Improvement of exertional dyspnea and breathing pattern of inspiration to expiration after bronchial thermoplasty

 
Keisuke Miki, Mari MikiKenji YoshimuraKazuyuki TsujinoHiroyuki KagawaYohei OshitaniYuko OharaYuki HosonoRyuya EdahiroHiroyuki Kurebe and Seigo Kitada. Allergy, Asthma & Clinical Immunology 2018 14:74

Abstract

Background

Bronchial thermoplasty (BT) is a bronchoscopic treatment that can ameliorate the symptoms of severe asthma. However, little is known about the mechanism by which BT improves exertional dyspnea without significantly changing the resting pulmonary function in asthmatics. To understand the mechanism, cardiopulmonary variables were investigated using cardiopulmonary exercise testing (CPET) in a patient with severe asthma before and after BT.

Case presentation

A 57-year-old Japanese man visited our hospital for consultation of the intractable asthma, which we managed with three treatment sessions of BT. Comparison of the findings pre-BT and at 1 year after BT demonstrated that (1) the resting tests for respiration showed no improvement in forced expiratory volume in 1 s, but the forced oscillation technique showed decreases in both inhalation and exhalation respiratory resistance values, and (2) the CPET results showed (i) improvement in exertional dyspnea, exercise endurance, and arterial oxygen saturation at the end of exercise; (ii) that the expiratory tidal volume exceeded the inspiratory tidal volume during exercise, which implied that a sufficient exhalation enabled longer inspiratory time and adequate oxygen absorption; and (iii) that an increase in respiratory frequency could be prevented throughout exercise.

Conclusions

This case report described a novel mechanism of BT in improving exertional dyspnea and exercise duration, which was brought about by ventilatory improvements related to the breathing pattern of inspiration to expiration.

Download PDF

(You must be logged in to add and reply comments)

Interasma on Twitter

Interasma Top story: Job vacancy: Paediatric Clinical Research Nurse, Guy's and St Thomas' NHS Foundation Trust, London… https://t.co/kdWOhiMk8D
4hreplyretweetfavorite
Interasma RT @SocLatAlergia: Abierto el plazo para el envío de trabajos libres. https://t.co/3F3ZTY50oR https://t.co/aQSnTdOTSn
7hreplyretweetfavorite
Interasma RT @worldallergy: WISC 2019: You Are Invited to Attend! Registration and Abstract Submission are Now Open https://t.co/YKCvRwdO1j
7hreplyretweetfavorite
Interasma RT @Aller_MD: Top story: Job vacancy: Paediatric Clinical Research Nurse, Guy's and St Thomas' NHS Foundation Trust, London https://t.co/hm
9hreplyretweetfavorite
Interasma RT @Aller_MD: “Researchers identify comprehensive guidelines for managing severe atopic dermatitis” https://t.co/jh5FxCO1QW https://t.co/FS
9hreplyretweetfavorite

Editor: Juan C. Ivancevich, MD

Copyright © Interasma 2003-2017  •  Terms of Use  •  Privacy Policy  •  Contact Us  •  Sitemap

Powered by FREI SA

InterAsma