' postoperative oxygenation...
March 2018: Danish Medical Journal
Barış Akça, Nevzat Erdil, Mehmet Cengiz Colak, Olcay Murat Disli, Bektas Battaloglu, Cemil Colak
BACKGROUND:  We aimed to investigate the risk factors of post-coronary artery bypass grafting (CABG) atrial fibrillation (AF) in male and female patients without any history of AF, to identify the sex-specific risk factors, and to examine the effect of sex-specific risk factors on the overall population. METHODS:  This retrospective study was conducted using the hospital database with 4,758 patients who underwent CABG surgery. Among them, 2,836 patients with complete data participated in this study...
March 6, 2018: Thoracic and Cardiovascular Surgeon
Neil J Stewart, Ho-Fung Chan, Paul J C Hughes, Felix C Horn, Graham Norquay, Madhwesha Rao, Denise P Yates, Rob H Ireland, Matthew Q Hatton, Bilal A Tahir, Paul Ford, Andrew J Swift, Rod Lawson, Helen Marshall, Guilhem J Collier, Jim M Wild
BACKGROUND: To support translational lung MRI research with hyperpolarized129 Xe gas, comprehensive evaluation of derived quantitative lung function measures against established measures from3 He MRI is required. Few comparative studies have been performed to date, only at 3T, and multisession repeatability of129 Xe functional metrics have not been reported. PURPOSE/HYPOTHESIS: To compare hyperpolarized129 Xe and3 He MRI-derived quantitative metrics of lung ventilation and microstructure, and their repeatability, at 1...
March 5, 2018: Journal of Magnetic Resonance Imaging: JMRI
Michael Furian, Sara E Hartmann, Tsogyal D Latshang, Deborah Flueck, Christian Murer, Philipp M Scheiwiller, Batyr Osmonov, Silvia Ulrich, Malcolm Kohler, Marc J Poulin, Konrad E Bloch
BACKGROUND: Effects of hypobaric hypoxia at altitude on exercise performance of lowlanders with chronic obstructive pulmonary disease (COPD) have not been studied in detail. OBJECTIVES: To quantify changes in exercise performance and associated physiologic responses in lowlanders with COPD travelling to moderate altitude. METHODS: A total of 31 COPD patients with a median age (quartiles) of 66 years (59; 69) and FEV1 of 56% predicted (49; 69) living below 800 m performed a constant-load bicycle exercise to exhaustion at 60% of the maximal work rate at 490 m (Zurich) and at an identical work rate at 2,590 m (Davos) in randomized order...
March 2, 2018: Respiration; International Review of Thoracic Diseases
Antonello Nicolini, Bruna Grecchi, Maura Ferrari-Bravo, Cornelius Barlascini
Purpose: Chest physiotherapy is an important tool in the treatment of COPD. Intrapulmonary percussive ventilation (IPV) and high-frequency chest wall oscillation (HFCWO) are techniques designed to create a global percussion of the lung which removes secretions and probably clears the peripheral bronchial tree. We tested the hypothesis that adding IPV or HFCWO to the best pharmacological therapy (PT) may provide additional clinical benefit over chest physiotherapy in patients with severe COPD...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Nousheen Akhter, Nadeem Ahmed Rizvi
Objective: To evaluate the effectiveness and safety of using BiPAP through endotracheal tube in comatose Chronic Obstructive Pulmonary Disease (COPD) patients with hypercapnic respiratory failure. Methods: This is a prospective study done at Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Karachi, during March to June 2017. It included all comatose COPD patients with hypercapnic respiratory failure who had a poor functional status prior to the illness and who did not meet the criteria to be kept on mechanical ventilator...
November 2017: Pakistan Journal of Medical Sciences Quarterly
C A L Deus, P S Vigário, F S Guimarães, A J Lopes
Pulmonary function tests (PFTs) traditionally used in clinical practice do not accurately predict exercise intolerance in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to assess whether the nitrogen single-breath washout (N2SBW) test explains exercise intolerance and poor quality of life in stable COPD patients. This cross-sectional study included 31 patients with COPD subjected to PFTs (including the N2SBW test) and a cardiopulmonary exercise test (CPET). Patients were also evaluated using the following questionnaires: the COPD assessment test (CAT), the 36-Item Short Form Health Survey (SF36) and St...
2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Irfan Ismail Ayub, Abdul Majeed Arshad, Prathipa Sekar, Natraj Manimaran, Dhanasekar Thangaswamy, Chandrasekar Chockalingam
Background: There is dearth of literature on asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS) in India. The aim was to compare clinical characteristics between patients with ACOS and non-ACOS COPD and to identify clinical predictors of ACOS in patients with COPD. Methods: We conducted a retrospective study by reviewing data collected from patients performing spirometry at our hospital. Those with postbronchodilator FEV1 /FVC <70% were included in the study...
