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Does negative expiratory pressure (NEP) during spontaneous breathing predict respiratory impairment in elderly?
Objective: The purpose of this study is to assess whether expiratory flow limitation (FL), as measured by applying a negative pressure at the mouth during tidal expiration, can evaluate the respiratory impairment in elderly patients. Methods: The study was carried out in 67 consecutive elderly inpat...
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| Published in: | Respiratory medicine 2005, Vol.99 (1), p.66-69 |
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| container_title | Respiratory medicine |
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| creator | Vanpee, D. Delwiche, J.P. Swine, C. Jamart, J. Delaunois, L. |
| description | Objective: The purpose of this study is to assess whether expiratory flow limitation (FL), as measured by applying a negative pressure at the mouth during tidal expiration, can evaluate the respiratory impairment in elderly patients.
Methods: The study was carried out in 67 consecutive elderly inpatients (24 men and 43 women). Negative expiratory pressure (NEP) of –5 (NEP 5) and –10 (NEP 10) cm H
2O were applied during spontaneous tidal expiration. According to the results of the NEP technique, the patients were stratified in two categories: not flow limited and flow limited. We realized then classic forced expiratory manœuvres (FEV
1, FVC) and clinical evaluation of dyspnea (NYHA). According to the values of the lung function data, elderly patients were then divided in 3 groups (normal, obstructive, restrictive).
Results: The sensitivity, the specificity, the positive and negative predictive values for the diagnosis of obstructive syndrome by the presence of flow limitation during NEP 5 were 53, 74, 45, 79% respectively and 58, 83, 58, 83% respectively during NEP 10. These findings show that the correlation between FL obtained by the NEP technique during spontaneous breathing and spirometry is not very good despite the fact that both were well correlated with dyspnea score.
Conclusions: In clinical practice, faced with an elderly dyspneic patient unable to perform maximal expiratory manoeuvres, the evaluation of flow limitation by NEP technique seems nor to be reliable to predict an obstructive functional impairment nor to be able to explain the origin of his dyspnea. |
| doi_str_mv | 10.1016/j.rmed.2004.05.011 |
| format | article |
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Methods: The study was carried out in 67 consecutive elderly inpatients (24 men and 43 women). Negative expiratory pressure (NEP) of –5 (NEP 5) and –10 (NEP 10) cm H
2O were applied during spontaneous tidal expiration. According to the results of the NEP technique, the patients were stratified in two categories: not flow limited and flow limited. We realized then classic forced expiratory manœuvres (FEV
1, FVC) and clinical evaluation of dyspnea (NYHA). According to the values of the lung function data, elderly patients were then divided in 3 groups (normal, obstructive, restrictive).
Results: The sensitivity, the specificity, the positive and negative predictive values for the diagnosis of obstructive syndrome by the presence of flow limitation during NEP 5 were 53, 74, 45, 79% respectively and 58, 83, 58, 83% respectively during NEP 10. These findings show that the correlation between FL obtained by the NEP technique during spontaneous breathing and spirometry is not very good despite the fact that both were well correlated with dyspnea score.
Conclusions: In clinical practice, faced with an elderly dyspneic patient unable to perform maximal expiratory manoeuvres, the evaluation of flow limitation by NEP technique seems nor to be reliable to predict an obstructive functional impairment nor to be able to explain the origin of his dyspnea.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2004.05.011</identifier><identifier>PMID: 15672851</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Aged ; Aged, 80 and over ; Airways obstruction ; Anthropometry ; Biological and medical sciences ; Chronic obstructive pulmonary disease, asthma ; Dyspnea ; Dyspnea - diagnosis ; Dyspnea - etiology ; Dyspnea - physiopathology ; Elderly ; Epidemiologic Methods ; Exhalation ; Female ; Forced Expiratory Volume ; Humans ; Male ; Medical sciences ; Negative expiratory pressure ; Pneumology ; Pulmonary Ventilation ; Respiratory system : syndromes and miscellaneous diseases ; Spirometry ; Vital Capacity</subject><ispartof>Respiratory medicine, 2005, Vol.99 (1), p.66-69</ispartof><rights>2004 Elsevier Ltd</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-2f7ced5bd9535fe3c66cea0fb7bdf549f72932afbc8ed47b44ffeea4971415933</citedby><cites>FETCH-LOGICAL-c456t-2f7ced5bd9535fe3c66cea0fb7bdf549f72932afbc8ed47b44ffeea4971415933</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,4043,27956,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16383610$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15672851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vanpee, D.</creatorcontrib><creatorcontrib>Delwiche, J.P.</creatorcontrib><creatorcontrib>Swine, C.</creatorcontrib><creatorcontrib>Jamart, J.</creatorcontrib><creatorcontrib>Delaunois, L.</creatorcontrib><title>Does negative expiratory pressure (NEP) during spontaneous breathing predict respiratory impairment in elderly?</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>Objective: The purpose of this study is to assess whether expiratory flow limitation (FL), as measured by applying a negative pressure at the mouth during tidal expiration, can evaluate the respiratory impairment in elderly patients.
