scholarly journals Inspiratroy Capacity and Exercise Tolerance in Chronic Obstructive Pulmonary Disease

2000 ◽  
Vol 7 (3) ◽  
pp. 282-285 ◽  
Author(s):  
Joseph Milic-Emili
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Airway Obstruction ◽  
Pulmonary Disease ◽  
Exercise Tolerance ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Peripheral Muscle ◽  
Past Half Century

During the past half-century, many studies have investigated the correlation of exercise tolerance to routine lung function in patients with obstructive pulmonary disease. In virtually all of these studies, the degree of airway obstruction was assessed in terms of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Because in most studies only a weak correlation was found between exercise tolerance and degree of airway obstruction, it has been concluded that factors other than lung function impairment (eg, deconditioning and peripheral muscle dysfunction) play a predominant role in limiting exercise capacity in patients with chronic airway obstruction. Recent work, however, suggests that in patients with chronic obstructive pulmonary disease, the inspiratory capacity is a more powerful predictor of exercise tolerance than FEV1 and FVC.

scholarly journals Prognostic and Functional Impact of Perioperative LAＭA/LABA Inhaled Therapy In Patients With Lung Cancer and Chronic Obstructive Pulmonary Disease 

2021 ◽  
Author(s):  
Yoko Azuma ◽  
Atsushi Sano ◽  
Takashi Sakai ◽  
Satoshi Koezuka ◽  
Hajime Otsuka ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Chronic Obstructive Pulmonary Disease ◽  
Postoperative Complications ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Long Acting

Abstract Background: Chronic obstructive pulmonary disease (COPD) is an important risk factor for postoperative complications and mortality. The utility of several perioperative bronchodilators in patients with COPD requiring surgery for lung cancer has been reported, but the most suitable agent and its specific effect on postoperative long-term prognosis remain unclear. To determine the effects of perioperative combination therapy, using a long-acting muscarinic antagonist (LAMA) and a long-acting β2 agonist (LABA), on preoperative lung function, postoperative morbidity and mortality, and long-term outcome in COPD patients.Methods: Between January 2005 and October 2019, 130 consecutive patients with newly diagnosed COPD underwent surgery for lung cancer. We conducted a retrospective review of their medical records. Patients were divided into 3 groups according to perioperative management: LAMA/LABA (n=64), LAMA (n=23) and rehabilitation only (no bronchodilator) (n=43). Results: Patients who received preoperative LAMA/LABA therapy showed significant improvement in lung function before surgery (p<0.001 for both forced expiratory volume in 1 second (FEV1) and percentage of predicted forced expiratory volume in 1 second (FEV1 %pred). Compared with patients who received preoperative LAMA therapy, patients with LAMA/LABA therapy had significantly improved lung function (ΔFEV1, 223.1 mL vs 130.0 mL, ΔFEV1 %pred, 10.8% vs 6.8%; both p<0.05). There was a trend toward a lower incidence of postoperative complications in the LAMA/LABA group compared with the LAMA and rehabilitation-only groups. In patients with moderate to severe air flow limitation (n=61), those who received LAMA/LABA therapy had significantly longer overall survival and disease-free survival compared with patients in the other groups. Perioperative LAMA/LABA therapy was also associated with lower recurrence rates. Conclusions: Patients who receive perioperative LAMA/LABA for moderate to severe COPD have improved prognosis and better pulmonary function with surgery for lung cancer. We believe this treatment combination is optimal for patients with lung cancer and COPD.

scholarly journals Análise da Revisão Cochrane: Uso de Corticoterapia Sistémica nas Exacerbações Agudas da Doença Pulmonar Obstrutiva Crónica. Cochrane Database Syst Rev. 2014,9:CD001288

2014 ◽  
Vol 27 (5) ◽  
pp. 537
Author(s):  
Pedro Azevedo ◽  
João Costa ◽  
António Vaz-Carneiro
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Treatment Failure ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Cochrane Review ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Early Improvement

