Document Detail


Mechanisms of functional loss in patients with chronic lung disease.
MedLine Citation:
PMID:  18718036     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Functional loss (often quantified as exercise limitation) is common in patients with chronic lung disease. The factors involved are multiple and many may be present together in a given patient. Ventilatory factors involve an imbalance in load/capacity relationships. Specifically, breathing loads from abnormal respiratory-system mechanics and/or excessive ventilatory demand cannot be handled by respiratory muscles that are dysfunctional or malpositioned. Gas-exchange factors involve impaired ventilation-perfusion relationships that lead to hypoxemia, impaired oxygen delivery, and pulmonary hypertension. Cardiovascular factors involve coexisting intrinsic heart disease, right-ventricular overload from pulmonary vascular abnormalities, and simple deconditioning. Skeletal muscle (both respiratory and limb) factors involve direct inflammatory mediator effects on muscle function, malnutrition, blood-gas abnormalities, compromised oxygen delivery from right-heart dysfunction, electrolyte imbalances, drugs, and comorbid states. Other less well understood factors include excessive dyspnea, impaired motivation, orthopedic issues, and psychiatric issues.
Authors:
Neil R MacIntyre
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Respiratory care     Volume:  53     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-22     Completed Date:  2008-12-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1177-84     Citation Subset:  IM    
Affiliation:
Respiratory Care Services, PO Box 3911, Duke University Medical Center, Durham NC 27710, USA. neil.macintyre@duke.edu
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MeSH Terms
Descriptor/Qualifier:
Cardiac Output
Cardiovascular System / physiopathology
Humans
Muscle Weakness / complications,  physiopathology
Pulmonary Disease, Chronic Obstructive / complications,  physiopathology*
Pulmonary Gas Exchange / physiology*
Respiratory Function Tests
Respiratory Mechanics / physiology*

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


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