Simplified Detection of Dynamic Hyperinflation

Gelb, Arthur F.; Gutiérrez, C.; Weisman, Idelle M.; Newsom, Randy; Taylor, Colleen Flynn; Zamel, Noé

doi:10.1378/chest.126.6.1855

Cited by 79 publications

(93 citation statements)

References 18 publications

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“…The maximum number they can speak is inversely correlated with the intensity, 9 since it depends on the expiratory time, which is shortened when the respiratory rate increases during exercise. 16,17 Interestingly, this finding is very similar to a variation of the talk test, the counting talk test. Both the counting talk test and the count scale are semiquantitative tools and determine how high the patient can count before taking a second breath.…”

Section: Discussionsupporting

confidence: 65%

Translation of Exercise Test Response to Training Intensity Using the Count Scale

Wang

Miao

et al. 2015

Respir Care

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BACKGROUND: Exercise testing is recommended before prescribing individualized exercise intensity. However, there are few data demonstrating how exercise test responses are translated into individualized training intensity using a simple method. We previously developed a simple method to rate dyspnea called the count scale, including the count scale number (CSN) and count scale time. The purpose of this study was to assess the CSN for translation of exercise test response to training intensity. METHODS: Twenty-eight subjects (22 men and 6 women) with COPD age 66.6 ؎ 8.22 y participated in 2 exercise sessions. During the first session, in which exercise was guided by the heart rate, the CSN and heart rate were obtained (ie, CSN 1 and HR 1 ) while the heart rate was increased by 20% compared with the resting heart rate. During the second session, exercise was guided by the CSN. When the CSN was close to the CSN 1 , the CSN and corresponding heart rate were recorded as CSN 2 and HR 2 . Differences between CSN 1 and CSN 2 and between HR 1 and HR 2 were compared. The relationship between HR 1 and HR 2 was analyzed. Agreement between HR 1 and HR 2 was evaluated by Bland-Altman plots. RESULTS: No significant differences were seen between HR 1 and HR 2 (96 ؎ 11 and 97 ؎ 11, respectively; P ‫؍‬ .14). A high correlation between HR 1 and HR 2 was found (r ‫؍‬ 0.932, P < .001). The 95% CI for the difference between HR 1 and HR 2 was ؊1.2 to 8.5 beats/min. CONCLUSIONS: Exercise guided by the CSN alone could result in a given heart rate response, suggesting that the CSN is a simple and practical tool in translating exercise test results into individualized training intensity. With the CSN as the intensity indicator, patients can exercise safely and effectively.

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Section: Discussionsupporting

confidence: 65%

Translation of Exercise Test Response to Training Intensity Using the Count Scale

Wang

Miao

et al. 2015

Respir Care

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“…Studies that measured DH during cardiopulmonary exercise tests found a reduction in IC during exercise as the ventilatory demand increased. 2,4,38,39 Another reason for the lower DH rate may be the use of bronchodilator, which was offered to all participants before the exercise, because we were interested in evaluating the effects of EPAP over DH in COPD patients with their best possible condition. Additionally, our findings, therefore, could not be generalized for COPD patients without recent use of bronchodilator, since the use of bronchodilator immediately before an exercise test interferes with the degree of DH developed during the test.…”

Section: Methodological Considerationsmentioning

confidence: 99%

Effects of Expiratory Positive Airway Pressure on Dynamic Hyperinflation During Exercise in Patients With COPD

et al. 2012

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“…In addition, a metronome-paced breathing test was added during the last third of the study as a simple measure of dynamic hyperinflation [18]. A pacing rate of 30 breaths/min was used without controlling inspiratory or expiratory times.…”

Section: Methodsmentioning

confidence: 99%

A Multicenter Pilot Study of a Bronchial Valve for the Treatment of Severe Emphysema

et al. 2009

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Background: Chronic obstructive pulmonary disease (COPD) affects millions of people and has limited treatment options. Surgical treatments for severe COPD with emphysema are effective for highly selected patients. A minimally invasive method for treating emphysema could decrease morbidity and increase acceptance by patients. Objective: To study the safety and effectiveness of the IBV® Valve for the treatment of severe emphysema. Methods: A multicenter study treated 91 patients with severe obstruction, hyperinflation and upper lobe (UL)-predominant emphysema with 609 bronchial valves placed bilaterally into ULs. Results: Valves were placed in desired airways with 99.7% technical success and no migration or erosion. There were no procedure-related deaths and 30-day morbidity and mortality were 5.5 and 1.1%, respectively. Pneumothorax was the most frequent serious device-related complication and primarily occurred when all segments of a lobe, especially the left UL, were occluded. Highly significant health-related quality of life (HRQL) improvement (–8.2 ± 16.2, mean ± SD change at 6 months) was observed. HRQL improvement was associated with a decreased volume (mean –294 ± 427 ml, p = 0.007) in the treated lobes without visible atelectasis. FEV₁, exercise tests, and total lung volume were not changed but there was a proportional shift, a redirection of inspired volume to the untreated lobes. Combined with perfusion scan changes, this suggests that there is improved ventilation and perfusion matching in non-UL lung parenchyma. Conclusion: Bronchial valve treatment of emphysema has multiple mechanisms of action and acceptable safety, and significantly improves quality of life for the majority of patients.

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Simplified Detection of Dynamic Hyperinflation

Cited by 79 publications

References 18 publications

Translation of Exercise Test Response to Training Intensity Using the Count Scale

Translation of Exercise Test Response to Training Intensity Using the Count Scale

Effects of Expiratory Positive Airway Pressure on Dynamic Hyperinflation During Exercise in Patients With COPD

A Multicenter Pilot Study of a Bronchial Valve for the Treatment of Severe Emphysema

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