Pulmonary characteristics in COPD and mechanisms of increased work of breathing
Open accessAbstract
Mechanical characteristics and gas exchange inefficiencies of the lungs contribute to increased work of ventilation in chronic obstructive pulmonary disease (COPD) at rest and exercise, and the energy cost of ventilation is increased in COPD at any external work level. Assuming typical ventilatory variables and respiratory characteristics, we estimated the relative contributions of inspiratory and expiratory resistance, dynamic elastance, intrinsic positive end-expiratory pressure, and gas exchange inefficiency to the work of breathing, finding that the last of these is likely to be of major importance. Dynamic hyperinflation can be seen as both an impediment to inspiratory muscle function and an essential component of adaptation to severe obstruction. Extrinsic restriction, in which the chest wall fails to achieve and maintain abnormally high lung volumes in COPD, can limit ventilatory function and contribute to disability.
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During exercise, hyperinflation increases the work of breathing in COPD.
“During exercise, hyperinflation may impede cardiac19,20 and respiratory muscle function and increase the work of breathing.21”
From Pathogenesis of hyperinflation in chronic obstructive pulmonary disease (2014) · cites this paper as [21]
Functionally weakened respiratory muscles coupled with increased elastic and threshold loading of the inspiratory muscles results in a substantial increase in the work and oxygen cost of breathing.
“These functionally weakened respiratory muscles coupled with the increased elastic and threshold loading of the inspiratory muscles61 results in a substantial increase in the work and oxygen cost of breathing.21,62”
From Pathogenesis of hyperinflation in chronic obstructive pulmonary disease (2014) · cites this paper as [21]
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- Authors
- Loring, S. H., Garcia-Jacques, M., & Malhotra, A.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Harvard University (US)
- Venue
- Journal of Applied Physiology
- Publisher
- American Physiological Society
- Published
- 2009-07
- Volume
- 107
- Issue
- 1
- Pages
- 309-314
- ISSN
- 0161-7567 (ISSN-L)
- 8750-7587
- 1522-1601
- PMC
- PMC2711781
- OpenAlex
- W2096486935
- Cited by
- 246
- References
- 36
- Citations by year
- 2026: 9 · 2025: 7 · 2024: 14 · 2023: 8 · 2022: 13 · 2021: 6 · 2020: 5 · 2019: 105 · 2018: 9 · 2017: 9 · 2016: 15 · 2015: 6 · 2014: 9 · 2013: 10 · 2012: 6
- FWCI
- 1.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Applied Physiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (7k24hl093218-06, 5r01hl090897-02)
- National Heart, Lung, and Blood Institute (R01-HL090897, P01HL095491, K24 HL-093218, HL52586, R01HL085188, R01HL052586)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- chronic obstructive pulmonary disease, work of breathing, inspiratory resistance, expiratory resistance, intrinsic positive end-expiratory pressure, dynamic hyperinflation, inspiratory muscle function, chest wall, physical activity
- MeSH terms
- Humans, Lung, Pulmonary Gas Exchange, Respiratory Muscles, Work of Breathing, Respiratory Mechanics, Pulmonary Disease, Chronic Obstructive, Thoracic Wall
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