| A quick and easy method of measuring the hypercapnic ventilatory response in patients with COPD. | |
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MedLine Citation:
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PMID: 18842399 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Hypercapnic ventilatory response (HCVR) techniques have not previously been adequately validated in patients with chronic obstructive pulmonary disease (COPD). We have tested the hypothesis that end-tidal PCO(2) may be used to test the HCVR in COPD during non-steady-state rebreathing, despite the fact that large (arterial-end-tidal) PCO(2) differences (P(a-et)CO(2)) exist during air breathing. METHODS: Eight patients and 11 healthy volunteers underwent steady-state HCVR testing and non-steady-state rebreathing HCVR testing, using Pa and PetCO(2). RESULTS: In COPD patients, PetCO(2) was lower than PaCO(2) by a constant amount throughout steady-state HCVR, but equalised with PaCO(2) during non-steady-state HCVR. Consequently there were no differences in HCVR slope using either method (steady-state p=0.91; rebreathing p=0.73), or HCVR intercept in rebreathing (p=0.68) whether PaCO(2) or PetCO(2) was used. The steady-state HCVR intercept using PetCO(2) was greater than that using PaCO(2) (p=0.02). In healthy volunteers PetCO(2) equalised with PaCO(2) during steady-state HCVR, but was progressively greater than PaCO(2) during non-steady-state. Consequently, there was no difference in HCVR slope (p=0.21) or intercept (p=0.46) whether PaCO(2) or PetCO(2) was used. During non-steady-state there was a P(a-et)CO(2) difference in slope (p=0.03) and intercept (p=0.04). CONCLUSIONS: In COPD patients non-steady-state HCVR using PetCO(2) is well tolerated, which is as accurate as PaCO(2). HCVR slope may be derived using PetCO(2) during steady-state testing, though there may be errors in intercept compared to use of PaCO(2). In healthy volunteers PetCO(2) may be used to estimate PaCO(2) during steady-state but not rebreathing HCVR. |
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Authors:
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Annabel H Nickol; Helen Dunroy; Michael I Polkey; Anita Simonds; Jeremy Cordingley; Douglas R Corfield; Mary J Morrell |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-10-07 |
Journal Detail:
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Title: Respiratory medicine Volume: 103 ISSN: 1532-3064 ISO Abbreviation: Respir Med Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-01-23 Completed Date: 2009-03-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8908438 Medline TA: Respir Med Country: England |
Other Details:
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Languages: eng Pagination: 258-67 Citation Subset: IM |
Affiliation:
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Clinical and Academic Unit of Sleep and Breathing, National Heart and Lung Institute, Royal Brompton Hospital, Fulham Road, London SW3 6NP, UK. annabel@medex.org.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Breath Tests / methods Carbon Dioxide / physiology* Female Humans Hypercapnia / physiopathology* Male Middle Aged Pulmonary Disease, Chronic Obstructive / physiopathology* Tidal Volume / physiology Ventilation-Perfusion Ratio / physiology* |
| Grant Support | |
ID/Acronym/Agency:
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//Wellcome Trust |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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