The Relationship Between Clinical and Physiological Findings in Chronic Obstructive Disease of the Lungs

Nash, Eleanor S.; Briscoe, W. A.; Cournand, André

doi:10.1159/000192416

Cited by 39 publications

(13 citation statements)

References 13 publications

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“…In accordance with analogous pub lished data, generally obtained from more limited series of subjects [1,6,10,17,18,25,28], the statistical results presented in table II show significant nitrogen clear ance abnormalities in patients with chronic obstructive pulmonary disease, as compared with a group of healthy nonsmokers and smokers. Table II indicates that nitrogen washout data are correlated with the results of spirometric, lung mech anics and arterial blood gas measure ments; this finding is predictable on the basis of the relationships between lung mechanical properties and distribution of ventilation [31 ].…”

Section: Discussionsupporting

confidence: 88%

Informative Value of Simple Multibreath Nitrogen Washout Measurements for Clinical and Research Purposes

et al. 1985

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Some simple multibreath nitrogen washout indexes quantifying inspired gas distribution and ventilatory efficiency were obtained in a group of patients with mild to advanced chronic obstructive pulmonary disease (COPD) and studied in their relationships with routine pulmonary function tests. The indexes (lung clearance index (LCI), mixing ratio (MR) and data obtained by graphic analysis of the washout curve) were correlated with spirometric, pulmonary mechanics and arterial blood gas measurements, but only 8–38% of the interindividual variation in these indexes was explained by the above routine tests. An additional 5–13% of the variation was explained by the washout tidal volume (V_T); this finding may reflect changes in gas distribution with V_T and/or the influence of the dead space on ventilatory efficiency. Our data indicate that, in patients with COPD, nitrogen washout indexes tend to change in parallel with routine pulmonary function tests, reflecting the severity of the disease; these indexes also contain specific information (in addition to that provided by routine physiologic tests), presumably related to the distribution and efficiency of ventilation. Nitrogen washout measurements may thus represent a helpful adjunct to routine pulmonary function testing; LCI and MR appear to be particularly convenient for practical purposes because of their simplicity, and an informative content comparable with that of more complex indexes.

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Section: Discussionsupporting

confidence: 88%

Informative Value of Simple Multibreath Nitrogen Washout Measurements for Clinical and Research Purposes

et al. 1985

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“…A clini cal, roentgenologic, biological score, as pro posed by Nash el al. [14] and slightly modi fied by us [25] was computed for 49 of the patients, separating the 'predominantly bronchitic' (n = 14, B group) from the 'predominantly emphysematous' (n = 16, E group) and leaving 19 'mixed' (B + E) pa tients in between. As seen in table I, E group patients had normal PaCO.…”

Section: Discussionmentioning

confidence: 99%

“…3) suits are in agreement with the concept pro posed by Robin and O'Neill [18]: at similar severity of airway obstruction some patients 'fight' maintaining near normal blood gases, but are dyspneic (also called 'pink puffers'), while other patients resign ('nonfighters') to chronic respiratory insufficiency ('blue bloated') presumably adapting their respira tory centers. The PaC02 was found to be increased in COLD patients with less ana tomic emphysema at postmortem [5] and in patients labelled bronchitic on clinical and/or roentgenologic criteria [6,9,10,13,14]. Hypercapnia was considered as a 'bronchitic' functional feature in the 1966 revision of the classification of COLD by Burrows el al.…”

Section: Discussionmentioning

confidence: 99%

Relationships of Carbon Dioxide Retention to Ventilatory Impairment and Hypoxemia in Chronic Obstructive Lung Disease

Teculescu¹,

Racoveanu²,

Manicatide³

1979

Respiration

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In a group of 80 male patients (average age 52.5 years) with severe obstructive ventilatory impairment (FEV_{1 0} less than 40% of predicted) due to chronic bronchitis and/or emphysema, the blood carbon dioxide tension measured at rest, in a stable clinical status, was confronted to the spirometric variables and the oxygen tension. PaCO₂ (range 31–60 mm Hg) was loosely related to the VC (r = -0.28) and the FEV (r = -0.30, both p < 0.05) and strongly related to the PaO₂ (r = 0.60; p < 0.001). When patients were classified as bronchitic or emphysematous according to clinical, roentgenologic and biological criteria, the correlations above were found to be higher for bronchitics. In patients with chronic bronchitis with severe obstruction a very good estimation of PaCO₂ is possible from PaO₂: PaCO₂ = 75.8–0.44 PaO₂ (SEE 0.1 mm Hg).

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“…The To define the types of chronic obstructive lung disease, we utilized the classification of Nash, Briscoe, and Cournand. 9 They have described two major categories: type A-patients who display cough, occasional scanty sputum, fixed dyspnea, thin habitus, large translucent lungs with low diaphragms and small cardiothoracic ratio, absence of cor pulmonale, and a normal hematocrit; type B-patients who manifest much cough and sputum, fluctuating dyspnea, normal or stout habitus, normal appearing lung fields and normal position of the diaphragm on X-ray, normal or increased cardiothoracic ratio, congestive failure due to cor pulmonale, and a high hematocrit Each patient had the protocol explained to him in detail, and his written permission was secured for all procedures. The day before the study, the patients were familiarized with the respiratory equipment.…”

Section: Methodsmentioning

confidence: 99%

Effects of Isoproterenol on the Pulmonary Circulation in Patients with Chronic Obstructive Lung Disease

et al. 1971

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SUMMARYIsoproterenol produced an increase in pulmonary blood volume and pulmonary blood flow without a significant change in pulmonary vascular pressures in 14 patients with obstructive lung disease, six of whom had cor pulmonale. These findings are consistent with a vasodilating effect on the pulmonary vasculature. Evidence is presented that muscular pulmonary arteries constricted by hypoxia were affected by the drug. There is little to suggest that the compliance of the elastic arteries was altered by isoproterenol.

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The Relationship Between Clinical and Physiological Findings in Chronic Obstructive Disease of the Lungs

Cited by 39 publications

References 13 publications

Informative Value of Simple Multibreath Nitrogen Washout Measurements for Clinical and Research Purposes

Informative Value of Simple Multibreath Nitrogen Washout Measurements for Clinical and Research Purposes

Relationships of Carbon Dioxide Retention to Ventilatory Impairment and Hypoxemia in Chronic Obstructive Lung Disease

Effects of Isoproterenol on the Pulmonary Circulation in Patients with Chronic Obstructive Lung Disease

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