Brazilian studies on pulmonary function in COPD patients: what are the gaps?

Abstract

BackgroundCOPD is a major cause of death and morbidity worldwide, and is characterized by persistent airflow obstruction. The evaluation of obstruction is critically dependent on sensitive methods for lung-function testing. A wide body of knowledge has been accumulated in recent years showing that these methods have been significantly refined and seems promising for detection of early disease.ObjectivesThis review focuses on research on pulmonary function analysis in COPD performed in Brazil during this century.Materials and methodsThe literature was searched using a systematic search strategy limited to English language studies that were carried out in Brazil from the year 2000 onward, with study objectives that included a focus on lung function.ResultsAfter we applied our inclusion and exclusion criteria, 94 articles addressed our stated objectives. Among the new methods reviewed are the forced-oscillation technique and the nitrogen-washout test, which may provide information on small-airway abnormalities. Studies investigating the respiratory muscles and thoracoabdominal motion are also discussed, as well as studies on automatic clinical decision-support systems and complexity measurements. We also examined important gaps in the present knowledge and suggested future directions for the cited research fields.ConclusionThere is clear evidence that improvements in lung-function methods allowed us to obtain new pathophysiological information, contributing to improvement in our understanding of COPD. In addition, they may also assist in the diagnosis and prevention of COPD. Further investigations using prospective and longitudinal design may be of interest to elucidate the use of these new methods in the diagnosis and prevention of COPD.

Handgrip Strength and Pulmonary Disease in the Elderly: What is the Link?

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Forced oscillation technique for early detection of the effects of smoking and COPD: contribution of fractional-order modeling

“… 7 – 11 Assessment of respiratory obstruction in the early stages is critically dependent on the sensitivity of pulmonary function tests. 12 It has previously been observed that spirometric indices are not sensitive to small changes due to smoking. 13 …”

Nitrogen single-breath washout test for evaluating exercise tolerance and quality of life in patients with chronic obstructive pulmonary disease

“…In recent decades, there have been significant technological advances in tools used to measure lung function. Despite the technological sophistication of traditional functional assessment methods, new PFTs are gradually being incorporated into clinical practice ( 6 ). There has been growing interest in the use of the single-breath washout (N 2 SBW) test because it is a simple, non-invasive tool and can detect heterogeneity in the ventilation distribution and small airway disease in cases in which traditional PFTs indicate normal values ( 7 ).…”