Volumetric capnography for the evaluation of chronic airways diseases

Veronez, Liliani de Fátima; Pereira, Mônica Corso; Silva, Silvia Maria Doria da; Barcaui, Luisa Affi; Capitani, Eduardo Mello De; Moreira, Marcos Mello; Paschoal, Ilma Aparecida

doi:10.2147/copd.s62886

Cited by 15 publications

(12 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…AWD leads to increase in Slp3 compared to normal subjects. 38 In this study, the group with AWD presented Slp3 with higher values than the group with EMP, a fact which must reflect greater heterogeneity of gas distribution in the more peripheral airspaces of the lungs of the AWD group.…”

Section: Discussionmentioning

confidence: 49%

COPD phenotypes on computed tomography and its correlation with selected lung function variables in severe patients

Silva¹,

Paschoal²,

Capitani³

et al. 2016

COPD

Self Cite

View full text Add to dashboard Cite

BackgroundComputed tomography (CT) phenotypic characterization helps in understanding the clinical diversity of chronic obstructive pulmonary disease (COPD) patients, but its clinical relevance and its relationship with functional features are not clarified. Volumetric capnography (VC) uses the principle of gas washout and analyzes the pattern of CO2 elimination as a function of expired volume. The main variables analyzed were end-tidal concentration of carbon dioxide (ETCO2), Slope of phase 2 (Slp2), and Slope of phase 3 (Slp3) of capnogram, the curve which represents the total amount of CO2 eliminated by the lungs during each breath.ObjectiveTo investigate, in a group of patients with severe COPD, if the phenotypic analysis by CT could identify different subsets of patients, and if there was an association of CT findings and functional variables.Subjects and methodsSixty-five patients with COPD Gold III–IV were admitted for clinical evaluation, high-resolution CT, and functional evaluation (spirometry, 6-minute walk test [6MWT], and VC). The presence and profusion of tomography findings were evaluated, and later, the patients were identified as having emphysema (EMP) or airway disease (AWD) phenotype. EMP and AWD groups were compared; tomography findings scores were evaluated versus spirometric, 6MWT, and VC variables.ResultsBronchiectasis was found in 33.8% and peribronchial thickening in 69.2% of the 65 patients. Structural findings of airways had no significant correlation with spirometric variables. Air trapping and EMP were strongly correlated with VC variables, but in opposite directions. There was some overlap between the EMP and AWD groups, but EMP patients had signicantly lower body mass index, worse obstruction, and shorter walked distance on 6MWT. Concerning VC, EMP patients had signicantly lower ETCO2, Slp2 and Slp3. Increases in Slp3 characterize heterogeneous involvement of the distal air spaces, as in AWD.ConclusionVisual assessment and phenotyping of CT in COPD patients is feasible and may help identify functional and clinically different subsets of patients. VC may provide useful information about the heterogeneous involvement of lung structures in COPD.

show abstract

Section: Discussionmentioning

confidence: 49%

COPD phenotypes on computed tomography and its correlation with selected lung function variables in severe patients

Silva¹,

Paschoal²,

Capitani³

et al. 2016

COPD

Self Cite

View full text Add to dashboard Cite

show abstract

“…The authors concluded that gas-elimination curves were not sufficiently sensitive to monitor the severity of structural abnormalities, although the normalized Phase III slope needed to be studied further as a sensitive index for detecting small-airway diseases in COPD patients. 38 In another study conducted in Brazil, Masiero et al evaluated perfused lung fraction in COPD patients using single-photon emission computed tomography. They observed that the lung-volume fraction that receives blood from the pulmonary artery was reduced in these patients and that the degree of underperfusion correlated with the FEV 1 :FVC value ( r =0597; P <0.001).…”

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

“…, cystic fibrosis and noncystic fibrosis bronchiectasis [16][17][18] , asthma 19 , pulmonary embolism [20][21][22][23][24][25][26] .…”

Section: Resultsmentioning

confidence: 99%

Adjustable inspiratory occlusion valve in experimental bronchopleural fistula. A new therapeutic perspective

Toneloto¹,

Moreira

Bustorff‐Silva

et al. 2015

Acta Cir. Bras.

View full text Add to dashboard Cite

PURPOSE:To assess the efficacy of an adjustable inspiratory occlusion valve in experimental bronchopleural fistula during mechanical ventilation. METHODS:We studied six mechanically ventilated pigs in a surgically created, reproducible model of bronchopleural fistula managed with mechanical ventilation and water-sealed thoracic drainage. An adjustable inspiratory occlusion valve was placed between the thoracic drain and the endotracheal tube. Hemodynamic data, capnography and blood gases were recorded before and after the creation of the bronchopleural fistula as well as after every adjustment of the inspiratory occlusion valve. RESULTS:When compared with the standard water-sealed drainage treatment, the use of an adjustable inspiratory occlusion valve improved the alveolar tidal volume and reduced bronchopleural air leak (p<0.001), without hemodynamic compromise when compared with conventional water sealed drainage. CONCLUSION:The use of an adjustable inspiratory occlusion valve improved the alveolar tidal volume, reduced alveolar leak, in an experimental reproducible model of bronchopleural fistula, without causing any hemodynamic derangements when compared with conventional water sealed drainage.

show abstract

Volumetric capnography for the evaluation of chronic airways diseases

Cited by 15 publications

References 34 publications

COPD phenotypes on computed tomography and its correlation with selected lung function variables in severe patients

COPD phenotypes on computed tomography and its correlation with selected lung function variables in severe patients

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

Adjustable inspiratory occlusion valve in experimental bronchopleural fistula. A new therapeutic perspective

Contact Info

Product

Resources

About