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Titolo:
Assessment of bronchodilator efficacy in symptomatic COPD - Is spirometry useful?
Autore:
ODonnell, DE;
Indirizzi:
Queens Univ, Dept Med, Resp Invest Unit, Kingston, ON, Canada Queens UnivKingston ON Canada d, Resp Invest Unit, Kingston, ON, Canada
Titolo Testata:
CHEST
fascicolo: 2, volume: 117, anno: 2000, supplemento:, S
pagine: 42 - 47
SICI:
0012-3692(200002)117:2<42:AOBEIS>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
OBSTRUCTIVE PULMONARY-DISEASE; VOLUME REDUCTION SURGERY; AIR-FLOW LIMITATION; EXERCISE TOLERANCE; EXERTIONAL BREATHLESSNESS; DYNAMIC HYPERINFLATION; IPRATROPIUM BROMIDE; LUNG HYPERINFLATION; DOSE-RESPONSE; MECHANISMS;
Keywords:
bronchodilators; COPD; dyspnea; exercise; inspiratory capacity; lung hyperinflation; spirometry;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: O'Donnell, DE Richardson House,102 Stuart St, Kingston, ON K7L 2V6, Canada Richardson House,102 Stuart St Kingston ON Canada K7L 2V6 a
Citazione:
D.E. O'Donnell, "Assessment of bronchodilator efficacy in symptomatic COPD - Is spirometry useful?", CHEST, 117(2), 2000, pp. 42-47

Abstract

Bronchodilator therapy in COPD is deemed successful if it improves ventilatory mechanics to a degree where effective symptom alleviation and increased exercise capacity are achieved. A greater understanding of the pathophysiologic mechanisms of dyspnea and exercise intolerance in COPD has prompted a reevaluation of the manner in which we currently assess therapeutic efficacy. The traditional reliance on an improved postbronchodilator FEV1 as indicative of a positive clinical response has recognized limitations. To the extent that pharmacologic volume reduction is a desirable therapeutic goal with favorable implications for dyspnea relief and increased exercise tolerance, the potential value of bronchodilator-induced changes in lung volume measurements is currently being studied. It is unlikely, however, given themultifactorial nature of dyspnea and exercise limitation in COPD, that resting spirometric measurements of maximal flows and volumes alone will be sufficiently sensitive to adequately predict a positive clinical response to bronchodilator therapy. Thus, additional direct measurements of exercise dynamic hyperinflation and exercise endurance together with reliable subjective measurements of dyspnea and quality of life are recommended in the setting of a suitable placebo-controlled design.

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Documento generato il 19/09/20 alle ore 09:21:20