Evaluation of Dynamic Respiratory Mechanical Abnormalities During Conventional CPET

Frontiers in Medicine

article

Kathryn M. Milne¹  Nicolle J. Domnik¹  Devin B. Phillips¹  Matthew D. James¹  Sandra G. Vincent¹  J. Alberto Neder³  Denis E. O'Donnell¹ 

[1] Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Kingston Health Sciences Centre & Queen's University;Clinician Investigator Program, Department of Medicine, University of British Columbia;Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of Medicine, Kingston Health Sciences Centre & Queen's University

关键词: respiratory physiology;    dyspnea;    respiratory mechanics;    inspiratory capacity;    cardiopulmonary exercise test;   

DOI  :  10.3389/fmed.2020.00548

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Assessment of the ventilatory response to exercise is important in evaluating mechanisms of dyspnea and exercise intolerance in chronic cardiopulmonary diseases. The characteristic mechanical derangements that occur during exercise in chronic respiratory conditions have previously been determined in seminal studies using esophageal catheter pressure-derived measurements. In this brief review, we examine the emerging role and clinical utility of conventional assessment of dynamic respiratory mechanics during exercise testing. Thus, we provide a physiologic rationale for measuring operating lung volumes, breathing pattern, and flow–volume loops during exercise. We consider standardization of inspiratory capacity-derived measurements and their practical implementation in clinical laboratories. We examine the evidence that this iterative approach allows greater refinement in evaluation of ventilatory limitation during exercise than traditional assessments of breathing reserve. We appraise the available data on the reproducibility and responsiveness of this methodology. In particular, we review inspiratory capacity measurement and derived operating lung volumes during exercise. We demonstrate, using recent published data, how systematic evaluation of dynamic mechanical constraints, together with breathing pattern analysis, can provide valuable insights into the nature and extent of physiological impairment contributing to exercise intolerance in individuals with common chronic obstructive and restrictive respiratory disorders.

【 授权许可】

CC BY