Chronic Obstructive Pulmonary Disease: Clinical Integrative Physiology

被引:99
作者
O'Donnell, Denis E. [1 ]
Laveneziana, Pierantonio [2 ,3 ]
Webb, Katherine [1 ]
Neder, J. Alberto [1 ]
机构
[1] Queens Univ, Dept Med, Div Resp & Crit Care Med, Kingston, ON K7L 2V6, Canada
[2] Univ Paris 06, Fac Med, Serv Explorat Fonctionnelles Resp, F-75013 Paris, France
[3] Univ Paris 06, Dyspnee Hop Univ Pitie Salpetriere AP HP, Fac Med, Lab Physiopathol Resp, F-75013 Paris, France
关键词
Chronic obstructive pulmonary disease; Small airways; Lung mechanics; Dyspnea; Exercise; Cardiac output; VOLUME REDUCTION SURGERY; AIR-FLOW OBSTRUCTION; RESTING INSPIRATORY CAPACITY; HIGH-INTENSITY EXERCISE; WORK-RATE EXERCISE; DYNAMIC HYPERINFLATION; LUNG HYPERINFLATION; COPD PATIENTS; PHYSICAL-ACTIVITY; EXPIRATORY FLOW;
D O I
10.1016/j.ccm.2013.09.008
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Peripheral airway dysfunction, inhomogeneous ventilation distribution, gas trapping, and impaired pulmonary gas exchange are variably present in all stages of chronic obstructive pulmonary disease (COPD). This article provides a cogent physiologic explanation for the relentless progression of activity-related dyspnea and exercise intolerance that all too commonly characterizes COPD. The spectrum of physiologic derangements that exist in smokers with mild airway obstruction and a history compatible with COPD is examined. Also explored are the perceptual and physiologic consequences of progressive erosion of the resting inspiratory capacity. Finally, emerging information on the role of cardiocirculatory impairment in contributing to exercise intolerance in patients with varying degrees of airway obstruction is reviewed.
引用
收藏
页码:51 / +
页数:20
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