Teleconferences

Summaries

Chronic Obstructive and Restrictive Lung Disease and Pulmonary Hypertension
Summary of Webcast from AACVPR 5/25/11

Speakers:  E. Neil Schachter, MD
Angela Binns-Lindsey RRT

• Measurements of lung disease began with work of John Hutchinson. He established that VC was related to age and height, but only minimally to weight
• He also established that a compromise of VC related to ^ mortality
• Dr E Gaensler described the Forced Vital Capacity
• Discussed spirometric patterns of obstructive vs restrictive lung disease
• Pulm Rehab appropriate for restrictive lung disease as well as COPD
• There are many types of Restrictive Lung Disease (RLD)
• Those that do not benefit from Pulm Rehab include pleural effusion, rib fracture, and pneumothorax
• Some chronic forms of extrinsic RLD will respond, such as kyphoscoliosis
• Intrinsic Lung disease is about 50% of all cases. Causes may be asbestosis, radiation fibrosis, amiodarone, bleomycin and methotrexate. Other causes may be rheumatoid arthiritis, sarcoidosis, hypersensitivity pneumonitis or a result of inhalation of a toxic gas
• Many cases of RLD are idiopathic about 50% 
• RLD patients have abnormal breathing patterns due to stiffening of the lung, so has rapid shallow respirations at a lower tidal volume.
• During exercise ILD patients exhibit rapid shallow breathing, decrease arterial O2, increase V/Q mismatch.
• Deconditioning in ILD (interstitial lung disease) causes dyspnea and fatigue and leads to inactivity and steroids lead to muscle weakness and increased deconditioning.

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