Elevated static compliance of the total respiratory system: Early predictor of weaning unsuccess in severe COPD patients mechanically ventilated

1995 ◽  
Vol 21 (5) ◽  
pp. 399-405 ◽  
Author(s):  
E. Zanotti ◽  
F. Rubini ◽  
G. Iotti ◽  
A. Braschi ◽  
A. Palo ◽  
...  
Keyword(s):  
Respiratory System ◽  
Static Compliance ◽  
Mechanically Ventilated ◽  
Copd Patients ◽  
Early Predictor ◽  
Severe Copd

scholarly journals Influence of bronchodilatation on impedance of the respiratory system in mechanically ventilated COPD patients

Critical Care ◽  
10.1186/cc216 ◽  
1998 ◽  
Vol 2 (Suppl 1) ◽  
pp. P086
Author(s):  
C Gysbrechts ◽  
H Dits ◽  
E Frans ◽  
A Michels ◽  
A Wilmer ◽  
...  
Keyword(s):  
Respiratory System ◽  
Mechanically Ventilated ◽  
Copd Patients

InformedTogether: A decision aid to support shared decision making about mechanical ventilation in severe COPD patients

2018 ◽  
Author(s):  
Meliss Basile ◽  
Johanna Andrews ◽  
Sonia Jacome ◽  
Meng Zhang ◽  
Andrzej Kozikowski ◽  
...  
Keyword(s):  
Decision Making ◽  
Mechanical Ventilation ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Shared Decision ◽  
Copd Patients ◽  
Severe Copd

scholarly journals Single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) triple therapy versus tiotropium monotherapy in patients with COPD

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Sandeep Bansal ◽  
Martin Anderson ◽  
Antonio Anzueto ◽  
Nicola Brown ◽  
Chris Compton ◽  
...  
Keyword(s):  
Health Status ◽  
Triple Therapy ◽  
Treatment Guidelines ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Fluticasone Furoate ◽  
Double Blind ◽  
Once Daily ◽  
Copd Patients ◽  
Severe Copd

AbstractChronic obstructive pulmonary disease (COPD) treatment guidelines do not currently include recommendations for escalation directly from monotherapy to triple therapy. This 12-week, double-blind, double-dummy study randomized 800 symptomatic moderate-to-very-severe COPD patients receiving tiotropium (TIO) for ≥3 months to once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/25 mcg via ELLIPTA (n = 400) or TIO 18 mcg via HandiHaler (n = 400) plus matched placebo. Study endpoints included change from baseline in trough forced expiratory volume in 1 s (FEV1) at Days 85 (primary), 28 and 84 (secondary), health status (St George’s Respiratory Questionnaire [SGRQ] and COPD Assessment Test [CAT]) and safety. FF/UMEC/VI significantly improved trough FEV1 at all timepoints (Day 85 treatment difference [95% CI] 95 mL [62–128]; P < 0.001), and significantly improved SGRQ and CAT versus TIO. Treatment safety profiles were similar. Once-daily single-inhaler FF/UMEC/VI significantly improved lung function and health status versus once-daily TIO in symptomatic moderate-to-very-severe COPD patients, with a similar safety profile.

Mechanics of respiratory system in healthy anesthetized humans with emphasis on viscoelastic properties

1993 ◽  
Vol 75 (1) ◽  
pp. 132-140 ◽  
Author(s):  
B. Jonson ◽  
L. Beydon ◽  
K. Brauer ◽  
C. Mansson ◽  
S. Valind ◽  
...  
Keyword(s):  
Respiratory System ◽  
Driving Force ◽  
Viscoelastic Behavior ◽  
Elastic Recoil ◽  
Inspiratory Flow Rate ◽  
Static Compliance ◽  
Viscoelastic System ◽  
Flow Interruption ◽  
In Series ◽  
Flow Dependency

The classic model of the respiratory system (RS) is comprised of a Newtonian resistor in series with a capacitor and a viscoelastic unit including a resistor and a capacitor. The flow interruption technique has often been used to study the viscoelastic behavior under constant inspiratory flow rate. To study the viscoelastic behavior of the RS during complete respiratory cycles and to quantify viscoelastic resistance (Rve) and compliance (Cve) under unrestrained conditions, we developed an iterative technique based on a differential equation. We, as others, assumed Rve and Cve to be constant, which concords with volume and flow dependency of model behavior. During inspiration Newtonian resistance (R) was independent of flow and volume. During expiration R increased. Static elastic recoil showed no significant hysteresis. The viscoelastic behavior of the RS was in accordance with the model. The magnitude of Rve was 3.7 +/- 0.7 cmH2O.l-1 x s, i.e., two times R. Cve was 0.23 +/- 0.051 l/cmH2O, i.e., four times static compliance. The viscoelastic time constant, i.e., Cve.Rve, was 0.82 +/- 0.11s. The work dissipated against the viscoelastic system was 0.62 +/- 0.13 cmH2O x 1 for a breath of 0.56 liter, corresponding to 32% of the total energy loss within the RS. Viscoelastic recoil contributed as a driving force during the initial part of expiration.

