Login to your account

Username *
Password *
Remember Me

Blog With Right Sidebar

    Vous êtes ici :  
  1. Accueil
  2. Blog With Right Sidebar

Diffusing Capacity for Carbon Monoxide is Linked to Ventilatory Demand in Patients with Chronic Obstructive Pulmonary Disease.

Diffusing Capacity for Carbon Monoxide is Linked to Ventilatory Demand in Patients with Chronic Obstructive Pulmonary Disease.

COPD. 2012 Feb;9(1):16-21

Authors: Mahut B, Chevalier-Bidaud B, Plantier L, Essalhi M, Callens E, Graba S, Gillet-Juvin K, Valcke-Brossollet J, Delclaux C

Abstract
Abstract Dyspnea is deemed to result from an imbalance between ventilatory demand and capacity. The single-breath diffusing capacity for carbon monoxide (DLCO) is often the best correlate to dyspnea in COPD. We hypothesized that DLCO contributes to the assessment of ventilatory demand, which is linked to physiological dead space /tidal volume (VD/VT) ratio. An additional objective was to assess the validity of non-invasive measurement of transcutaneous P(CO2) allowing the calculation of this ratio. Forty-two subjects (median [range] age: 66 [43-80] years; 12 females) suffering mainly from moderate-to-severe COPD (GOLD stage 2 or 3: n = 36) underwent pulmonary function and incremental exercise tests while taking their regular COPD treatment. DLCO% predicted correlated with both resting and peak physiological VD/VT ratios (r = -0.55, p = 0.0015 and r = -0.40, p = 0.032; respectively). The peak physiological VD/VT ratio contributed to increase ventilation (increased ventilatory demand), to increase dynamic hyperinflation and to impair oxygenation on exercise. Indirect (MRC score) and direct (peak Borg score/% predicted V˙O2) exertional dyspnea assessments were correlated and demonstrated significant relationships with DLCO% predicted and physiological VD/VT at peak exercise, respectively. The non-invasive measurement of transcutaneous P(CO2) both at rest and on exercise was validated by Bland-Altman analyses. In conclusion, DLCO constitutes and indirect assessment of ventilatory demand, which is linked to exertional dyspnea in COPD patients. The assessment of this demand can also be non invasively obtained on exercise using transcutaneous PCO(2) measurement.

PMID: 22292594 [PubMed - in process]

Demographic, Physiologic and Radiographic Characteristics of COPD Patients Taking Chronic Systemic Corticosteroids.

Demographic, Physiologic and Radiographic Characteristics of COPD Patients Taking Chronic Systemic Corticosteroids.

COPD. 2012 Feb;9(1):29-35

Authors: Swift I, Satti A, Kim V, Make BJ, Newell J, Steiner RM, Wilson C, Murphy JR, Silverman EK, Criner The Copdgene Investigators GJ

Abstract
Abstract Long-term therapy with systemic corticosteroids is not recommended in the treatment of chronic obstructive pulmonary disease (COPD). However, experience demonstrates that some patients receive low dose therapy. Our objective was to describe the demographic, physiologic and radiologic characteristics of COPD patients treated with chronic systemic corticosteroids. We analyzed COPD subjects with GOLD I-IV disease in the COPDGene® study. Subjects were divided into 2 groups based on whether they reported using chronic oral steroids or not; 1264 subjects were included. Fifty-eight (4.5%) reported chronic systemic corticosteroid use. There were no differences in age, race, co-morbid conditions (other than asthma), or body mass index between the groups. There was a greater proportion of GOLD III (41% vs. 26%) and IV (41% vs. 13%) subjects in the group using chronic systemic corticosteroids. This group used more respiratory medications, required more oxygen (2.31 ± 0.21 vs. 0.59 ± 0.05 L/min; p < 0.0001), and walked less distance (245.4 ± 17.4 vs. 367.2 ± 3.9 meters; p < 0.0001). They reported more total (1.7 ± 0.16 vs. 0.62 ± 0.03; p < 0.0001) and severe exacerbations per year (0.41 ± 0.05 vs. 0.18 ± 0.01; p < 0.0001). BODE (5.0 ± 0.3 vs. 2.6 ± 0.1; p < 0.0001), MMRC (3.31 ± 0.19 vs. 1.90 ± 0.04; p < 0.0001) and SGRQ scores (54.9 ± 2.9 vs 53.3 ± 0.6; p < 0.0001) were higher. They also had a higher percentage of emphysema (22.4 ± 1.9 vs. 14.0 ± 0.4;%, p = <0.0001) on CT scan. COPD patients that report using chronic systemic corticosteroids have more severe clinical, physiologic, and radiographic disease.

PMID: 22292596 [PubMed - in process]

Effects of budesonide/formoterol combination therapy versus budesonide alone on airway dimensions in asthma

Conclusions : Budesonide/formoterol combination therapy is more effective than budesonide alone for reducing airway wall thickness and inflammation in individuals with asthma.© 2012

Efficacy of inhaled N‐acetylcysteine monotherapy in patients with early stage idiopathic pulmonary fibrosis

Conclusions : These findings indicate that NAC monotherapy may have some beneficial effect in patients with early stage IPF. Further trials, in more select IPF populations with progressive disease, are required to prove the efficacy of inhaled NAC.© 2012.

Obesity, obstructive sleep apnoea and metabolic syndrome

OSA is increasingly recognized as a major health problem in developed countries. Obesity is the most common risk factor in OSA and hence, the prevalence of OSA is undoubtedly rising given the epidemic of obesity.

Recent data also suggest that OSA is highly associated with the metabolic syndrome, and it is postulated that OSA contributes to cardiometabolic dysfunction, and subsequently vasculopathy.Current evidence regarding the magnitude of impact on ultimate cardiovascular morbidity or mortality attributable to OSA‐induced metabolic dysregulation is scarce. Given the known pathophysiological triggers of intermittent hypoxia and sleep fragmentation in OSA, the potential mechanisms of OSA–obesity–metabolic syndrome interaction involve sympathetic activation, oxidative stress, ...

Search

Search