HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (12) Citing Articles via Google Scholar Google Scholar Articles by Koulouris, N.G. Articles by Jordanoglou, J. Search for Related Content PubMed PubMed Citation Articles by Koulouris, N.G. Articles by Jordanoglou, J.

Tidal expiratory flow limitation, dyspnoea and exercise capacity in patients with bilateral bronchiectasis

¹ Dept of Respiratory Medicine, Respiratory Function Laboratory, University of Athens Medical School, "Sotiria" Hospital, Athens, Greece. ² Meakins-Christie Laboratories, McGill University, Montreal, Quebec, Canada

CORRESPONDENCE: N. G. Koulouris, Respiratory Function Laboratory, Dept of Respiratory Medicine, University of Athens, "Sotiria" Hospital for Diseases of the Chest, 152, Mesogion Ave, Athens, GR-115 27, Greece. Fax: 30 2107770423. E-mail: koulnik@med.uoa.gr

Keywords: bronchiectasis, exercise, high-resolution computed tomography, negative expiratory pressure, pulmonary function, respiratory mechanics

Received: December 5, 2001
Accepted December 12, 2002

In this study the authors investigated whether expiratory flow limitation (FL) is present during tidal breathing in patients with bilateral bronchiectasis (BB) and whether it is related to the severity of chronic dyspnoea (Medical Research Council (MRC) dyspnoea scale), exercise capacity (maximal mechanical power output (WR_max)) and severity of the disease, as assessed by high-resolution computed tomography (HRCT) scoring.

Lung function, MRC dyspnoea, HRCT score, WR_max and FL were assessed in 23 stable caucasian patients (six males) aged 56±17 yrs. FL was assessed at rest both in seated and supine positions. To detect FL, the negative expiratory pressure (NEP) technique was used. The degree of FL was rated using a five-point FL score. WR_max was measured using a cyclo-ergometer.

According to the NEP technique, five patients were FL during resting breathing when supine but not seated, four were FL both seated and supine, and 14 were NFL both seated and supine. Furthermore, it was shown that: 1) in stable BB patients FL during resting breathing is common, especially in the supine position; 2) the degree of MRC dyspnoea is closely related to the five-point FL score; 3) WR_max (% pred) is more closely correlated with the MRC dyspnoea score than with the five-point FL score; and 4) HRCT score is closely related to forced expiratory volume in one second % pred but not five-point FL score.

In conclusion, flow limitation is common at rest in sitting and supine positions in patients with bilateral bronchiectasis. Flow limitation and reduced exercise capacity are both associated with more severe dyspnoea. Finally, high-resolution computed tomography scoring correlates best with forced expiratory volume in one second.

This article has been cited by other articles:

				J Bott, S Blumenthal, M Buxton, S Ellum, C Falconer, R Garrod, A Harvey, T Hughes, M Lincoln, C Mikelsons, et al. Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient Thorax, May 1, 2009; 64(Suppl_1): i1 - i52. [Full Text] [PDF]

				M. A. Martinez-Garcia, J.-J. Soler-Cataluna, M. Perpina-Tordera, P. Roman-Sanchez, and J. Soriano Factors Associated With Lung Function Decline in Adult Patients With Stable Non-Cystic Fibrosis Bronchiectasis Chest, November 1, 2007; 132(5): 1565 - 1572. [Abstract] [Full Text] [PDF]

				F. Santamaria, S. Montella, L. Camera, C. Palumbo, L. Greco, and A. L. Boner Lung structure abnormalities, but normal lung function in pediatric bronchiectasis. Chest, August 1, 2006; 130(2): 480 - 486. [Abstract] [Full Text] [PDF]

				C Newall, R A Stockley, and S L Hill Exercise training and inspiratory muscle training in patients with bronchiectasis Thorax, November 1, 2005; 60(11): 943 - 948. [Abstract] [Full Text] [PDF]

				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]

				E.A. Edwards, I. Narang, A. Li, D.M. Hansell, M. Rosenthal, and A. Bush HRCT lung abnormalities are not a surrogate for exercise limitation in bronchiectasis Eur. Respir. J., October 1, 2004; 24(4): 538 - 544. [Abstract] [Full Text] [PDF]