[Pharmacological treatment of hyperinflation]

Rev Mal Respir. 2009 Jun;26(6):613-24. doi: 10.1016/s0761-8425(09)74692-3.
[Article in French]

Abstract

Introduction Lung hyperinflation leads to breathlessness, limitation in exercise capacity and tolerance, and impaired quality of life. Thus, it is important to target this key and characteristic feature of COPD. Current knowledge Available pharmacological approaches rely mainly on bronchodilators, in particular beta2 agonists and anticholinergic agents. These treatments act through the reduction of expiratory airflow limitation. However, changes in classical indices of airflow obstruction do not accurately predict effects on hyperinflation and symptoms. The decrease in operating lung volumes (as reflected by inspiratory capacity or functional residual capacity) at rest and during exercise is one of the mechanisms by which these treatments improve quality of life and maybe also decrease the impact of exacerbations. The effect of beta2 agonists on hyperinflation might be amplified by concurrent treatment with inhaled corticosteroids. Perspectives The effect of new treatments targeting airways inflammation on hyperinflation remains to be explored. Conclusions Measuring the reduction in the degree of lung hyperinflation allows a better understanding of the symptomatic effect of COPD pharmacological treatments.

Publication types

  • English Abstract

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adrenergic beta-Agonists / therapeutic use
  • Bronchodilator Agents / therapeutic use
  • Cholinergic Antagonists / therapeutic use
  • Humans
  • Lung / physiopathology*
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Respiratory Mechanics / physiology

Substances

  • Adrenal Cortex Hormones
  • Adrenergic beta-Agonists
  • Bronchodilator Agents
  • Cholinergic Antagonists