Attacking the disease spiral in chronic obstructive pulmonary disease
Michael I Polkey and John Moxham
DOI: https://doi.org/10.7861/clinmedicine.6-2-190
Clin Med March 2006 Michael I Polkey
Respiratory Medicine Laboratory, Royal Brompton Hospital, London
PhD FRCPRoles: Consultant Physician and Reader in Respiratory Medicine
John Moxham
Respiratory Muscle Laboratory, King's College Hospital, London
MD FRCPRoles: Professor of Respiratory Medicine
Abstract
Chronic obstructive pulmonary disease (COPD) is the commonest respiratory cause of mortality and morbidity in adults in the UK. Although the condition is initially a pulmonary one, data exist to support the concept that factors associated with COPD, including immobility, gives rise to secondary effects, including a quadriceps myopathy, which in turn cause anaerobic metabolism at low work rates. This, through bicarbonate buffering, leads to CO2 retention which, because of constraints imposed by pulmonary mechanics, cause acidosis and dyspnoea. Various therapeutic strategies to reverse this spiral may be employed including pulmonary rehabilitation, quadriceps strength training and surgical or bronchoscopic lung volume reduction.
- © 2006 Royal College of Physicians
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Attacking the disease spiral in chronic obstructive pulmonary disease
Michael I Polkey, John Moxham
Clinical Medicine Mar 2006, 6 (2) 190-196; DOI: 10.7861/clinmedicine.6-2-190
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