Zusammenfassung
Bei Patienten mit chronisch obstruktiver Atemwegserkrankung (COPD) und Emphysem beeinflussen die vorherrschende Atemflußbehinderung und die Lungenüberblähung sowohl direkt als auch indirekt entscheidend die mechanische Beanspruchung der inspiratorisch wirksamen Atemmuskulatur, vor allem die des Diaphragmas. Die Änderung des Atemmusters bei exspiratorischer Atemflußbehinderung trägt zu einer weiteren Erhöhung der mechanischen Beanspruchung der Inspirationsmuskulatur bei. Maßnahmen, die zu einer Verringerung der Lungenüberblähung und der exspiratorischen Atemflußbehinderung führen, tragen somit zu einer verbesserten Effizienz der inspiratorisch wirksamen Atemmuskulatur bei. Die jetzt veröffentlichten Ergebnisse bezüglich volumenreduzierender Operation weisen darauf hin, daß dieses Operationsverfahren die Atemmechanik sowie die Effizienz der Inspirationsmuskulatur entscheidend verbessern kann.
Summary
In patients with chronic obstructive pulmonary disease (COPD) and emphysema the increased airway resistance and the increased endexpiratory lung volume affect decisively the mechanical load on the inspiratory muscles, particularly that of the diaphragm. The compensatory changes of the breathing pattern due to expiratory flow limitation lead to a further increase of the mechanical load on the inspiratory muscles.Therapeutic strategies which reduce hyperinflation and the increased airway resistance improve the efficiency of the inspiratory muscles. Recently published studies analyzing the effects of lung volume reduction surgery indicate that this new surgical procedure improves the ventilatory mechanics as well as the efficiency of the inspiratory muscles in patients with COPD and emphysema.
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Wanke, T. Die Atemmechanik beim Lungenemphysem. Z. Herz-, Thorax-, Gefäßchir. 11, 145–148 (1997). https://doi.org/10.1007/BF03042143
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DOI: https://doi.org/10.1007/BF03042143