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Chronic obstructive pulmonary disease: clinical integrative physiology
Denis E O'Donnell1, Pierantonio Laveneziana2, Katherine Webb1
1Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, 102 Stuart Street, Kingston, Ontario K7L 2V6, Canada.
Clinics in Chest Medicine
|February 11, 2014
Summary
Chronic obstructive pulmonary disease (COPD) involves airway dysfunction, leading to worsening shortness of breath and exercise intolerance. This review explains the physiological basis for these progressive symptoms in COPD patients.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
Background:
- Chronic obstructive pulmonary disease (COPD) is characterized by peripheral airway dysfunction, inhomogeneous ventilation, gas trapping, and impaired gas exchange.
- These factors contribute to the progressive nature of COPD symptoms.
Purpose of the Study:
- To provide a physiological explanation for activity-related dyspnea and exercise intolerance in COPD.
- To examine physiological derangements in smokers with mild airway obstruction.
- To review the consequences of reduced resting inspiratory capacity and the role of cardiocirculatory impairment.
Main Methods:
- Review of existing literature on COPD pathophysiology.
- Examination of physiological changes associated with disease progression.
- Analysis of perceptual and physiological impacts of inspiratory capacity decline.
- Review of emerging data on cardiocirculatory contributions.
Main Results:
- Peripheral airway dysfunction and impaired gas exchange are present across all COPD stages.
- Reduced resting inspiratory capacity has significant perceptual and physiological consequences.
- Cardiocirculatory impairment plays a role in exercise intolerance, even with mild airway obstruction.
Conclusions:
- Understanding the physiological underpinnings of COPD symptoms is crucial for managing disease progression.
- Addressing both respiratory and cardiocirculatory factors is important for improving exercise tolerance in COPD patients.
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