Dynamic Expiratory Tracheal Collapse in Morbidly Obese COPD Patients

@article{Boiselle2013DynamicET,
  title={Dynamic Expiratory Tracheal Collapse in Morbidly Obese COPD Patients},
  author={Phillip M. Boiselle and Diana E. Litmanovich and Gaetane C. Michaud and David H Roberts and Stephen H Loring and Hilary M. Womble and Mary E Millett and Carl R O'donnell},
  journal={COPD: Journal of Chronic Obstructive Pulmonary Disease},
  year={2013},
  volume={10},
  pages={604 - 610}
}
Abstract Morbid obesity may influence several aspects of airway function. However, the effect of morbid obesity on expiratory tracheal collapse in COPD patients is unknown. We thus prospectively studied 100 COPD patients who underwent full pulmonary function tests (PFTs), 6-minute walk test (6MWT), Saint George's Respiratory Questionnaire (SGRQ), and low-dose CT at total lung capacity and during dynamic exhalation with spirometric monitoring. We examined correlations between percentage dynamic… 

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References

SHOWING 1-10 OF 29 REFERENCES

Dynamic expiratory tracheal collapse in COPD: correlation with clinical and physiologic parameters.

Excessive expiratory tracheal collapse is observed in a subset of patients with COPD, but the magnitude of collapse is independent of disease severity and does not correlate significantly with physiologic parameters.

Age and sex dependence of forced expiratory central airway collapse in healthy volunteers.

The influence of age and sex on forced expiratory tracheal collapse should be considered in the diagnostic evaluation of expiratories dynamic airway collapse and/or tracheomalacia.

Respiratory restriction and elevated pleural and esophageal pressures in morbid obesity.

It is concluded that many severely obese supine subjects at relaxation volume have positive P(pl) throughout the chest, which suggests high P(Pl) in such individuals.

Tracheobronchomalacia: comparison between end-expiratory and dynamic expiratory CT for evaluation of central airway collapse.

PURPOSE To compare dynamic expiratory and end-expiratory computed tomography (CT) for depicting central airway collapse in patients with acquired tracheobronchomalacia (TBM). MATERIALS AND METHODS

Airway stabilization with silicone stents for treating adult tracheobronchomalacia: a prospective observational study.

In the short term, airway stabilization with silicone stents in patients with severe TBM can improve respiratory symptoms, quality of life, and functional status.

The metabolic syndrome in patients with chronic obstructive pulmonary disease.

The presence of metabolic syndrome is frequent in patients with COPD who participated in a cardiopulmonary rehabilitation program and this population should be considered for screening for the metabolic syndrome.

Obesity and the lung: 5 · Obesity and COPD

It is proposed that, in patients with COPD, reduced oxidative capacity and systemic hypoxia may amplify these disturbances, not only in obese patients but also in subjects with hidden loss of fat-free mass.

The relation of body mass index to asthma, chronic bronchitis, and emphysema.

Patients with emphysema are more likely to be underweight, and patients with CB are morelikely to be obese, however, the temporal relationship between abnormal BMI and the onset of COPD is uncertain.

Tracheal collapsibility in healthy volunteers during forced expiration: assessment with multidetector CT.

Healthy volunteers demonstrate a wide range of forced expiratory tracheal collapse, frequently exceeding the current diagnostic criterion for tracheomalacia.