By C F Donner; N Ambrosino; Roger Goldstein
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Mirabella A et 01. MetaUoprotinase9/tissue inhibitor of metalloprotmase-l ratio correlates with airflow obstruction in asthma and chronic bronchitis. Am) Respir C"t Core Med 1998; 158: 1945-50. 15. Delmastro M, Balbi B. Acute exacerbations of COPO: is inflammation central to prevention and treatment strategies? MonoId; ArchChest Dis 2002; 57: 293-6. 16. Berend N. Woolcock AJ. Marlin GE. Correlation between the function and the structure of the lung in smokers. Am Rev Respir Dis 1979; 119: 695-702.
The overall result is the simultaneous coexistence of high VofVT regions with regions of low VIi:} match. Both increase the ven tilatory demand,thereby taxing the respiratory system of these patients even more. As ventilatory demand increases, so does the work of breathing, as the patient with COPD must attempt to increase ventilation in order to maintain an adequate delivery of oxy gen. Alveolar ventilation must also be sufficient to eliminate the CO, produced. If this does not occur,P,CO, will increase.
Oi Stefano A. Turato G. C08+ T -lymphocytes in peripheral airways of smokers with chronic obstructive pulmonary disease. Am) RespirCritCore Med 1998; 157: 822-6. 9. Finkelstein R, Fraser RS, Ghezzo H, Cosio MG. Alveolar inflammation and its relation to emphysema in smokers. Am) RespirCritCore Med 1995; 152: 1666-72. Key points • • • • • • • • Most of our knowledge about the effects of pulmonary rehabilitation centres on COPD, because these patients are the ones most often studied. COPD is primarily an airways disease associated, to a greater or lesser degree, with parenchymal lung destruction.
