I nternational guidelines1 have correctly highlighted dyspnea alleviation and improvement in exercise tolerance as being among the most important management goals in patients with COPD. Bronchodilator therapy is the first step in achieving these goals, and, in this respect, the advent of therapy with newer long-acting bronchodilators represents a significant clinical advance. Historically, the ...

Hyperinflation or atelectasis of a lung or one of its lobes is generally due to partial or complete bronchial obstruction. Intramural large airway obstructive lesions or cysts are uncommon in the pediatric age group. They are usually discovered in the supraglottic or glottic areas. Primary pulmonary, tracheal, or bronchial tumors are very unusual in children. In this report, we describe an infa...

INTRODUCTION The effect of expiratory endotracheal tube (ETT) resistance on dynamic lung inflation is unknown. We hypothesized that ETT resistance causes dynamic lung hyperinflation by impeding lung emptying. We further hypothesized that compensation for expiratory ETT resistance by automatic tube compensation (ATC) attenuates dynamic lung hyperinflation. METHODS A ventilator equipped with th...

BACKGROUND Previous in vivo data suggest that high airway resistance (R(aw)) promotes dynamic hyperinflation, especially when coupled to high minute ventilation (V(E)). However, no studies have systematically examined the relative effects of various mechanical parameters on dynamic hyperinflation. METHODS Intrinsic positive end-expiratory pressure (PEEPi) was measured with a ventilator-lung m...

Background Lung hyperinflation and exercise intolerance are hallmarks of chronic obstructive pulmonary disease (COPD). However, their relationship remains uncertain. A combined analysis of two placebo-controlled, randomized studies examined the effects of the long-acting muscarinic antagonist umeclidinium (UMEC) and long-acting β2-agonist vilanterol (VI) separately and in combination on static ...

The physiological hallmark of chronic obstructive pulmonary disease (COPD) is expiratory flow limitation. However, it is the resultant air trapping and associated increases in lung volume (hyperinflation) that provide a mechanistic link between the physiological impairment and the characteristic symptoms of COPD, such as dyspnoea (breathlessness), exercise intolerance and reduced health-related...

BACKGROUND High frequency percussive ventilation (HFPV) combines diffusive (high frequency mini-bursts) and convective ventilation patterns. Benefits include enhanced oxygenation and hemodynamics, and alveolar recruitment, while providing hypothetic lung-protective ventilation. No study has investigated HFPV-induced changes in lung aeration in patients with early acute respiratory distress synd...

Investigators model noncardiogenic pulmonary hypertension by constricting the pulmonary artery to increase right ventricular afterload. To investigate this model's validity, we compared the right ventricular afterload, quantified as pulmonary input impedance, created by constricting the pulmonary artery and by inducing a pulmonary microvascular injury (with glass beads infused into the pulmonar...

BACKGROUND Chronic obstructive pulmonary disease (COPD) is a common disease characterized by airflow obstruction and lung hyperinflation leading to dyspnea and exercise capacity limitation. OBJECTIVES The present study was designed to evaluate whether an extra-fine combination of beclomethasone and formoterol (BDP/F) was effective in reducing air trapping in COPD patients with hyperinflation....