Lung volumes and airway resistance in patients with a possible restrictive pattern on spirometry

Schultz, Kenia; D'Aquino, Luiz Carlos; Soares, Maria Raquel; Gimenez, Andréa; Pereira, Carlos Alberto de Castro

doi:10.1590/s1806-37562016000000091

Cited by 8 publications

(9 citation statements)

References 35 publications

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“…Respiratory dysfunction in PD can derive from peripheral (eg, motor) and central mechanisms [12]. In our study, the decline in FEV 1 and FVC with little change in FEV 1 /FVC over the 1-year study period suggests a decrease in lung volume rather than development or worsening of airway obstruction [29,30]. Similarly, although the DL CO did not change significantly, the decline in DL CO components of VA and IVC with little change in DL CO /VA over 1 year suggests a decrease in lung volume rather than an intrinsic pulmonary parenchymal process that could lead to a reduction in gas exchange [30].…”

Section: Discussionmentioning

confidence: 49%

“…Similarly, although the DL CO did not change significantly, the decline in DL CO components of VA and IVC with little change in DL CO /VA over 1 year suggests a decrease in lung volume rather than an intrinsic pulmonary parenchymal process that could lead to a reduction in gas exchange [30]. Unfortunately, spirometry cannot be used to measure lung volume directly, so a decrease in volume can only be inferred; direct measurement of lung volume by body plethysmography or gas dilution would be necessary to characterize the pattern of lung disease [29,30]. However, VA is a close surrogate for lung volume (or total lung capacity, TLC) when FEV 1 /FVC is normal [31], as it is here.…”

Section: Discussionmentioning

confidence: 99%

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Natural history of lung function over one year in patients with Parkinson's disease

Kaminsky

Grosset

Kegler-Ebo

et al. 2021

Respiratory Medicine

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Background:Little is known about decline in lung function in Parkinson's disease (PD). To assess these changes, we assessed the changes in lung function that occurred over 12 months in patients on standard PD therapy as part of the observational cohort of an open-label study of inhaled levodopa (CVT-301) in PD. Methods: PD patients on stable oral PD therapy and no chronic respiratory disease had spirometry and diffusing capacity of the lungs for carbon monoxide (DL CO ) measured at 3, 6, 9, and 12 months. Results: 106 patients (81.5%) in the observational cohort on no investigational therapy completed the study. Mean FEV 1 declined at 12 months from 2.88L at baseline with a mean change of − 0.11L, greater than the − 0.030-0.045L/year observed in healthy, non-smokers aged 60-70 years. FVC declined from 3.77L (mean change − 0.19L); FEV 1 /FVC ratio remained relatively constant. DL CO mean change was − 0.48 mL/min/mmHg from a baseline of 24.24 mL/min/mmHg. This change in DL CO , while not significant, was similar to that seen in non-smokers aged 60-70 years (DL CO -0.42-0.63 mL/min/mmHg/year). Decreases in alveolar volume (VA) and inspiratory vital capacity (IVC) rather than the transfer coefficient (DL CO /VA) were observed. Conclusions: PD patients had greater declines in FEV 1 , and FVC, but not in DL CO, compared to healthy nonsmokers of similar age. Declines in FEV 1 and FVC with little change in FEV 1 /FVC, and decline in VA and IVC with little change in DL CO /VA, suggest these changes were due to decreases in lung volume and are compatible with progressive PD-associated respiratory muscle weakness. Trial registration: ClinicalTrials.gov (NCT02352363 Registered January 26, 2015 [https://clinicaltrials.gov/ct2/ show/NCT02352363]) and EudraCT (2014-003799-22).

