LUNG HYPERINFLATION IN COPD: What the Clinician Needs to Know

Lung hyperinflation, chronic dyspnea and reduced exercise capacity are inextricably linked and are independent predictors of increased mortality in COPD. It is no surprise, therefore, that a major goal of management is to reduce lung hyperinflation in the hope of improving dyspnea, exercise tolerance and related long term patientcentered outcomes. The negative effects of lung hyperinflation on respiratory muscle and cardio-circulatory function are now well established and the negative effects of acute dynamic hyperinflation during exacerbations and physical activity are increasingly recognized. Additional evidence of the importance of lung hyperinflation comes from multiple studies which have examined the clinical benefits of therapeutic interventions that reduce the effect of lung hyperinflation. The current review summarizes the causes and clinical consequences of lung hyperinflation and provides a strong rationale for its therapeutic reversal.