Differences in spontaneous breathing pattern and mechanics in patients with severe COPD recovering from acute excerbation

M. Vitacca, R. Porta, L. Bianchi, E. Clini, N. Ambrosino

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8 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)365-370
Number of pages6
JournalEuropean Respiratory Journal
Volume13
Issue number2
DOIs
Publication statusPublished - 1999

Fingerprint

Respiratory Mechanics
Chronic Obstructive Pulmonary Disease
Respiration
Work of Breathing
Mechanics
Pressure
Positive-Pressure Respiration
Respiratory Function Tests
Tidal Volume
Gases
Hemodynamics
Demography
Muscles
Lung
Population

Keywords

  • Acute respiratory failure
  • Chronic respiratory insufficiency
  • Ineffective efforts
  • Mechanical ventilation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

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title = "Differences in spontaneous breathing pattern and mechanics in patients with severe COPD recovering from acute excerbation",
abstract = "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.",
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AU - Porta, R.

AU - Bianchi, L.

AU - Clini, E.

AU - Ambrosino, N.

PY - 1999

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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.

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KW - Chronic respiratory insufficiency

KW - Ineffective efforts

KW - Mechanical ventilation

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