Oxygen delivery-utilization mismatch in contracting locomotor muscle in COPD: peripheral factors

2015 ◽  
Vol 308 (2) ◽  
pp. R105-R111 ◽  
Author(s):  
Wladimir M. Medeiros ◽  
Mari C. T. Fernandes ◽  
Diogo P. Azevedo ◽  
Flavia F. M. de Freitas ◽  
Beatriz C. Amorim ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Near Infrared ◽  
Neuromuscular Electrical Stimulation ◽  
Muscle Oxygenation ◽  
Whole Body ◽  
Chronic Obstructive ◽  
Copd Patients ◽  
Skeletal Muscle Oxygenation ◽  
Severe Copd

Central cardiorespiratory and gas exchange limitations imposed by chronic obstructive pulmonary disease (COPD) impair ambulatory skeletal muscle oxygenation during whole body exercise. This investigation tested the hypothesis that peripheral factors per se contribute to impaired contracting lower limb muscle oxygenation in COPD patients. Submaximal neuromuscular electrical stimulation (NMES; 30, 40, and 50 mA at 50 Hz) of the quadriceps femoris was employed to evaluate contracting skeletal muscle oxygenation while minimizing the influence of COPD-related central cardiorespiratory constraints. Fractional O2 extraction was estimated by near-infrared spectroscopy (deoxyhemoglobin/myoglobin concentration; deoxy-[Hb/Mb]), and torque output was measured by isokinetic dynamometry in 15 nonhypoxemic patients with moderate-to-severe COPD (SpO2 = 94 ± 2%; FEV1 = 46.4 ± 10.1%; GOLD II and III) and in 10 age- and gender-matched sedentary controls. COPD patients had lower leg muscle mass than controls (LMM = 8.0 ± 0.7 kg vs. 8.9 ± 1.0 kg, respectively; P < 0.05) and produced relatively lower absolute and LMM-normalized torque across the range of NMES intensities ( P < 0.05 for all). Despite producing less torque, COPD patients had similar deoxy-[Hb/Mb] amplitudes at 30 and 40 mA ( P > 0.05 for both) and higher deoxy-[Hb/Mb] amplitude at 50 mA ( P < 0.05). Further analysis indicated that COPD patients required greater fractional O2 extraction to produce torque (i.e., ↑Δdeoxy-[Hb/Mb]/torque) relative to controls ( P < 0.05 for 40 and 50 mA) and as a function of NMES intensity ( P < 0.05 for all). The present data obtained during submaximal NMES of small muscle mass indicate that peripheral abnormalities contribute mechanistically to impaired contracting skeletal muscle oxygenation in nonhypoxemic, moderate-to-severe COPD patients.

Flow and volume dependence of expiratory resistance in anesthetized cats

1989 ◽  
Vol 67 (3) ◽  
pp. 1013-1019 ◽  
Author(s):  
M. Skaburskis ◽  
F. Shardonofsky ◽  
J. Milic-Emili
Keyword(s):  
Respiratory System ◽  
Volume Flow ◽  
Flow Profile ◽  
Pressure Flow ◽  
Lung Inflation ◽  
Mechanically Ventilated ◽  
Volume Dependence ◽  
Flow Dependence ◽  
Lung Deflation ◽  
Respiratory Muscle Activity

In five anesthetized paralyzed cats, mechanically ventilated with tidal volumes of 36–48 ml, the isovolume pressure-flow relationships of the lung and respiratory system were studied. The expiratory pressure was altered between 3 and -12 cmH2O for single tidal expirations. Isovolume pressure-flow plots for three lung volumes showed that the resistive pressure-flow relationships were curvilinear in all cases, fitting Rohrer's equation: P = K1V + K2V2, where P is the resistive pressure loss, K1 and K2 are Rohrer's coefficients, and V is flow. Values of K1 and K2 declined with lung inflation, consistent with the volume dependence of pulmonary (RL) and respiratory system resistances (Rrs). During lung deflation against atmospheric pressure, RL and Rrs tended to remain constant through most of expiration, resulting in a nearly linear volume-flow relationship. In the presence of a fixed respiratory system elastance, the shape of the volume-flow profile depended on the balance between the volume and the flow dependence of RL and Rrs. However, the flow dependence of RL and Rrs indicates that their measured values will be affected by all factors that modify expiratory flow, e.g., respiratory system elastance, equipment resistance, and the presence of respiratory muscle activity.

scholarly journals Prevalence of obstructive sleep apnea among patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Osama Ibrahim Mohammad ◽  
Ahmed Gouda Elgazzar ◽  
Shymaa Mohammad Mahfouz ◽  
Marwa Elsayed Elnaggar
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obese Patients ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Obstructive Sleep ◽  
Severe Copd

Abstract Background The conjunction of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is known as overlap syndrome (OS). The coexistence of these diseases has cardiovascular morbidity and mortality. The aim of this study is to assess the prevalence of OSA in COPD patients. One hundred COPD patients (obese and non-obese) performed sleep questionnaires and polysomnograms. Results OSA prevalence in COPD was 50% and it increases with increasing disease severity (P < 0.001). The highest prevalence of OSA was found in obese patients with severe COPD; 90.5% of these patients have OSA. In the OSA group, obese patients were found to have significantly higher STOP-Bang Questionnaire (SBQ), Epworth Sleep Scale (ESS), modified medical research council (mMRC) dyspnea scale, apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and oxygen desaturation index (ODI). Both obese and non-obese COPD patients showed significant positive correlations between AHI and smoking index (SI), SBQ, ESS, mMRC, ODI, and neck circumference (NC). Conclusions From this study, it can be concluded that moderate and severe COPD patients had a higher diagnosis of sleep-disordered breathing. Also, obese-COPD patients are more susceptible to develop OSA. Trial registration Name of the registry: Benha University Protocol Record Benha U123, Obstructive Sleep Apnea Prevalence in Patients With Chronic Obstructive Pulmonary Diseases. Trial registration number: NCT04903639. Date of registry: 5/22/2021 (retrospective study).

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