Document Detail


Assessment of respiratory mechanics by impulse oscillometry in orthopneic patients with acute left ventricular failure.
MedLine Citation:
PMID:  20723981     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study investigated the respiratory function and mechanics of patients with orthopnea caused by acute left ventricular failure (ALVF).
METHODS: The study comprised 40 patients with ALVF and 15 control subjects. All patients underwent lung function tests and impulse oscillometry in both sitting and supine positions. In a subgroup of 22 patients, isosorbide dinitrate was administered and impulse oscillometry was performed 15 minutes later in the supine position.
RESULTS: No patient reported dyspnea while seated, and the orthopnea score was 2.9 ± 1.4. Left ventricular ejection fraction was 43% ± 10%. Patients demonstrated restrictive spirometric pattern in the sitting position, whereas functional residual capacity was comparable to that of the control group. In the supine position, all pulmonary volumes decreased, except inspiratory capacity which increased. Respiratory reactance (Xrs5) was higher in patients in both sitting (421.8 ± 630.6%pred vs 147.2 ± 72.8%pred, P = .01) and supine (699.8 ± 699.9%pred vs 251.2 ± 151.6%pred, P ≤ .001) positions. Respiratory resistance (Rrs5) (10.6% ± 17.8% mean decrease) and Xrs5 (17.2% ± 39.4% mean decrease) improved after nitrates administration. Orthopnea was better correlated with Xrs5%pred in the supine position (r = .42, P = .007). Ejection fraction was positively correlated with inspiratory capacity %pred (r = .42, P = .007) in the sitting position.
CONCLUSION: Patients with ALVF demonstrated increased respiratory reactance that correlated with orthopnea severity and improved after nitrates administration.
Authors:
Dionisios G Spyratos; Georg P Glattki; Lazaros T Sichletidis; Dimitrios Patakas
Publication Detail:
Type:  Journal Article     Date:  2010-08-17
Journal Detail:
Title:  Heart & lung : the journal of critical care     Volume:  40     ISSN:  1527-3288     ISO Abbreviation:  Heart Lung     Publication Date:    2011 Mar-Apr
Date Detail:
Created Date:  2011-03-14     Completed Date:  2011-07-21     Revised Date:  2011-10-24    
Medline Journal Info:
Nlm Unique ID:  0330057     Medline TA:  Heart Lung     Country:  United States    
Other Details:
Languages:  eng     Pagination:  97-104     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Pulmonary, Aristotle University of Thessaloniki, G. Papanicolaou Hospital, Exochi, Thessaloniki, Greece. diospyrato@yahoo.gr
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Airway Resistance
Case-Control Studies
Female
Forced Expiratory Volume
Health Status Indicators
Heart Failure / diagnosis*,  pathology
Humans
Isosorbide Dinitrate / diagnostic use
Lung Diseases / diagnosis*,  pathology
Male
Middle Aged
Oscillometry / instrumentation*
Respiratory Mechanics*
Statistics, Nonparametric
Stroke Volume
Supine Position
Vasodilator Agents / diagnostic use
Ventricular Function, Left
Vital Capacity
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 87-33-2/Isosorbide Dinitrate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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