Continuous Positive Airway Pressure Effects on Regional Lung Aeration in Patients With COPD

Holanda, Marcelo Alcântara; Fortaleza, Simone Castelo Branco; Almeida, Mirizana Alves de; Winkeler, Georgia Freire Paiva; Reis, Ricardo; Felix, J. H. S.; Lima, José Wellington Oliveira; Pereira, Eanes Delgado Barros

doi:10.1378/chest.09-2850

Cited by 29 publications

(35 citation statements)

References 34 publications

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“…The calibration is carried out within three months taking exams, as specified by the manufacturer (Toshiba, 1997). Moreover, a tomographic cut with a water phantom with a known density is performed for analysis and parameter control (Holanda et al, 2010). The images are quantified in 16 bits and stored in a DICOM format (Digital Imaging and Communications in Medicine).…”

Section: The Medical Image Acquisition and Lung Segmentationmentioning

confidence: 99%

“…The data set comprises an image cluster obtained in collaboration with the Walter Cantídio Hospital of the Federal University of Ceará, submitted to an earlier study (Holanda et al, 2010;Winkeler, 2006). This study was approved and evaluated by the UFC Research Ethics Committee -COMEPE, (Protocol nº 35/06) and complied with the demands of Resolution nº 196/96 of the National Health Council, concerning research in human beings.…”

Section: The Medical Image Acquisition and Lung Segmentationmentioning

confidence: 99%

“…Therefore, research in the fi eld of Pulmonology has great importance in public health studies and focuses mainly on asthma, bronchiectasis and Chronic Obstructive Pulmonary Disease (COPD) (Holanda et al, 2010;Winkeler, 2006).…”

Section: Introductionmentioning

confidence: 99%

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Lung disease detection using feature extraction and extreme learning machine

Ramalho

Filho

Medeiros

et al. 2014

Rev. Bras. Eng. Bioméd.

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Introduction: The World Health Organization estimates that by 2030 the Chronic Obstructive Pulmonary Disease (COPD) will be the third leading cause of death worldwide. Computerized Tomography (CT) images of lungs comprise a number of structures that are relevant for pulmonary disease diagnosis and analysis. Methods: In this paper, we employ the Adaptive Crisp Active Contour Models (ACACM) for lung structure segmentation. And we propose a novel method for lung disease detection based on feature extraction of ACACM segmented images within the cooccurrence statistics framework. The spatial interdependence matrix (SIM) synthesizes the structural information of lung image structures in terms of three attributes. Finally, we perform a classifi cation experiment on this set of attributes to discriminate two types of lung diseases and health lungs. We evaluate the discrimination ability of the proposed lung image descriptors using an extreme learning machine neural network (ELMNN) comprising 4-10 neurons in the hidden layer and 3 neurons in the output layer to map each pulmonary condition. This network was trained and validated by applying a holdout procedure. Results:The experimental results achieved 96% accuracy demonstrating the effectiveness of the proposed method on identifying normal lungs and diseases as COPD and fi brosis. Conclusion: Our results lead to conclude that the method is suitable to integrate clinical decision support systems for pulmonary screening and diagnosis.

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Section: The Medical Image Acquisition and Lung Segmentationmentioning

confidence: 99%

Section: The Medical Image Acquisition and Lung Segmentationmentioning

confidence: 99%

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Lung disease detection using feature extraction and extreme learning machine

Ramalho

Filho

Medeiros

et al. 2014

Rev. Bras. Eng. Bioméd.

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“…For instance, NIV reduces total lung capacity by 10% in stable hypercapnic COPD, possibly from increased cross-sectional areas of the airways, decreased airway resistance, and increased expiratory time, which may facilitate the emptying of diseased lung units. 24,25 In contrast, other studies have shown that CPAP only temporarily decreases hyperinflation in COPD. 26 Similarly, high-resolution computed tomographic studies show that although low CPAP (5 cm H 2 O) may cause regional deflation in some subjects, higher CPAP (10 -15 cm H 2 O) may promote overinflation of already hyperinflated zones.…”

Section: Discussionmentioning

confidence: 92%

“…26 Similarly, high-resolution computed tomographic studies show that although low CPAP (5 cm H 2 O) may cause regional deflation in some subjects, higher CPAP (10 -15 cm H 2 O) may promote overinflation of already hyperinflated zones. 25 One study showed that generally low CPAP (4 -11 cm H 2 O) in COPD can be individualized to the level best associated with an improvement in inspiratory capacity particularly in subjects with an emphysema phenotype rather than a chronic bronchitis phenotype of COPD. 27 Although we did not classify our subjects based on the COPD phenotype, our study does suggest that subjects with increased weight (more commonly associated with the chronic bronchitis phenotype) have better adherence (see Table 1), whereas those with lower diffusion capacity (more commonly associated with the emphysema phenotype) have a flatter diaphragm and reduced later adherence (see Table 2).…”

