CPAP Decreases Lung Hyperinflation in Patients With Stable COPD

Lopes, Agnaldo José; Nery, Flávio Pos; Sousa, Felipe C; Guimarães, Fernando Silva; Dias, Claudia Mazza; Oliveira, José Santos; Menezes, Sara L. S.

doi:10.4187/respcare.01092

Cited by 11 publications

(13 citation statements)

References 30 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For review of agreement between responder and non‐responder individuals between the two modes of NIV we used the Kappa statistic . Based on previous studies, we performed a post hoc sub‐group analysis, searching for the degree of changes in response to NIV. Statistical tests were performed using SPSS 20.0 software (SPSS Inc., Chicago, Illinois).…”

Section: Methodsmentioning

confidence: 99%

“…Another study on on CPAP evaluated the lungs using computerized tomography and showed increases in emphysematous areas in all parts of the lungs with a pressure of 10 cmH 2 O . In contrast, serial measurements of IC off CPAP plus residual volume (RV), functional residual capacity and total lung capacity measures indicated gradual deflation for up to 15 minutes. A couple of studies have demonstrated that there are patients with a potential to hyperinflation and others to deflation of the lungs with both on CPAP and off CPAP, depending not only on the pressure level studied but also the phenotype of COPD .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

CPAP and EPAP elicit similar lung deflation in a non‐equivalent mode in GOLD 3‐4 COPD patients

Müller

Christofoletti

Koch

et al. 2017

Clinical Respiratory J

View full text Add to dashboard Cite

Twenty-one eligible COPD patients were studied (13 male/8 female, FEV % predicted of 36.5 ± 9.8). Both CPAP and EPAP demonstrated significant post-pre (Δ) changes for IC and PImax, with mean ΔIC for CPAP and EPAP of 200 ± 100 mL and 170 ± 105 mL (P = .001 for both) in 13 and 12 patients (responders) respectively. There were similar changes in % predicted IC and PImax (∼7%, P = .001 for both) for responders and poor responder/non-responder agreement depending on CPAP/EPAP mode (Kappa = .113, P = .604). There were no differences in CPAP and EPAP regarding intensity of lung deflation (P =.254) and no difference was measured regarding HR (P = .235) or SpO (P = .111) CONCLUSIONS: Both CPAP and EPAP presented a similar effect on lung deflation, without guaranteeing that the response to one modality would be predictive of the response to the other.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

CPAP and EPAP elicit similar lung deflation in a non‐equivalent mode in GOLD 3‐4 COPD patients

Müller

Christofoletti

Koch

et al. 2017

Clinical Respiratory J

View full text Add to dashboard Cite

show abstract

“…They observed that continuous PAP reduced lung volume and R aw for 15 minutes, but lung volume returned to baseline values within 30 minutes. 34 Monteiro et al evaluated the effects of expiratory PAP on operating lung volume during exercise in COPD patients. These authors observed that the application of expiratory PAP reduced DH, as demonstrated by lower operating lung volume after submaximal exercise in patients with COPD who had previously exhibited DH during exercise.…”

Section: Resultsmentioning

confidence: 99%

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

Lopes

Melo

2016

COPD

View full text Add to dashboard Cite

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.

show abstract

“…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. 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.…”

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

View full text Add to dashboard Cite

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.

show abstract

CPAP Decreases Lung Hyperinflation in Patients With Stable COPD

Cited by 11 publications

References 30 publications

CPAP and EPAP elicit similar lung deflation in a non‐equivalent mode in GOLD 3‐4 COPD patients

CPAP and EPAP elicit similar lung deflation in a non‐equivalent mode in GOLD 3‐4 COPD patients

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

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

Contact Info

Product

Resources

About