Document Detail


Breathing pattern and chest wall volumes during exercise in patients with cystic fibrosis, pulmonary fibrosis and COPD before and after lung transplantation.
MedLine Citation:
PMID:  20805177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary fibrosis (PF), cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) often cause chronic respiratory failure (CRF). METHODS: In order to investigate if there are different patterns of adaptation of the ventilatory pump in CRF, in three groups of lung transplant candidates with PF (n=9, forced expiratory volume in 1 s (FEV(1))=37+/-3% predicted, forced vital capacity (FVC)=32+/-2% predicted), CF (n=9, FEV(1)=22+/-3% predicted, FVC=30+/-3% predicted) and COPD (n=21, FEV(1)=21+/-1% predicted, FVC=46+/-2% predicted), 10 healthy controls and 16 transplanted patients, total and compartmental chest wall volumes were measured by opto-electronic plethysmography during rest and exercise. RESULTS: Three different breathing patterns were found during CRF in PF, CF and COPD. Patients with COPD were characterised by a reduced duty cycle at rest and maximal exercise (34+/-1%, p<0.001), while patients with PF and CF showed an increased breathing frequency (49+/-6 and 34+/-2/min, respectively) and decreased tidal volume (0.75+/-0.10 and 0.79+/-0.07 litres) (p<0.05). During exercise, end-expiratory chest wall and rib cage volumes increased significantly in patients with COPD and CF but not in those with PF. End-inspiratory volumes did not increase in CF and PF. The breathing pattern of transplanted patients was similar to that of healthy controls. CONCLUSIONS: There are three distinct patterns of CRF in patients with PF, CF and COPD adopted by the ventilatory pump to cope with the underlying lung disease that may explain why patients with PF and CF are prone to respiratory failure earlier than patients with COPD. After lung transplantation the chronic adaptations of the ventilatory pattern to advanced lung diseases are reversible and indicate that the main contributing factor is the lung itself rather than systemic effects of the disease.
Authors:
H Wilkens; B Weingard; A Lo Mauro; E Schena; A Pedotti; G W Sybrecht; A Aliverti
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thorax     Volume:  65     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-10-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  808-14     Citation Subset:  IM    
Affiliation:
Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological / physiology
Adult
Cystic Fibrosis / complications,  physiopathology,  surgery
Exercise / physiology*
Female
Forced Expiratory Volume / physiology
Humans
Lung Diseases / physiopathology*,  surgery
Lung Transplantation / physiology*
Male
Middle Aged
Plethysmography / methods
Postoperative Period
Pulmonary Disease, Chronic Obstructive / complications,  physiopathology,  surgery
Pulmonary Fibrosis / complications,  physiopathology,  surgery
Respiratory Insufficiency / etiology,  physiopathology,  surgery
Respiratory Mechanics / physiology*
Thoracic Wall / physiopathology*
Vital Capacity / physiology

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


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