V̇/Q̇ Mismatch

Neder, J. Alberto; Kirby, Miranda; Santyr, Giles; Pourafkari, Marina; Smyth, Reginald M; Phillips, Devin B.; Crinion, Sophie J.; de-Torres, Juan P.; O’Donnell, Denis E.

doi:10.1016/j.chest.2022.03.033

Cited by 11 publications

(2 citation statements)

References 45 publications

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“…Therefore, perhaps ‘less is more’ with respect to oxygen supplementation in nonresponders. Furthermore, pharmacologic treatments such as bronchodilators and anti-inflammatory medications may improve gas-exchange inefficiency, exertional dyspnea, and exercise tolerance across the spectrum of COPD severity, ultimately making SOT unnecessary in some patients [30 ▪▪ ].…”

Section: Discussionmentioning

confidence: 99%

Supplemental oxygen therapy in chronic obstructive pulmonary disease: is less is more? How much is too much?

Daher,

Dreher

2023

Current Opinion in Pulmonary Medicine

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Purpose of review Currently available evidence supporting the use of supplemental oxygen therapy (SOT) in chronic obstructive pulmonary disease (COPD) is complex, and data on the mortality reduction associated with SOT usage in patients with severe daytime resting hypoxemia have not been updated since the development of other treatments. Recent findings No reduction in mortality was found when SOT was used in patients with moderate resting daytime, isolated nocturnal, or exercise-induced hypoxemia. However, some of these patients obtain other significant benefits during SOT, including increased exercise endurance, and a mortality reduction is possible in these ‘responders’. The adverse effects of long-term oxygen therapy also need to be considered, such as reduced mobility and social stigma. Furthermore, conservative SOT could improve outcomes in the setting of COPD exacerbations compared with higher concentration oxygen regimens. Compared with usual fixed-dose SOT, automated oxygen administration devices might reduce dyspnea during exercise and COPD exacerbations. Summary Current recommendations for SOT need to be revised to focus on patients who respond best and benefit most from this therapy. A conservative approach to SOT can reduce side effects compared with higher concentration oxygen regimens, and automated oxygen administration devices may help to optimize SOT.

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Section: Discussionmentioning

confidence: 99%

Supplemental oxygen therapy in chronic obstructive pulmonary disease: is less is more? How much is too much?

Daher,

Dreher

2023

Current Opinion in Pulmonary Medicine

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“…Meanwhile, this paper only uses chest HRCT images and PFT parameters for dyspnea identification. Other clinical information should be collected to further improve dyspnea's classification performance, such as the heterogeneity parameter ventilation/perfusion V ′ A /Q' is a major contributor to dyspnea in COPD patients (54,55). Besides, the mMRC score of 1 is a rather low dyspnea level and can even be physiological breathlessness in older subjects.…”

Section: The Limitations In This Study and Future Directionmentioning

confidence: 99%

Multi-modal data combination strategy based on chest HRCT images and PFT parameters for intelligent dyspnea identification in COPD

Yang

Chen

et al. 2022

Front. Med.

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IntroductionBecause of persistent airflow limitation in chronic obstructive pulmonary disease (COPD), patients with COPD often have complications of dyspnea. However, as a leading symptom of COPD, dyspnea in COPD deserves special consideration regarding treatment in this fragile population for pre-clinical health management in COPD. Methods: Based on the above, this paper proposes a multi-modal data combination strategy by combining the local and global features for dyspnea identification in COPD based on the multi-layer perceptron (MLP) classifier.MethodsFirst, lung region images are automatically segmented from chest HRCT images for extracting the original 1,316 lung radiomics (OLR, 1,316) and 13,824 3D CNN features (O3C, 13,824). Second, the local features, including five selected pulmonary function test (PFT) parameters (SLF, 5), 28 selected lung radiomics (SLR, 28), and 22 selected 3D CNN features (S3C, 22), are respectively selected from the original 11 PFT parameters (OLF, 11), 1,316 OLR, and 13,824 O3C by the least absolute shrinkage and selection operator (Lasso) algorithm. Meantime, the global features, including two fused PFT parameters (FLF, 2), six fused lung radiomics (FLR, 6), and 34 fused 3D CNN features (F3C, 34), are respectively fused by 11 OLF, 1,316 OLR, and 13,824 O3C using the principal component analysis (PCA) algorithm. Finally, we combine all the local and global features (SLF + FLF + SLR + FLR + S3C + F3C, 5+ 2 + 28 + 6 + 22 + 34) for dyspnea identification in COPD based on the MLP classifier.ResultsOur proposed method comprehensively improves classification performance. The MLP classifier with all the local and global features achieves the best classification performance at 87.7% of accuracy, 87.7% of precision, 87.7% of recall, 87.7% of F1-scorel, and 89.3% of AUC, respectively.DiscussionCompared with single-modal data, the proposed strategy effectively improves the classification performance for dyspnea identification in COPD, providing an objective and effective tool for COPD management.

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Cardiopulmonary exercise testing applied to respiratory medicine: Myths and facts

Neder¹

2023

Respiratory Medicine

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V̇/Q̇ Mismatch

Cited by 11 publications

References 45 publications

Supplemental oxygen therapy in chronic obstructive pulmonary disease: is less is more? How much is too much?

Supplemental oxygen therapy in chronic obstructive pulmonary disease: is less is more? How much is too much?

Multi-modal data combination strategy based on chest HRCT images and PFT parameters for intelligent dyspnea identification in COPD

Cardiopulmonary exercise testing applied to respiratory medicine: Myths and facts

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