Section: Discussionmentioning

confidence: 99%

Hyperinflation on Chest Radiograph as a Marker of Low Adherence to Positive Airway Pressure Therapy in the Overlap Syndrome

Theerakittikul

Hatipoğlu²,

Aboussouan

2013

Respir Care

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BACKGROUND: Positive airway pressure (PAP) in subjects with both obstructive sleep apnea and COPD reduces the risk of pulmonary hypertension, death, and hospitalizations from COPD exacerbations, but adherence to the intervention is low, similar to the experience with noninvasive ventilation in stable COPD. We sought to assess whether hyperinflation on chest radiographs contributes to low adherence to PAP therapy in the overlap syndrome. METHODS: Records of patients with a listed diagnosis of COPD at the time of polysomnography were reviewed. Overlap syndrome was diagnosed when COPD was clinically confirmed with spirometry showing a fixed airway obstruction and when the apnea-hypopnea index was > 5. Hyperinflation was evaluated by a review of the right diaphragm height on a lateral chest radiograph. Adherence was assessed clinically or through device download at a 3-month follow-up, and later adherence was assessed by telephone interviews. A receiver operating curve was used to determine whether diaphragm height was associated with adherence. RESULTS: Twenty-one of 41 subjects (51%) were considered adherent to PAP therapy at the 3-month visit. Adherent subjects were more overweight compared with non-adherent subjects (body mass index of 36.0 ؎ 5.7 vs 32.0 ؎ 5.7 kg/m 2 , P ‫؍‬ .03), sleepier at the onset (Epworth sleepiness scale score of 13.0 ؎ 5.8 vs 9.4 ؎ 5.4, P < .05), and less likely to have hyperinflation as defined by a right diaphragm height < 2.45 cm (33% vs 65%, P ‫؍‬ .04). The body mass index and initial sleepiness no longer predicted adherence beyond 3 months, but 35% of subjects with a right diaphragm height < 2.45 cm were adherent beyond 3 months compared with 75% of those with a right diaphragm height > 2.45 cm (P ‫؍‬ .04 by Fisher exact test). CONCLUSIONS: Hyperinflation is associated with decreased adherence to PAP therapy in the overlap syndrome.

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Comparing high and low levels of continuous positive airway pressure on lung aeration in patients with pleural drainage: A feasibility study for a randomized controlled trial

Santos

Campos

Carmo

et al. 2018

Physiotherapy Res Intl

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Objective:We explored the feasibility of use of continuous positive airway pressure (CPAP) with 15-and 4-cmH 2 O for a randomized controlled trial with patients with pleural drainage.Methods: Ten patients with traumatic pleural effusion drained within 24 hr, with controlled pain received randomly CPAP with 0-, 4-, and 15-cmH 2 O. Computed tomography was used to assess the lung aeration. Patients reported the level of tolerability. Air leak was also observed as a parameter of safety. The levels of pressure were compared using the Friedman test followed by the Tukey test as post hoc. Results:The lung area under CPAP with 15 cmH 2 O (median = 3,913 mm 2 ; IQR = 3,416-4,390 mm 2 ) was greater than 4 (median = 3,495 mm 2 ; IQR = 3,075-3,954 mm 2 ) and 0 cmH 2 O (median = 3,382 mm 2 ; IQR = 2,962-3,658 mm 2 ; p < 0.001). There was no difference between lung areas under CPAP with 4 and 0 cmH 2 O. All levels of pressure were well tolerated by patients. No air leak was observed during the assessments.Conclusion: CPAP with 15 cmH 2 O is able to expand lungs of patients with pleural drainage. CPAP with 4 cmH 2 O seems not have therapeutic effect. In addition, CPAP with 15 cmH 2 O is well tolerated and safe in this population. KEYWORDScontinuous positive airway pressure, computerized tomography, pleural effusion, thoracic surgery

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Continuous Positive Airway Pressure Effects on Regional Lung Aeration in Patients With COPD

Cited by 29 publications

References 34 publications

Lung disease detection using feature extraction and extreme learning machine

Lung disease detection using feature extraction and extreme learning machine

Hyperinflation on Chest Radiograph as a Marker of Low Adherence to Positive Airway Pressure Therapy in the Overlap Syndrome

Comparing high and low levels of continuous positive airway pressure on lung aeration in patients with pleural drainage: A feasibility study for a randomized controlled trial

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