March 2018: Lung India: Official Organ of Indian Chest Society
Jo Raskin, Kristina Vermeersch, Stephanie Everaerts, Pascal Van Bleyenbergh, Wim Janssens
There is growing awareness of the need for advance care planning in patients with chronic obstructive pulmonary disease (COPD). However, do-not-resuscitate (DNR) order implementation remains a challenge in clinical practice. We retrospectively analysed an observational cohort of 569 COPD patients with 2.5-8 years of follow-up in secondary care, to evaluate potential determinants and the prognostic significance of DNR order implementation and specification. 345 patients (61%) had no DNR order, of whom 27% died during a median (interquartile range (IQR)) follow-up of 1935 (1290-2448) days...
January 2018: ERJ Open Research
Shin-Hwar Wu, Lih-Jen Shyu, Chin-Hsing Li, Chao-Hung Yu, Huang-Chi Chen, Chew-Teng Kor, Chu-Hsien Wang, Kai-Huang Lin
INTRODUCTION: The optimal dose of inhaled metered-dose bronchodilators for intubated patients with chronic obstructive pulmonary disease (COPD) is unknown. In this study, we proposed a bronchodilator dosing schedule based on an individual's airway resistance (Raw ) and tested its efficacy in reducing Raw . METHODS: A total of 51 newly admitted patients with invasively ventilated COPD were randomly assigned to receive personalized or fixed bronchodilator dosing. Personal target Raw was defined by measuring each individual's Raw after maximal pharmacologic bronchodilatation...
February 20, 2018: Pulmonary Pharmacology & Therapeutics
Tadahiro Goto, Mohammad Kamal Faridi, Carlos A Camargo, Kohei Hasegawa
Little is known about the effect of long-term aspirin use on acute severity of COPD. We hypothesized that, in patients hospitalized for acute exacerbation of COPD (AECOPD), long-term aspirin use is associated with lower risks of disease severity (in-hospital death, mechanical ventilation use, and hospital length-of-stay). We conducted a retrospective cohort study using large population-based data from 2012 through 2013. Among 206,686 patients (aged ≥40 years) hospitalized for AECOPD, aspirin users had lower in-hospital mortality (1...
February 21, 2018: NPJ Primary Care Respiratory Medicine
Javier de Miguel-Díez, Ana López-de-Andrés, Valentín Hernández-Barrera, Isabel Jiménez-Trujillo, Manuel Méndez-Bailón, José María de Miguel-Yanes, Rodrigo Jiménez-García
BACKGROUND: To describe and compare incidence, characteristics and outcomes of postoperative pneumonia among patients with or without COPD. METHODS: We included hospitalized patients aged ≥40 years whose medical diagnosis included pneumonia and ventilator-associated pneumonia in the secondary's diagnosis field and who were discharged from Spanish hospitals from 2001 to 2015. Irrespectively of the position at the procedures coding list, we retrieved data about the type of surgical procedures using the enhanced ICD-9-CM codes...
February 13, 2018: European Journal of Internal Medicine
Neeraj Mukesh Shah, Rebecca Francesca D'Cruz, Patrick B Murphy
Chronic obstructive pulmonary disease (COPD) remains a common cause of morbidity and mortality worldwide. Patients with COPD and respiratory failure, whether acute or chronic have a poorer prognosis than patients without respiratory failure. Non-invasive ventilation (NIV) has been shown to be a useful tool in both the acute hospital and chronic home care setting. NIV has been well established as the gold standard therapy for acute decompensated respiratory failure complicating an acute exacerbation of COPD with reduced mortality and intubation rates compared to standard therapy...
January 2018: Journal of Thoracic Disease
Detajin Junhasavasdikul, Irene Telias, Domenico Luca Grieco, Lu Chen, Cinta Millan Gutierrez, Thomas Piraino, Laurent Brochard
Expiratory flow limitation (EFL) is present when the flow cannot rise despite an increase of the expiratory driving pressure. The mechanisms of EFL are debated but are thought to be related to the collapsibility of small airways. In mechanically ventilated patients, EFL can exist during tidal ventilation, representing an extreme situation where lung volume cannot decrease whatever the expiratory driving forces. It is a key factor for the generation of auto- or intrinsic positive end-expiratory pressure (auto-PEEP or PEEPi) and requires specific management such as positioning and adjustment of external PEEP...
February 9, 2018: Chest
Mihaela S Stefan, Patrick Eckert, Bogdan Tiru, Jennifer Friderici, Peter K Lindenauer, Jay S Steingrub
OBJECTIVE: To examine the use of high flow nasal cannula oxygen therapy (HFNC) between 2008 and 2014 in patients 18 years or older at a community teaching hospital. METHODS: Yearly utilization rates of HFNC, noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) were calculated among admissions with a set of cardiopulmonary diagnoses (heart failure, COPD, asthma or pneumonia). RESULTS: Among the 41,711 admissions with at least one of the above cardiopulmonary condition, HFNC was utilized in 1,128 or 27...
February 15, 2018: Hospital Practice (Minneapolis)
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