Changes of Respiratory Mechanics in COPD Patients from Stable State to Acute Exacerbations with Respiratory Failure.

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  • Additional Information
    • Author-Supplied Keywords:
      COPD
      exacerbations
      respiratory mechanics
      respiratory muscles
    • Abstract:
      Symptoms, clinical course, functional and biological data during an exacerbation of chronic obstructive pulmonary disease (EXCOPD) have been investigated, but data on physiological changes of respiratory mechanics during a severe exacerbation with respiratory acidosis requiring noninvasive mechanical ventilation (NIMV) are scant. The aim of this study was to evaluate changes of respiratory mechanics in COPD patients comparing data observed during EXCOPD with those observed during stable state in the recovery phase. In 18 COPD patients having severe EXCOPD requiring NIMV for global respiratory failure, we measured respiratory mechanics during both EXCOPD (T0) and once the patients achieved a stable state (T1). The diaphragm and inspiratory muscles effort was significantly increased under relapse, as well as the pressure-time product of the diaphragm and the inspiratory muscle (PTPdi and PTPes). The resistive loads to breathe (i.e., PEEPi,dyn, compliance and inspiratory resistances) were also markedly increased, while the maximal pressures generated by the diaphragm and the inspiratory muscles, together with forced expired volumes were decreased. All these indices statistically improved but with a great intrasubject variability in stable condition. Moreover, tension-time index (TTdi) significantly improved from the EXCOPD state to the condition of clinical stability (0.156 ± 0.04 at T0 vs. 0.082 ± 0.02 at T1 p < 0.001). During an EXCOPD, the load/capacity of the respiratory pump is impaired, and although the patients exhibit a rapid shallow breathing pattern, this does not necessarily correlate with a TTdi ≥ 0.15. These changes are reverted once they recover from the EXCOPD, despite a large variability between patients. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • Author Affiliations:
      1Respiratory Rehabilitation Division, Salvatore Maugeri Foundation IRCCS, Institute of Pavia, Pavia, Italy
      2Respiratory Rehabilitation Division, Salvatore Maugeri Foundation IRCCS, Institute of Lumezzane, Lumezzane, Italy
      3Institute of Respiratory Diseases, Policlinico S. Orsola and Alma Mater University, Bologna, Italy
    • ISSN:
      1541-2555
    • Accession Number:
      10.1080/15412555.2016.1254173
    • Accession Number:
      121994397
  • Citations
    • ABNT:
      CERIANA, P. et al. Changes of Respiratory Mechanics in COPD Patients from Stable State to Acute Exacerbations with Respiratory Failure. COPD: Journal of Chronic Obstructive Pulmonary Disease, [s. l.], v. 14, n. 2, p. 150–155, 2017. DOI 10.1080/15412555.2016.1254173. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=121994397&custid=s6224580. Acesso em: 20 jan. 2020.
    • AMA:
      Ceriana P, Vitacca M, Carlucci A, Paneroni M, Pisani L, Nava S. Changes of Respiratory Mechanics in COPD Patients from Stable State to Acute Exacerbations with Respiratory Failure. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2017;14(2):150-155. doi:10.1080/15412555.2016.1254173.
    • APA:
      Ceriana, P., Vitacca, M., Carlucci, A., Paneroni, M., Pisani, L., & Nava, S. (2017). Changes of Respiratory Mechanics in COPD Patients from Stable State to Acute Exacerbations with Respiratory Failure. COPD: Journal of Chronic Obstructive Pulmonary Disease, 14(2), 150–155. https://doi.org/10.1080/15412555.2016.1254173
    • Chicago/Turabian: Author-Date:
      Ceriana, Piero, Michele Vitacca, Annalisa Carlucci, Mara Paneroni, Lara Pisani, and Stefano Nava. 2017. “Changes of Respiratory Mechanics in COPD Patients from Stable State to Acute Exacerbations with Respiratory Failure.” COPD: Journal of Chronic Obstructive Pulmonary Disease 14 (2): 150–55. doi:10.1080/15412555.2016.1254173.
    • Harvard:
      Ceriana, P. et al. (2017) ‘Changes of Respiratory Mechanics in COPD Patients from Stable State to Acute Exacerbations with Respiratory Failure’, COPD: Journal of Chronic Obstructive Pulmonary Disease, 14(2), pp. 150–155. doi: 10.1080/15412555.2016.1254173.
    • Harvard: Australian:
      Ceriana, P, Vitacca, M, Carlucci, A, Paneroni, M, Pisani, L & Nava, S 2017, ‘Changes of Respiratory Mechanics in COPD Patients from Stable State to Acute Exacerbations with Respiratory Failure’, COPD: Journal of Chronic Obstructive Pulmonary Disease, vol. 14, no. 2, pp. 150–155, viewed 20 January 2020, .
    • MLA:
      Ceriana, Piero, et al. “Changes of Respiratory Mechanics in COPD Patients from Stable State to Acute Exacerbations with Respiratory Failure.” COPD: Journal of Chronic Obstructive Pulmonary Disease, vol. 14, no. 2, Apr. 2017, pp. 150–155. EBSCOhost, doi:10.1080/15412555.2016.1254173.
    • Chicago/Turabian: Humanities:
      Ceriana, Piero, Michele Vitacca, Annalisa Carlucci, Mara Paneroni, Lara Pisani, and Stefano Nava. “Changes of Respiratory Mechanics in COPD Patients from Stable State to Acute Exacerbations with Respiratory Failure.” COPD: Journal of Chronic Obstructive Pulmonary Disease 14, no. 2 (April 2017): 150–55. doi:10.1080/15412555.2016.1254173.
    • Vancouver/ICMJE:
      Ceriana P, Vitacca M, Carlucci A, Paneroni M, Pisani L, Nava S. Changes of Respiratory Mechanics in COPD Patients from Stable State to Acute Exacerbations with Respiratory Failure. COPD: Journal of Chronic Obstructive Pulmonary Disease [Internet]. 2017 Apr [cited 2020 Jan 20];14(2):150–5. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=121994397&custid=s6224580