Ventilatory limitation and dynamic hyperinflation during exercise testing in Cystic Fibrosis

Abstract

Dynamic hyperinflation is common in CF and it is not associated with traditionally defined ventilatory limitation parameters during the MST. Pediatr Pulmonol. 2017;52:29-33. © 2016 Wiley Periodicals, Inc.

Within‐breath changes in respiratory system impedance in children with cystic fibrosis

“…In COPD patients, EFL T promotes dynamic hyperinflation, with a concomitant increase in inspiratory work of breathing, impairment of inspiratory muscles function and adverse effects on hemodynamics. Also in CF patients ELF T is associated with lung hyperinflation, which in turn limits exercise . Moreover, in a recent longitudinal study conducted in adult CF patients, Vilozni, and colleagues found that the onset of EFL T predicts a decline in clinical course better than FEV1 and other spirometric indices …”

“…8,28,29 33 which in turn limits exercise. [33][34][35][36] Moreover, in a recent longitudinal study conducted in adult CF patients, Vilozni, and colleagues found that the onset of EFL T predicts a decline in clinical course better than FEV1 and other spirometric indices. 13 In conclusion, in the present study the within-breath analysis of respiratory system impedance provided interesting insights in the physiological changes associated with early CF lung disease, suggesting the occurrence of dynamic airway compression, which may eventually lead to EFL T .…”

Pediatric Pulmonology year in review 2017: Part 3

“…Decreased exercise capacity did not correlate with spirometric indices, and the authors speculate that diminished physical activity due to chronic disease state and physical growth failure are responsible for exercise limitation in these patients. 45 thoracic compression technique at 10 weeks and 13 months of age. 46 They determined that chest CT obtained during quiet breathing showed a higher discriminative power than forced expiratory volume in 0.5 s (FEV 0.5 ) in evaluating lung disease.…”

“…Decreased exercise capacity did not correlate with spirometric indices, and the authors speculate that diminished physical activity due to chronic disease state and physical growth failure are responsible for exercise limitation in these patients. Karapanagiotis et al performed a retrospective analysis of dynamic hyperinflation in 28 children with cystic fibrosis (CF) who underwent testing using the modified shuttle test. Dynamic hyperinflation during exercise was common in children with CF, but this was not associated with traditionally defined measures of ventilatory limitation or severity of disease.…”

Static hyperinflation is associated with ventilatory limitation and exercise tolerance in adult cystic fibrosis

“…Lung hyperinflation is another potential mechanism limiting exercise tolerance; however, data in cystic fibrosis are limited. Available data show a relationship between dynamic hyperinflation (lung hyperinflation during exercise) and exercise performance in both children and adults with cystic fibrosis. It has also been shown to be a major cause of breathlessness during exercise and can present even in mild disease .…”