Elsevier

Clinics in Chest Medicine

Volume 25, Issue 3, September 2004, Pages 435-453
Clinics in Chest Medicine

Resting and exercise physiology in interstitial lung diseases

https://doi.org/10.1016/j.ccm.2004.05.005Get rights and content

Section snippets

Resting physiology

Most ILDs share a common pattern of physiologic abnormalities [2], with a restrictive ventilatory defect being typical. This defect is reflected by a downward and rightward shift of the static expiratory pressure–volume curve. The lung recoil is increased over the range of the inspiratory capacity with a reduction of total lung capacity (TLC) and vital capacity [3], [4], [5]. The coefficient of retraction (pleural pressure at TLC/lung volume at TLC) is elevated compared with normal persons [3],

Clinical applications

Measurement of pulmonary physiology by means of PFT, 6-minute walk testing (6MWT), and cardiopulmonary exercise testing (CPET) can be used (1) to aid in diagnosis, (2) to provide clues regarding differential diagnosis, (3) to assess the severity and prognosis, and (4) to determine response to therapeutic interventions in these diseases.

Summary

ILDs are a heterogeneous group of parenchymal pulmonary disorders with varying histologic appearances. PFTs have assumed a prominent role in the diagnosis and management of patients with these disorders. Although their role in the differential diagnosis of the various ILDs is limited, physiologic measurements are pivotal studies providing clues regarding disease severity, prognosis, and response to therapy.

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