Distinct Mechanical Properties of the Respiratory System Evaluated by Forced Oscillation Technique in Acute Exacerbation of COPD and Acute Decompensated Heart Failure
Discriminating between cardiac and pulmonary dyspnea is essential for patients’ management. We investigated the feasibility and ability of forced oscillation techniques (FOT) in distinguishing between acute exacerbation of COPD (AECOPD), and acute decompensated heart failure (ADHF) in a clinical eme...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/3/554 |
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| author | Silvia Terraneo Rocco Francesco Rinaldo Giuseppe Francesco Sferrazza Papa Fulvia Ribolla Carlo Gulotta Laura Maugeri Emiliano Gatti Stefano Centanni Fabiano Di Marco |
| author_facet | Silvia Terraneo Rocco Francesco Rinaldo Giuseppe Francesco Sferrazza Papa Fulvia Ribolla Carlo Gulotta Laura Maugeri Emiliano Gatti Stefano Centanni Fabiano Di Marco |
| author_sort | Silvia Terraneo |
| collection | DOAJ |
| description | Discriminating between cardiac and pulmonary dyspnea is essential for patients’ management. We investigated the feasibility and ability of forced oscillation techniques (FOT) in distinguishing between acute exacerbation of COPD (AECOPD), and acute decompensated heart failure (ADHF) in a clinical emergency setting. We enrolled 49 patients admitted to the emergency department (ED) for dyspnea and acute respiratory failure for AECOPD, or ADHF, and 11 healthy subjects. All patients were able to perform bedside FOT measurement. Patients with AECOPD showed a significantly higher inspiratory resistance at 5 Hz, Xrs<sub>5</sub> (179% of predicted, interquartile range, IQR 94–224 vs. 100 IQR 67–149; <i>p</i> = 0.019), and a higher inspiratory reactance at 5 Hz (151%, IQR 74–231 vs. 57 IQR 49–99; <i>p</i> = 0.005) than patients with ADHF. Moreover, AECOPD showed higher heterogeneity of ventilation (respiratory system resistance difference at 5 and 19 Hz, Rrs<sub>5-19</sub>: 1.49 cmH<sub>2</sub>O/(L/s), IQR 1.03–2.16 vs. 0.44 IQR 0.22–0.76; <i>p</i> = 0.030), and a higher percentage of flow limited breaths compared to ADHF (10%, IQR 0–100 vs. 0 IQR 0–12; <i>p</i> = 0.030). FOT, which resulted in a suitable tool to be used in the ED setting, has the ability to identify distinct mechanical properties of the respiratory system in AECOPD and ADHF. |
| first_indexed | 2024-03-10T13:04:00Z |
| format | Article |
| id | doaj.art-973b6e48d9d24bcdb5b5ed8cbad9e11c |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T13:04:00Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-973b6e48d9d24bcdb5b5ed8cbad9e11c2023-11-21T11:15:33ZengMDPI AGDiagnostics2075-44182021-03-0111355410.3390/diagnostics11030554Distinct Mechanical Properties of the Respiratory System Evaluated by Forced Oscillation Technique in Acute Exacerbation of COPD and Acute Decompensated Heart FailureSilvia Terraneo0Rocco Francesco Rinaldo1Giuseppe Francesco Sferrazza Papa2Fulvia Ribolla3Carlo Gulotta4Laura Maugeri5Emiliano Gatti6Stefano Centanni7Fabiano Di Marco8Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, ItalyRespiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, ItalyDepartment of Health Sciences, Università degli Studi di Milano, 20142 Milan, ItalyPneumologia AOU San Luigi Gonzaga, 10043 Orbassano, Turin, ItalyRespiratory Unit, Papa Giovanni XXIII Hospital, Department of Health Sciences, Università degli Studi di Milano, 24127 Bergamo, ItalyRespiratory Unit, Papa Giovanni XXIII Hospital, Department of Health Sciences, Università degli Studi di Milano, 24127 Bergamo, ItalyRespiratory Unit, Papa Giovanni XXIII Hospital, Department of Health Sciences, Università degli Studi di Milano, 24127 Bergamo, ItalyRespiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, ItalyCasa di Cura del Policlinico, Department of Neurorehabilitation Sciences, 20144 Milan, ItalyDiscriminating between cardiac and pulmonary dyspnea is essential for patients’ management. We investigated the feasibility and ability of forced oscillation techniques (FOT) in distinguishing between acute exacerbation of COPD (AECOPD), and acute decompensated heart failure (ADHF) in a clinical emergency setting. We enrolled 49 patients admitted to the emergency department (ED) for dyspnea and acute respiratory failure for AECOPD, or ADHF, and 11 healthy subjects. All patients were able to perform bedside FOT measurement. Patients with AECOPD showed a significantly higher inspiratory resistance at 5 Hz, Xrs<sub>5</sub> (179% of predicted, interquartile range, IQR 94–224 vs. 100 IQR 67–149; <i>p</i> = 0.019), and a higher inspiratory reactance at 5 Hz (151%, IQR 74–231 vs. 57 IQR 49–99; <i>p</i> = 0.005) than patients with ADHF. Moreover, AECOPD showed higher heterogeneity of ventilation (respiratory system resistance difference at 5 and 19 Hz, Rrs<sub>5-19</sub>: 1.49 cmH<sub>2</sub>O/(L/s), IQR 1.03–2.16 vs. 0.44 IQR 0.22–0.76; <i>p</i> = 0.030), and a higher percentage of flow limited breaths compared to ADHF (10%, IQR 0–100 vs. 0 IQR 0–12; <i>p</i> = 0.030). FOT, which resulted in a suitable tool to be used in the ED setting, has the ability to identify distinct mechanical properties of the respiratory system in AECOPD and ADHF.https://www.mdpi.com/2075-4418/11/3/554heart failureacute exacerbation of COPDFOT |
| spellingShingle | Silvia Terraneo Rocco Francesco Rinaldo Giuseppe Francesco Sferrazza Papa Fulvia Ribolla Carlo Gulotta Laura Maugeri Emiliano Gatti Stefano Centanni Fabiano Di Marco Distinct Mechanical Properties of the Respiratory System Evaluated by Forced Oscillation Technique in Acute Exacerbation of COPD and Acute Decompensated Heart Failure Diagnostics heart failure acute exacerbation of COPD FOT |
| title | Distinct Mechanical Properties of the Respiratory System Evaluated by Forced Oscillation Technique in Acute Exacerbation of COPD and Acute Decompensated Heart Failure |
| title_full | Distinct Mechanical Properties of the Respiratory System Evaluated by Forced Oscillation Technique in Acute Exacerbation of COPD and Acute Decompensated Heart Failure |
| title_fullStr | Distinct Mechanical Properties of the Respiratory System Evaluated by Forced Oscillation Technique in Acute Exacerbation of COPD and Acute Decompensated Heart Failure |
| title_full_unstemmed | Distinct Mechanical Properties of the Respiratory System Evaluated by Forced Oscillation Technique in Acute Exacerbation of COPD and Acute Decompensated Heart Failure |
| title_short | Distinct Mechanical Properties of the Respiratory System Evaluated by Forced Oscillation Technique in Acute Exacerbation of COPD and Acute Decompensated Heart Failure |
| title_sort | distinct mechanical properties of the respiratory system evaluated by forced oscillation technique in acute exacerbation of copd and acute decompensated heart failure |
| topic | heart failure acute exacerbation of COPD FOT |
| url | https://www.mdpi.com/2075-4418/11/3/554 |
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