The DOI matches its Crossref record; 8 of the 8 references it cites were found in a registry or an index.
Can bronchodilators improve exercise tolerance in COPD patients without dynamic hyperinflation?
Abstract
OBJECTIVE: To investigate the modulatory effects that dynamic hyperinflation (DH), defined as a reduction in inspiratory capacity (IC), has on exercise tolerance after bronchodilator in patients with COPD. METHODS: An experimental, randomized study involving 30 COPD patients without severe hypoxemia. At baseline, the patients underwent clinical assessment, spirometry, and incremental cardiopulmonary exercise testing (CPET). On two subsequent visits, the patients were randomized to receive a combination of inhaled fenoterol/ipratropium or placebo. All patients then underwent spirometry and submaximal CPET at constant speed up to the limit of tolerance (Tlim). The patients who showed ΔIC(peak-rest) < 0 were considered to present with DH (DH+). RESULTS: In this sample, 21 patients (70%) had DH. The DH+ patients had higher airflow obstruction and lower Tlim than did the patients without DH (DH-). Despite equivalent improvement in FEV1 after bronchodilator, the DH- group showed higher ΔIC(bronchodilator-placebo) at rest in relation to the DH+ group (p < 0.05). However, this was not found in relation to ΔIC at peak exercise between DH+ and DH- groups (0.19 ± 0.17 L vs. 0.17 ± 0.15 L, p > 0.05). In addition, both groups showed similar improvements in Tlim after bronchodilator (median [interquartile range]: 22% [3-60%] vs. 10% [3-53%]; p > 0.05). CONCLUSIONS: Improvement in TLim was associated with an increase in IC at rest after bronchodilator in HD- patients with COPD. However, even without that improvement, COPD patients can present with greater exercise tolerance after bronchodilator provided that they develop DH during exercise.
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“By increasing resting IC, bronchodilators also increase the available dynamic IRV and thereby delay the onset of critical respiratory-mechanical constraints on V T expansion (and thereby _ V E) during exercise [60,78,79,90,91].”
From Lung hyperinflation in COPD: applying physiology to clinical practice (2015) · cites this paper as [91]
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Citations
Cites
Dynamic Hyperinflation and Exercise Intolerance in Chronic Obstructive Pulmonary Disease
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Cited by
Lung hyperinflation in COPD: applying physiology to clinical practice
O’Donnell, D. E., Webb, K. A., & Neder, J. A. (2015) · COPD Research and Practice · doi:10.1186/s40749-015-0008-8 · Cited by 93
Self-citation
Metadata
- Authors
- Scuarcialupi, M. E. A., Berton, D. C., Cordoni, P. K., Squassoni, S. D., Fiss, E., & Neder, J. A.
- Venue
- Jornal Brasileiro de Pneumologia
- Publisher
- FapUNIFESP (SciELO)
- Published
- 2014-04
- Volume
- 40
- Issue
- 2
- Pages
- 111-118
- ISSN
- 1806-3713
- Cited by
- 5
- References
- 8
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