<p>Acute exacerbations of chronic obstructive pulmonary disease are a major cause of hospital admissions and mortality, contributing to the decline in lung function, exercise capacity and quality of life. Infections are the major cause of exacerbations and treatment includes antibiotics, bronchodilators and systemic corticosteroids as anti- inflammatory agents. This Cochrane review compared: 1. use of oral and parenteral corticosteroids with placebo use; 2. routes of administration among themselves. The results indicate that there is evidence for the use of corticosteroids in the treatment of chronic obstructive pulmonary disease exacerbations since early improvement in lung function [assessed by forced expiratory volume in one second (FEV1)] has been noted, the likelihood of treatment failure and relapse in the first month has been reduced and it shortens the hospital stay in patients who do not require intensive care regimen. However, corticosteroid therapy causes an increase in adverse effects associated with drug, namely hyperglycaemia, especially if the route of administration is parenteral. Parenteral route has not shown to be superior to oral route in treatment failure, relapse, or death. Mortality up to 30 days does not seem to be affected by the use of corticosteroids.</p><p><br /><strong>Keywords:</strong> Adrenal Cortex Hormones; Pulmonary Disease, Chronic Obstructive /drug therapy; Pulmonary Disease, Chronic Obstructive/ complications; Randomized Controlled Trials as Topic.</p>

scholarly journals Diaphragmatic Excursion is Correlated With the Improvement in Exercise Tolerance After Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease

2021 ◽  
Author(s):  
Masashi Shiraishi ◽  
Yuji Higashimoto ◽  
Ryuji Sugiya ◽  
Hiroki Mizusawa ◽  
Yu Takeda ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Roc Curve ◽  
Pulmonary Rehabilitation ◽  
Exercise Tolerance ◽  
Maximum Level ◽  
Quadriceps Muscle ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Abstract Background: In patients with chronic obstructive pulmonary disease (COPD), the maximum level of diaphragm excursion (DEmax) is correlated with dynamic lung hyperinflation and exercise tolerance. This study aims to clarify the utility of DEmax to predict the improvement in exercise tolerance after pulmonary rehabilitation (PR) in patients with COPD.Methods: This was a prospective cohort study. Sixty-two patients with stable COPD participated in an outpatient PR programme from April 2018 to February 2021, and 50 completed the programme. Six-minute walk distance (6MWD) was used to evaluate exercise tolerance, and ultrasonography was used to measure DEmax. Responders to PR in exercise capacity were defined as patients with an increase >30 m in 6MWD. The receiver operating characteristic (ROC) curve was used to determine the cut-off point of DEmax to predict responses to PR.Results: Baseline levels of forced expiratory volume in one second (%FEV1), 6MWD, maximum inspiratory pressure (PImax), DEmax and quadriceps muscle strength (QMS) were significantly higher, and peak dyspnoea of modified Borg (mBorg) scale was lower in responders (n = 30) than in non-responders (n = 20) to PR (p < 0.01). In multivariate analysis, DEmax was significantly correlated with an increase of >30 m in 6MWD. The area under the ROC curve of DEmax to predict responders was 0.915, with a sensitivity of 83% and a specificity of 95% at a cut-off point of 44.9 mm of DEmax.Conclusion: DEmax well predicted the improvement in exercise tolerance after PR in patients with COPD.

How Accurately Can We Predict Forced Expiratory Volume in One Second after Major Pulmonary Resection?

2007 ◽  
Vol 73 (10) ◽  
pp. 1047-1051 ◽  
Author(s):  
Tina Wang ◽  
Alvin Tagayun ◽  
Alicia Bogardus ◽  
Dajun Qian ◽  
Brian Tiep ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Airway Obstruction ◽  
Pulmonary Disease ◽  
Pulmonary Resection ◽  
Pearson Correlation ◽  
Forced Expiratory Volume ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Standard formulas for predicting postoperative forced expiratory volume in 1 second (po-FEV1) do not consider bronchi obstructed by tumor or chronic obstructive pulmonary disease, e.g., Formula 1 [ppo-FEV1 = (pre-opFEV1) x (# segments remaining)/(# of total segments)] whereas Formula 2 [ppo-FEV1 = (pre-opFEV1) x (# segments remaining)/(# of total unobstructed segments)] does. A retrospective chart review was conducted to determine accuracy of predicting po-FEV1, at a comprehensive cancer center. Predicted po-FEV1 was calculated using different formulas and analyzed using regression analysis and Pearson correlation. We found good correlation between po-FEV1 and predicted po-FEV1 using Formulas 1 and 2. In patients with tumor airway obstruction or chronic obstructive pulmonary disease, predictive accuracy decreased for both formulas. Prediction of FEV1 in patients undergoing pulmonary resection was generally accurate, but major errors were observed in some cases; therefore, better predictive formulas are needed in patients with airway obstruction by tumor or chronic obstructive pulmonary disease.

