RT Journal Article
SR Electronic
T1 Flow limitation and dynamic hyperinflation: key concepts in modern respiratory physiology
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 186
OP 199
DO 10.1183/09031936.04.00113204
VO 25
IS 1
A1 P. M. A. Calverley
A1 N. G. Koulouris
YR 2005
UL http://erj.ersjournals.com/content/25/1/186.abstract
AB Fashions in ideas, like clothes, come and go. From approximately 1950–1980, physiological research was seen as the key discipline in understanding lung disease and was at the cutting edge of pulmonary science. Subsequently, its importance has been down played amid a widely accepted but unfounded assumption that we now have a perfect working understanding of the physiological behaviour of the respiratory system in health and disease. Although it seems improbable that completely new disciplines within respiratory physiology will emerge with fundamentally different ways of describing the mechanical or gas exchanging function of the lung, advances in computing and new observations in disease have highlighted previously unsuspected physiological abnormalities that have changed the way we view lung disease and the interface between disordered lung mechanics, symptomatology and disability. This is especially true for the two related physiological concepts of expiratory flow limitation and dynamic hyperinflation, which are now being taken from the physiological laboratory to the bedside with dramatic effect. Each arises from well-established theoretical and practical observations first made 40 yrs ago and now adapted to a range of settings, particularly in the field of obstructive lung disease. This review focuses on how these conditions are defined and assessed and what evidence there is that they might be important in lung disease. SERIES “RESPIRATORY MONITORING: REVISITING CLASSICAL PHYSIOLOGICAL PRINCIPLES WITH NEW TOOLS” Edited by M.I. Polkey, R. Farré and A.T. Dinh-Xuan Number 3 in this Series