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• W2564023569 abstract "Flow/volume (F/V) spirometry is routinely used for assessing the type and severity of lung disease. Forced vital capacity (FVC) and timed vital capacity (FEV1) provide the best estimates of air£ow obstruction in patients with asthma, chronic obstructive pulmonary disease (COPD) and emphy- sema. Computerized spirometers are now available for early home recognition of asthma exacerbation in high risk patients with severe persistent disease, and for recognition of either infection or rejection in lung transplant patients. Patients with severe COPD may exhibit expiratory £ow limitation (EFL) on tidal volume (VT T) expiratory F/V (VTF/V) curves, either with or without applying negative expiratory pressure (NEP). EFL results in dynamic hyperin£ation and persistently raised alveolar pressure or intrinsic PEEP (PEEPi). Hyperin£ation and raised PEEPi greatly enhance dyspnea with exertion through the added work of the threshold load needed to overcome raised pleural pressure. Esophageal (pleural) pressure monitoring may be added to VTF/V loops for assessing the severity of PEEPi: 1) to optimize assisted ventilation by mask or via endotracheal tube with high inspiratory £ow rates to lower I :E ratio, and 2) to assess the e⁄cacy of either pressure support ventilation (PSV) or low level extrinsic PEEP in reducing the threshold load of PEEPi. Intraoperative tidal volume F/V loops can also be used to document the e⁄cacy of emphysema lung volume reduction surgery (LVRS) via disappearance of EFL. Finally, the mechanism of ventilatory constraint can be identi¢ed with the use of exercise tidal volume F/V loops referenced to maximum F/V loops and static lung volumes. Patients with severe COPD show inspiratory F/V loops approaching 95% of total lung capacity, and £ow limitation over the entire expiratory F/V curve during light levels of exercise. Surprisingly, patients with a history of congestive heart failure may lower lung volume towards residual volume during exercise, thereby reducing airwaydiameter and induc- ing expiratory £owlimitation." @default.
• W2564023569 created "2017-01-06" @default.
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• W2564023569 date "2001-01-01" @default.
• W2564023569 modified "2023-09-27" @default.
• W2564023569 title "ASSESSMENTANDMONITORINGOFFLOW LIMITATIONANDOTHERPARAMETERSFROM FLOW/VOLUMELOOPS" @default.
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