scholarly journals Diaphragmatic excursion is correlated with the improvement in exercise tolerance after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Masashi Shiraishi ◽  
Yuji Higashimoto ◽  
Ryuji Sugiya ◽  
Hiroki Mizusawa ◽  
Yu Takeda ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Roc Curve ◽  
Pulmonary Rehabilitation ◽  
Exercise Tolerance ◽  
Maximum Level ◽  
Quadriceps Muscle ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Abstract Background In patients with chronic obstructive pulmonary disease (COPD), the maximum level of diaphragm excursion (DEmax) is correlated with dynamic lung hyperinflation and exercise tolerance. This study aimed to elucidate the utility of DEmax to predict the improvement in exercise tolerance after pulmonary rehabilitation (PR) in patients with COPD. Methods This was a prospective cohort study. Of the 62 patients with stable COPD who participated in the outpatient PR programme from April 2018 to February 2021, 50 completed the programme. Six-minute walk distance (6MWD) was performed to evaluate exercise tolerance, and ultrasonography was performed to measure DEmax. Responders to PR in exercise capacity were defined as patients who demonstrated an increase of > 30 m in 6MWD. The receiver operating characteristic (ROC) curve was used to determine the cut-off point of DEmax to predict responses to PR. Results Baseline levels of forced expiratory volume in 1 s, 6MWD, maximum inspiratory pressure, DEmax and quadriceps muscle strength were significantly higher, and peak dyspnoea of modified Borg (mBorg) scale score was lower in responders (n = 30) than in non-responders (n = 20) to PR (p < 0.01). In multivariate analysis, DEmax was significantly correlated with an increase of > 30 m in 6MWD. The area under the ROC curve of DEmax to predict responders was 0.915, with a sensitivity and specificity of 83% and 95%, respectively, at a cut-off value of 44.9 mm of DEmax. Conclusion DEmax could adequately predict the improvement in exercise tolerance after PR in patients with COPD.

scholarly journals Molecular Diagnosis of Intermediate and Severe α1-Antitrypsin Deficiency: MZ Individuals with Chronic Obstructive Pulmonary Disease May Have Lower Lung Function Than MM Individuals

2001 ◽  
Vol 47 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Morten Dahl ◽  
Børge G Nordestgaard ◽  
Peter Lange ◽  
Jørgen Vestbo ◽  
Anne Tybjærg-Hansen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Function ◽  
Pulmonary Disease ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Antitrypsin Deficiency ◽  
Lower Lung ◽  
Compound Heterozygotes

Abstract Background: We tested whether intermediate (MZ, SZ) and severe (ZZ) α1-antitrypsin deficiency affects lung function in the population at large. Methods: We performed spirometry [forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)] and genotyping of 9187 individuals from the adult general population of Copenhagen, Denmark. Results: As expected, the frequencies of individuals with MM, MS, SS, MZ, SZ, and ZZ genotypes were 0.891, 0.054, 0.001, 0.052, 0.001, and 0.001, respectively. Genotype interacted with clinically established chronic obstructive pulmonary disease (COPD) on the percentage of the predicted FEV1 (P = 0.004): the percentage of the predicted FEV1 was reduced in MZ compared with MM individuals among those with clinically established COPD, but not among those without COPD. Furthermore, SZ compound heterozygotes had lower FEV1/FVC ratios than MM individuals (P &lt;0.05), and ZZ homozygotes had lower percentages of the predicted FEV1 and FEV1/FVC ratios than MM, MS, SS, and MZ individuals (all Ps &lt;0.01). Reduced lung function in SZ and ZZ vs MM individuals could be demonstrated in current and ex-smokers, but not in nonsmokers. Compared with MM individuals in the same groups, FEV1 was reduced 655 mL in MZ individuals with clinically established COPD, 364 mL in SZ current smokers, and 791 mL in ZZ current smokers. Conclusions: In the population at large, MZ was associated with reduced pulmonary function in individuals with clinically established COPD, whereas SZ and ZZ were associated with reduced pulmonary function in smokers. The presence of the α1-antitrypsin MZ genotype may in certain circumstances produce marked aggravation of airway obstruction in individuals prone to develop COPD.

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