Chest ACCP Career Connection
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (7)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Eltayara, L.
Right arrow Articles by Milic-Emili, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Eltayara, L.
Right arrow Articles by Milic-Emili, J.
(Chest. 2001;119:99-104.)
© 2001 American College of Chest Physicians

Orthopnea and Tidal Expiratory Flow Limitation in Patients With Stable COPD*

Loubna Eltayara, MD; Heberto Ghezzo, PhD and Joseph Milic-Emili, MD

* From the Meakins-Christie Laboratories, and Montreal Chest Institute Research Centre, McGill University, Montreal, Quebec, Canada.

Correspondence to: Joseph Milic-Emili, MD, Meakins-Christie Laboratories, McGill University, 3626 St. Urbain St, Montreal, Quebec H2X 2P2, Canada; e-mail: milic{at}meakins.lan.mcgill.ca

Background: Orthopnea is a common feature in COPD patients, although its nature is poorly understood.

Objective: To study the role of tidal expiratory flow limitation (FL) in the genesis of orthopnea in patients with stable COPD.

Measurements: Tidal FL was assessed in 117 ambulatory COPD patients in sitting and supine positions using the negative expiratory pressure method. The presence or absence of orthopnea was also noted.

Results and conclusions: In patients with stable COPD with tidal expiratory FL in seated and/or supine position, there is a high prevalence of orthopnea, which probably results in part from increased inspiratory efforts due to dynamic pulmonary hyperinflation and the concomitant increase in inspiratory threshold load due to intrinsic positive end-expiratory pressure. Increased airway resistance in supine position due to lower end-expiratory lung volume probably also plays a role in the genesis of orthopnea.

Key Words: inspiratory work • intrinsic positive end-expiratory pressure • negative expiratory pressure method to detect flow limitation • posture • routine lung function




This article has been cited by other articles:


Home page
 ChestHome page
R. Torchio, C. Gulotta, P. Greco-Lucchina, A. Perboni, L. Avonto, H. Ghezzo, and J. Milic-Emili
Orthopnea and tidal expiratory flow limitation in chronic heart failure.
Chest, August 1, 2006; 130(2): 472 - 479.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
P. M. A. Calverley and N. G. Koulouris
Flow limitation and dynamic hyperinflation: key concepts in modern respiratory physiology
Eur. Respir. J., January 1, 2005; 25(1): 186 - 199.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
P.-H. Wang, P.-H. Kuo, C.-L. Hsu, H.-D. Wu, Y.-S. Chang, S.-H. Kuo, and P.-C. Yang
Diagnostic Value of Negative Expiratory Pressure for Airway Hyperreactivity
Chest, November 1, 2003; 124(5): 1762 - 1767.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
R. Torchio, C. Gulotta, A. Perboni, C. Ciacco, M. Guglielmo, F. Orlandi, and J. Milic-Emili
Orthopnea and Tidal Expiratory Flow Limitation in Patients With Euthyroid Goiter
Chest, July 1, 2003; 124(1): 133 - 140.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2001 by the American College of Chest Physicians.