Chest
Clinical InvestigationsCOPDOrthopnea and Tidal Expiratory Flow Limitation in Patients With Stable COPD
Section snippets
Subjects
A cross-sectional study was carried out on 117 consecutiveambulatory COPD patients (75 men and 42 women). All patients weresuffering from COPD according to the American Thoracic Society (ATS)guidelines,18 and were studied in a stable clinical andfunctional state. Their anthropometric characteristics and lungfunction data are given in Table 1. Thirty-six of the patients had clinical evidence of chronic right heartfailure. Each patient gave informed consent and the study protocol wasapproved by
Results
There were 24 patients (20.5%) who did not report orthopnea and93 patients (79.5%) who did. None of the 24 patients who did notreport orthopnea used two or more pillows. Among the 93 patients whoreported orthopnea, 40 patients (43%) used two pillows, 35 patients(38%) used three pillows, and 18 patients (19%) used four or morepillows.
The anthropometric and lung function data of the 117 COPD patientsstratified according to presence or absence of orthopnea are shown inTable 1. While age, height,
Discussion
In this study, we have examined the association of orthopnea withthe 3-point FL score and routine lung function data in 117 patientswith stable COPD. The main finding is that FL is the strongest riskfactor for reported orthopnea.
The fact that patients with severe COPD may be FL during restingbreathing is well recognized, and the consequences in terms of dynamicpulmonary hyperinflation, increased work of breathing, and impairedinspiratory muscle function and hemodynamics have been welldocumented.
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2023, Journal of Affective DisordersExpiratory Flow Limitation During Mechanical Ventilation
2018, ChestCitation Excerpt :In intubated obese patients, changing the position from supine to sitting can reduce EFLT.52 The effect of positioning on EFLT seems consistent in many studies with nonintubated patients (eg, obese patients),22,24 patients with acute and chronic heart failure, and those with stable COPD.21,23,43,54,75,82,83 Studies in patients with cardiopulmonary diseases revealed an effect of bronchodilator administration on EFLT.
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2014, International Journal of GerontologyCitation Excerpt :Patients with COPD often experience an increased sensation of breathlessness in supine compared to sitting positions27. Increased inspiratory resistive work is thought to be responsible for orthopnea in COPD patients28. In our study, orthopnea explained 9% of the variance in physical inactivity.
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This study was supported by the J. Costello Memorial Research Fund, Royal Victoria Foundation, and the Montreal Chest Institute Research Center.