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Wheezing triggered by dorsal decubitus: pulmonary function changes

V Popa1, P Zumstein

  • 1Department of Medicine, University of California at Davis, Sacramento 95823.

Respiration; International Review of Thoracic Diseases
|January 1, 1993
PubMed
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Changing position to lying down can trigger wheezing in chronic obstructive pulmonary disease (COPD) patients. These breathing changes are reproducible and quickly resolve upon returning to a sitting position.

Area of Science:

  • Pulmonary Medicine
  • Respiratory Physiology

Background:

  • Wheezing is a common symptom in Chronic Obstructive Pulmonary Disease (COPD).
  • Positional changes can influence respiratory mechanics and symptoms in COPD patients.

Purpose of the Study:

  • To investigate the ventilatory changes and patterns associated with wheezing in COPD patients when moving from a sitting to a dorsal decubitus position.
  • To assess the reproducibility and reversibility of these positional-induced respiratory changes.

Main Methods:

  • 23 COPD subjects experiencing wheezing upon changing to dorsal decubitus (DD) were studied.
  • Lung volumes and flow-volume loops were recorded in sitting (S1), DD, and immediately after resuming sitting (S2).
  • Ventilatory changes were categorized into acute obstruction (AO), acute restriction (AR), or indeterminate response (IR).

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Main Results:

  • Three patterns of ventilatory changes were observed: AO (n=14), AR (n=7), and IR (n=2).
  • These changes, including altered lung volumes and airflow, were generally reproducible and rapidly reversible upon resuming the sitting position (S2).
  • The observed responses were heterogeneous and distinct from those seen during bronchoprovocation.

Conclusions:

  • Dorsal decubitus positioning can precipitate wheezing in COPD patients.
  • The associated physiological changes are reproducible, rapidly reversible, and heterogeneous, offering insights into COPD symptom triggers.