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Natural history of lung function over one year in patients with Parkinson's disease

Kaminsky

Grosset

Kegler-Ebo

et al. 2021

Respiratory Medicine

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“…Apparent restriction on spirometry (reduction of FVC and FEV 1 , with FEV 1 / FVC in the expected range) in many cases it is not confirmed by reduced TLC. This combination is called nonspecific pattern and is commonly observed in obstructive diseases with airway closure, obesity and neuromuscular diseases 2 . In patients with reduced TLC, a disproportionately reduced FVC (TLC%-FVC expected> 10%), recently termed “complex restrictive pattern”, points to clinical entities that result in impaired pulmonary emptying, such as neuromuscular diseases, obstruction and chest wall disease 3 .…”

Section: Introductionmentioning

confidence: 99%

“…In Brazil, reference values for pulmonary volumes were derived by Neder et al 12 in 1999 in 50 men and 50 women of different races and are used in some centers 12 . In Brazil, the Crapo equation is also used as a reference for pulmonary volumes, but its adequacy to our population has never been tested 2 13 …”

Section: Introductionmentioning

confidence: 99%

Reference values for pulmonary volumes by plethysmography in a Brazilian sample of white adults

Lessa¹,

Pereira²,

Soares³

et al. 2019

J. bras. pneumol.

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Objective: To derive reference values for healthy white Brazilian adults who have never smoked and to compare the obtained values with reference values derived by Crapo and by Neder. Methods: Reference equations by quantile regressions were derived in 122 men and 122 women, non-obese, living in seven cities in Brazil. Age ranged from 21 to 92 years in women and from 25 to 88 years in men. Lung function tests were performed using SensorMedics automated body plethysmographies according ATS/ERS recommendations. Lower and upper limits were derived by specific equations for 5 and 95 percentiles. The results were compared to those suggested by Crapo in 1982, and Neder in 1999. Results: Median values for total lung capacity (TLC) were influenced only by stature in men, and by stature and age in women. Residual volume was influenced by age and stature in both genders. Weight was directly related to inspiratory capacity and inversely with functional residual capacity and expiratory reserve volume in both genders. A comparison of observed TLC data with values predicted by Neder equations showed significant lower values by the present data. Mean values were similar between data from present study and those derived by Crapo. Conclusion: New predicted values for lung volumes were obtained in a sample of white Brazilians. The values differ from those derived by Neder, but are similar to those derived by Crapo.

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“…Several situations in clinical practice favor subjects developing reduced lung volumes, characterizing a restrictive respiratory pattern [ 1 ]. Current evidence has already described that several patterns can be observed in the postoperative period of cardiac and abdominal surgeries [ 2 , 3 ], in patients with cystic fibrosis [ 4 ], obesity [ 5 ], Parkinson’s disease [ 6 ] and post-stroke [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Acute effects of three pulmonary reexpansion modalities on thoracoabdominal motion of healthy subjects: Randomized crossover study

et al. 2019

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BackgroundChest physiotherapy can be an alternative to increase lung volumes through pulmonary expansion therapies, but there is still inconsistency in the literature in order to determine which device can promote a greater volume increase at the expense of a better ventilatory pattern. Therefore, the aim of this study was to evaluate and compare the chest wall kinematics of healthy subjects submitted to the use of three different devices for pulmonary reexpansion.MethodsChest wall compartmental and operational volumes, breathing pattern and thoracoabdominal asynchrony were evaluated in 12 healthy individuals through optoelectronic plethysmography during quiet breathing, pulmonary reexpansion and recovery. Three different devices (volume-oriented incentive spirometer–IS-v; positive expiratory pressure–PEP; and incentive spirometer volume and pressure oriented–IS-vp) were administered in a random order with at least 48h between the devices.ResultsA greater volume variation in the chest wall and its compartments was observed when the IS-vp was used in comparison with the other devices (p<0.05). Furthermore, the IS-vp mobilizes a greater amount of volume accompanied by greater synchronism between the compartments when compared to IS-v (p <0.05).ConclusionThe IS-vp may be able to increase total and compartmental chest wall volumes, as well as improve synchrony among compartments when compared to IS-v and PEP devices, thus constituting an important tool for treating patients with restrictive ventilatory pattern.

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Lung volumes and airway resistance in patients with a possible restrictive pattern on spirometry

Cited by 8 publications

References 35 publications

Natural history of lung function over one year in patients with Parkinson's disease

Natural history of lung function over one year in patients with Parkinson's disease

Reference values for pulmonary volumes by plethysmography in a Brazilian sample of white adults

Acute effects of three pulmonary reexpansion modalities on thoracoabdominal motion of healthy subjects: Randomized crossover study

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