TY - JOUR
T1 - Differences in spontaneous breathing pattern and mechanics in patients with severe COPD recovering from acute excerbation
AU - Vitacca, M.
AU - Porta, R.
AU - Bianchi, L.
AU - Clini, E.
AU - Ambrosino, N.
PY - 1999
Y1 - 1999
N2 - The aims of this study were to assess spontaneous breathing patterns in patients with chronic obstructive pulmonary disease (COPD) recovering from acute exacerbation and to assess the relationship between different breathing patterns and clinical and functional parameters of respiratory impairment. Thirty-four COPD patients underwent assessment of lung function tests, arterial blood gases, haemodynamics, breathing pattern (respiratory frequency (f(R)), tidal volume (V(T)), inspiratory and expiratory time (t(I) and t(E)), duty cycle (t(I)/t(tot)), V(T)/t(I)) and mechanics (oesophageal pressure (P(oes)), work of breathing (WOB), pressure-time product and index, and dynamic intrinsic positive end-expiratory pressure (PEEP(i,dyn))). According to the presence (group 1) or absence (group 2) of P(oes) swings during the expiratory phase (premature inspiration), 20 (59%) patients were included in group 1 and 14 (41%) in group 2. Premature inspirations were observed 4.5±6.4 times·min-1 (range 1-31), i.e. 20±21% (3.7-100%) of total f(R) calculated from V(T) tracings. In group I the coefficient of variation in V(T), t(E), t(I)/t(tot), PEEP(i,dyn), P(oes) and WOB of the eight consecutive breaths immediately preceding the premature inspiration was greater than that of eight consecutive breaths in group 2. There were no significant differences in the assessed parameters between the two groups in the overall population, whereas patients with chronic hypoxaemia in group 1 showed a more severe impairment in clinical conditions, mechanics and lung function than hypoxaemic patients in group 2. In spontaneously breathing patients with chronic obstructive pulmonary disease recovering from an acute exacerbation, detectable activity of inspiratory muscles during expiration was found in more than half of the cases. This phenomenon was not associated with any significant differences in anthropometric, demographic, physiological or clinical characteristics.
AB - The aims of this study were to assess spontaneous breathing patterns in patients with chronic obstructive pulmonary disease (COPD) recovering from acute exacerbation and to assess the relationship between different breathing patterns and clinical and functional parameters of respiratory impairment. Thirty-four COPD patients underwent assessment of lung function tests, arterial blood gases, haemodynamics, breathing pattern (respiratory frequency (f(R)), tidal volume (V(T)), inspiratory and expiratory time (t(I) and t(E)), duty cycle (t(I)/t(tot)), V(T)/t(I)) and mechanics (oesophageal pressure (P(oes)), work of breathing (WOB), pressure-time product and index, and dynamic intrinsic positive end-expiratory pressure (PEEP(i,dyn))). According to the presence (group 1) or absence (group 2) of P(oes) swings during the expiratory phase (premature inspiration), 20 (59%) patients were included in group 1 and 14 (41%) in group 2. Premature inspirations were observed 4.5±6.4 times·min-1 (range 1-31), i.e. 20±21% (3.7-100%) of total f(R) calculated from V(T) tracings. In group I the coefficient of variation in V(T), t(E), t(I)/t(tot), PEEP(i,dyn), P(oes) and WOB of the eight consecutive breaths immediately preceding the premature inspiration was greater than that of eight consecutive breaths in group 2. There were no significant differences in the assessed parameters between the two groups in the overall population, whereas patients with chronic hypoxaemia in group 1 showed a more severe impairment in clinical conditions, mechanics and lung function than hypoxaemic patients in group 2. In spontaneously breathing patients with chronic obstructive pulmonary disease recovering from an acute exacerbation, detectable activity of inspiratory muscles during expiration was found in more than half of the cases. This phenomenon was not associated with any significant differences in anthropometric, demographic, physiological or clinical characteristics.
KW - Acute respiratory failure
KW - Chronic respiratory insufficiency
KW - Ineffective efforts
KW - Mechanical ventilation
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U2 - 10.1183/09031936.99.13236599
DO - 10.1183/09031936.99.13236599
M3 - Article
C2 - 10065683
AN - SCOPUS:0033018695
VL - 13
SP - 365
EP - 370
JO - European Journal of Respiratory Diseases
JF - European Journal of Respiratory Diseases
SN - 0903-1936
IS - 2
ER -