Lung hyperinflation in COPD: the impact of pharmacotherapy
Improvement in airway function in response to bronchodilator therapy is generally confirmed by simple spirometry. However, improvements in maximal expiratory flow rates have been shown to correlate poorly with important patient-centred outcomes, such as reduced exertional dyspnoea and improved exerc...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2006-12-01
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| Series: | European Respiratory Review |
| Subjects: | |
| Online Access: | http://err.ersjournals.com/cgi/content/full/15/100/85 |
| _version_ | 1811246110012866560 |
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| author | D. E. O'Donnell P. Laveneziana |
| author_facet | D. E. O'Donnell P. Laveneziana |
| author_sort | D. E. O'Donnell |
| collection | DOAJ |
| description | Improvement in airway function in response to bronchodilator therapy is generally confirmed by simple spirometry. However, improvements in maximal expiratory flow rates have been shown to correlate poorly with important patient-centred outcomes, such as reduced exertional dyspnoea and improved exercise performance. Recent studies have suggested that attendant reductions in end-expiratory lung volume as a result of bronchodilator-induced improvements in lung emptying may be more closely associated with symptom relief and increased exercise capacity than traditional spirometric indices. To the extent that chronic lung hyperinflation and the superimposition of acute dynamic hyperinflation (in response to increased ventilation or expiratory flow limitation) result in excessive loading and weakening of the inspiratory muscles, then pharmacological lung volume reduction should have important mechanical and sensory benefits for the patient. The present article will examine the mechanisms of lung deflation following short-term bronchodilator therapy. The physiological links between reduced hyperinflation, improved dyspnoea and exercise endurance will be examined, and the emerging evidence for the additive effects of combining various modern pharmacological therapies will be reviewed. |
| first_indexed | 2024-04-12T14:48:54Z |
| format | Article |
| id | doaj.art-502d2b49885348ec8bbe0965d7d5ec1c |
| institution | Directory Open Access Journal |
| issn | 0905-9180 1600-0617 |
| language | English |
| last_indexed | 2024-04-12T14:48:54Z |
| publishDate | 2006-12-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | European Respiratory Review |
| spelling | doaj.art-502d2b49885348ec8bbe0965d7d5ec1c2022-12-22T03:28:32ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172006-12-01151008589Lung hyperinflation in COPD: the impact of pharmacotherapyD. E. O'DonnellP. LavenezianaImprovement in airway function in response to bronchodilator therapy is generally confirmed by simple spirometry. However, improvements in maximal expiratory flow rates have been shown to correlate poorly with important patient-centred outcomes, such as reduced exertional dyspnoea and improved exercise performance. Recent studies have suggested that attendant reductions in end-expiratory lung volume as a result of bronchodilator-induced improvements in lung emptying may be more closely associated with symptom relief and increased exercise capacity than traditional spirometric indices. To the extent that chronic lung hyperinflation and the superimposition of acute dynamic hyperinflation (in response to increased ventilation or expiratory flow limitation) result in excessive loading and weakening of the inspiratory muscles, then pharmacological lung volume reduction should have important mechanical and sensory benefits for the patient. The present article will examine the mechanisms of lung deflation following short-term bronchodilator therapy. The physiological links between reduced hyperinflation, improved dyspnoea and exercise endurance will be examined, and the emerging evidence for the additive effects of combining various modern pharmacological therapies will be reviewed.http://err.ersjournals.com/cgi/content/full/15/100/85Bronchodilatorschronic obstructive pulmonary diseasedynamic hyperinflationdyspnoeaexerciserespiratory mechanics |
| spellingShingle | D. E. O'Donnell P. Laveneziana Lung hyperinflation in COPD: the impact of pharmacotherapy European Respiratory Review Bronchodilators chronic obstructive pulmonary disease dynamic hyperinflation dyspnoea exercise respiratory mechanics |
| title | Lung hyperinflation in COPD: the impact of pharmacotherapy |
| title_full | Lung hyperinflation in COPD: the impact of pharmacotherapy |
| title_fullStr | Lung hyperinflation in COPD: the impact of pharmacotherapy |
| title_full_unstemmed | Lung hyperinflation in COPD: the impact of pharmacotherapy |
| title_short | Lung hyperinflation in COPD: the impact of pharmacotherapy |
| title_sort | lung hyperinflation in copd the impact of pharmacotherapy |
| topic | Bronchodilators chronic obstructive pulmonary disease dynamic hyperinflation dyspnoea exercise respiratory mechanics |
| url | http://err.ersjournals.com/cgi/content/full/15/100/85 |
| work_keys_str_mv | AT deodonnell lunghyperinflationincopdtheimpactofpharmacotherapy AT plaveneziana lunghyperinflationincopdtheimpactofpharmacotherapy |