Respiratory Medicine
Volume 104, Issue 3 , Pages 389-396 , March 2010

Breath-by-breath quantification of progressive airflow limitation during exercise in COPD: A new method

  • Shuyi Ma

      Affiliations

    • Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W Carson Street, Torrance, CA 90502, USA
  • ,
  • Ariel Hecht

      Affiliations

    • Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W Carson Street, Torrance, CA 90502, USA
  • ,
  • Janos Varga

      Affiliations

    • Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W Carson Street, Torrance, CA 90502, USA
  • ,
  • Mehdi Rambod

      Affiliations

    • Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W Carson Street, Torrance, CA 90502, USA
  • ,
  • Sarah Morford

      Affiliations

    • Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W Carson Street, Torrance, CA 90502, USA
  • ,
  • Shinichi Goto

      Affiliations

    • Tokyo Women's Medical University School of Medicine, Tokyo, Japan
  • ,
  • Richard Casaburi

      Affiliations

    • Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W Carson Street, Torrance, CA 90502, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 310 222 8200; fax: +1 310 222 8249.
  • ,
  • Janos Porszasz

      Affiliations

    • Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W Carson Street, Torrance, CA 90502, USA

Received 13 August 2009 ,Accepted 19 October 2009.

References 

  1. Berry MJ. The relationship between exercise tolerance and other outcomes in COPD. COPD. 2007;4:205–216
  2. Milic-Emili J. Expiratory flow limitation: Roger S. Mitchell lecture. Chest. 2000;117:219S–223S
  3. O'Donnell DE. Ventilatory limitations in chronic obstructive pulmonary disease. Med Sci Sports Exerc. 2001;33:S647–S655
  4. Potter WA, Olafsson S, Hyatt RE. Ventilatory mechanics and expiratory flow limitation during exercise in patients with obstructive lung disease. J Clin Invest. 1971;50:910–919
  5. Stubbing DG, Pengelly LD, Morse JL, Jones NL. Pulmonary mechanics during exercise in subjects with chronic airflow obstruction. J Appl Physiol. 1980;49:511–515
  6. Calverley PM, Koulouris NG. Flow limitation and dynamic hyperinflation: key concepts in modern respiratory physiology. Eur Respir J. 2005;25:186–199
  7. McNamara JJ, Castile RG, Ludwig MS, Glass GM, Ingram RH, Fredberg JJ. Heterogeneous regional behavior during forced expiration before and after histamine inhalation in dogs. J Appl Physiol. 1994;76:356–360
  8. DeGraff AC, Bouhuys A. Mechanics of air flow in airway obstruction. Annu Rev Med. 1973;24:111–134
  9. Ingram RH, Schilder DP. Effect of thoracic gas compression on the flow–volume curve of the forced vital capacity. Am Rev Respir Dis. 1966;94:56–63
  10. Mead J, Turner JM, Macklem PT, Little JB. Significance of the relationship between lung recoil and maximum expiratory flow. J Appl Physiol. 1967;22:95–108
  11. Dellaca RL, Rotger M, Aliverti A, Navajas D, Pedotti A, Farre R. Noninvasive detection of expiratory flow limitation in COPD patients during nasal CPAP. Eur Respir J. 2006;27:983–991
  12. Hyatt RE. The interrelationships of pressure, flow, and volume during various respiratory maneuvers in normal and emphysematous subjects. Am Rev Respir Dis. 1961;83:676–683
  13. Koulouris NG. Negative expiratory pressure: a new tool. Monaldi Arch Chest Dis. 2002;57:69–75
  14. Dellaca RL, Santus P, Aliverti A, Stevenson N, Centanni S, Macklem PT, et al. Detection of expiratory flow limitation in COPD using the forced oscillation technique. Eur Respir J. 2004;23:232–240
  15. Farre R, Navajas D. Assessment of expiratory flow limitation in chronic obstructive pulmonary disease: a new approach. Eur Respir J. 2004;23:187–188
  16. ATS/ACCP . Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003;167:211–277
  17. Palange P, Ward SA, Carlsen KH, Casaburi R, Gallagher CG, Gosselink R, et al. Recommendations on the use of exercise testing in clinical practice. Eur Respir J. 2007;29:185–209
  18. Dawson SV, Elliott EA. Wave-speed limitation on expiratory flow-a unifying concept. J Appl Physiol. 1977;43:498–515
  19. Landau LI, Taussig LM, Macklem PT, Beaudry PH. Contribution of inhomogeneity of lung units to the maximal expiratory flow–volume curve in children with asthma and cystic fibrosis. Am Rev Respir Dis. 1975;111:725–731
  20. Mead J. Analysis of the configuration of maximum expiratory flow–volume curves. J Appl Physiol. 1978;44:156–165
  21. Pedersen OF, Ingram RH. Configuration of maximum expiratory flow–volume curve: model experiments with physiological implications. J Appl Physiol. 1985;58:1305–1313
  22. Tien YK, Elliott EA, Mead J. Variability of the configuration of maximum expiratory flow–volume curves. J Appl Physiol. 1979;46:565–570
  23. Hankinson JL, Crapo RO, Jensen RL. Spirometric reference values for the 6-s FVC maneuver. Chest. 2003;124:1805–1811
  24. Campbell SC. A comparison of the maximum voluntary ventilation with the forced expiratory volume in one second: an assessment of subject cooperation. J Occup Med. 1982;24:531–533
  25. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319–338
  26. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14:377–381
  27. Anton H. Calculus: A new horizon. New York: Wiley; 1999;p. 324–7
  28. Spliid H. Monitoring medical procedures by exponential smoothing. Stat Med. 2007;26:124–138
  29. Morris MJ, Lane DJ. Tidal expiratory flow patterns in airflow obstruction. Thorax. 1981;36:135–142
  30. Bardoczky GI, d'Hollander A. Continuous monitoring of the flow–volume loops and compliance during anesthesia. J Clin Monit. 1992;8:251–252
  31. Baydur A, Milic-Emili J. Expiratory flow limitation during spontaneous breathing: comparison of patients with restrictive and obstructive respiratory disorders. Chest. 1997;112:1017–1023
  32. What is exponential smoothing? In: NIST/SEMATECH e-handbook of statistical methods; 2006.

PII: S0954-6111(09)00347-3

doi: 10.1016/j.rmed.2009.10.014

Respiratory Medicine
Volume 104, Issue 3 , Pages 389-396 , March 2010