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No room to breathe: the importance of lung hyperinflation in COPD

No room to breathe: the importance of lung hyperinflation in COPD
No room to breathe: the importance of lung hyperinflation in COPD
Patients with chronic obstructive pulmonary disease (COPD) are progressively limited in their ability to undertake normal everyday activities by a combination of exertional dyspnoea and peripheral muscle weakness. COPD is characterised by expiratory flow limitation, resulting in air trapping and lung hyperinflation. Hyperinflation increases acutely under conditions such as exercise or exacerbations, with an accompanying sharp increase in the intensity of dyspnoea to distressing and intolerable levels. Air trapping, causing increased lung hyperinflation, can be present even in milder COPD during everyday activities. The resulting activity-related dyspnoea leads to a vicious spiral of activity avoidance, physical deconditioning, and reduced quality of life, and has implications for the early development of comorbidities such as cardiovascular disease. Various strategies exist to reduce hyperinflation, notably long-acting bronchodilator treatment (via reduction in flow limitation and improved lung emptying) and an exercise programme (via decreased respiratory rate, reducing ventilatory demand), or their combination. Optimal bronchodilation can reduce exertional dyspnoea and increase a patient’s ability to exercise, and improves the chance of successful outcome of a pulmonary rehabilitation programme. There should be a lower threshold for initiating treatments appropriate to the stage of the disease, such as long-acting bronchodilators and an exercise programme for patients with mild-to-moderate disease who experience persistent dyspnoea.
copd, dyspnoea, exacerbations, exercise, hyperinflation, inspiratory capacity
1471-4418
101-111
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Decramer, Marc
4eafe3a5-1fc0-4f7c-a275-3e4a857f0c58
O'Donnell, Denis E.
22ac891e-0ea5-41d6-8389-4a337ab43f9c
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Decramer, Marc
4eafe3a5-1fc0-4f7c-a275-3e4a857f0c58
O'Donnell, Denis E.
22ac891e-0ea5-41d6-8389-4a337ab43f9c

Thomas, Mike, Decramer, Marc and O'Donnell, Denis E. (2013) No room to breathe: the importance of lung hyperinflation in COPD. Primary Care Respiratory Journal, 22 (1), 101-111. (doi:10.4104/pcrj.2013.00025).

Record type: Article

Abstract

Patients with chronic obstructive pulmonary disease (COPD) are progressively limited in their ability to undertake normal everyday activities by a combination of exertional dyspnoea and peripheral muscle weakness. COPD is characterised by expiratory flow limitation, resulting in air trapping and lung hyperinflation. Hyperinflation increases acutely under conditions such as exercise or exacerbations, with an accompanying sharp increase in the intensity of dyspnoea to distressing and intolerable levels. Air trapping, causing increased lung hyperinflation, can be present even in milder COPD during everyday activities. The resulting activity-related dyspnoea leads to a vicious spiral of activity avoidance, physical deconditioning, and reduced quality of life, and has implications for the early development of comorbidities such as cardiovascular disease. Various strategies exist to reduce hyperinflation, notably long-acting bronchodilator treatment (via reduction in flow limitation and improved lung emptying) and an exercise programme (via decreased respiratory rate, reducing ventilatory demand), or their combination. Optimal bronchodilation can reduce exertional dyspnoea and increase a patient’s ability to exercise, and improves the chance of successful outcome of a pulmonary rehabilitation programme. There should be a lower threshold for initiating treatments appropriate to the stage of the disease, such as long-acting bronchodilators and an exercise programme for patients with mild-to-moderate disease who experience persistent dyspnoea.

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More information

Published date: 21 February 2013
Keywords: copd, dyspnoea, exacerbations, exercise, hyperinflation, inspiratory capacity
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 352686
URI: https://eprints.soton.ac.uk/id/eprint/352686
ISSN: 1471-4418
PURE UUID: 01f93575-30c3-454b-9ef2-be2dbb846958

Catalogue record

Date deposited: 20 May 2013 10:58
Last modified: 16 Jul 2019 21:33

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