Methods: The study was carried out in 67 consecutive elderly inpatients (24 men and 43 women). Negative expiratory pressure (NEP) of –5 (NEP 5) and –10 (NEP 10) cm H
2O were applied during spontaneous tidal expiration. According to the results of the NEP technique, the patients were stratified in two categories: not flow limited and flow limited. We realized then classic forced expiratory manœuvres (FEV
1, FVC) and clinical evaluation of dyspnea (NYHA). According to the values of the lung function data, elderly patients were then divided in 3 groups (normal, obstructive, restrictive).
Results: The sensitivity, the specificity, the positive and negative predictive values for the diagnosis of obstructive syndrome by the presence of flow limitation during NEP 5 were 53, 74, 45, 79% respectively and 58, 83, 58, 83% respectively during NEP 10. These findings show that the correlation between FL obtained by the NEP technique during spontaneous breathing and spirometry is not very good despite the fact that both were well correlated with dyspnea score.
Conclusions: In clinical practice, faced with an elderly dyspneic patient unable to perform maximal expiratory manoeuvres, the evaluation of flow limitation by NEP technique seems nor to be reliable to predict an obstructive functional impairment nor to be able to explain the origin of his dyspnea.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Airways obstruction</subject><subject>Anthropometry</subject><subject>Biological and medical sciences</subject><subject>Chronic obstructive pulmonary disease, asthma</subject><subject>Dyspnea</subject><subject>Dyspnea - diagnosis</subject><subject>Dyspnea - etiology</subject><subject>Dyspnea - physiopathology</subject><subject>Elderly</subject><subject>Epidemiologic Methods</subject><subject>Exhalation</subject><subject>Female</subject><subject>Forced Expiratory Volume</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Negative expiratory pressure</subject><subject>Pneumology</subject><subject>Pulmonary Ventilation</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Spirometry</subject><subject>Vital Capacity</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNp9kd2L1DAUxYMo7uzoP-CDBMRFH1qT5qMtCCLr-gGL-qDPIU1v1gydpJuki_PfmzLDCj74dOHe37kczkHoGSU1JVS-2dVxD2PdEMJrImpC6QO0oYI1FSOSP0Qb0gteSUrpGTpPaUcI6Tknj9EZFbJtOkE3KHwIkLCHG53dHWD4Pbuoc4gHPEdIaYmAX329-v4aj0t0_ganOfisPYQl4SGCzr_WbWFHZzIuknu928_aFYM-Y-cxTCPE6fDuCXpk9ZTg6Wlu0c-PVz8uP1fX3z59uXx_XRkuZK4a2xoYxTD2ggkLzEhpQBM7tMNoBe9t2_Ss0XYwHYy8HTi3FkDzvqWcip6xLbo4_p1juF0gZbV3ycA0Hb0r2bJOSNkV8MU_4C4s0RdvihImiKB9JwvVHCkTQ0oRrJqj2-t4KJBay1A7tZah1jIUEaqUUUTPT6-XYb3dS07pF-DlCdDJ6MlG7Y1LfznJOiaLiy16e-SgJHbnIKpkHPiSkItgshqD-5-PPzy3qjk</recordid><startdate>2005</startdate><enddate>2005</enddate><creator>Vanpee, D.</creator><creator>Delwiche, J.P.</creator><creator>Swine, C.</creator><creator>Jamart, J.</creator><creator>Delaunois, L.</creator><general>Elsevier Ltd</general><general>Elsevier</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>ASE</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>2005</creationdate><title>Does negative expiratory pressure (NEP) during spontaneous breathing predict respiratory impairment in elderly?</title><author>Vanpee, D. ; Delwiche, J.P. ; Swine, C. ; Jamart, J. ; Delaunois, L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-2f7ced5bd9535fe3c66cea0fb7bdf549f72932afbc8ed47b44ffeea4971415933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Airways obstruction</topic><topic>Anthropometry</topic><topic>Biological and medical sciences</topic><topic>Chronic obstructive pulmonary disease, asthma</topic><topic>Dyspnea</topic><topic>Dyspnea - diagnosis</topic><topic>Dyspnea - etiology</topic><topic>Dyspnea - physiopathology</topic><topic>Elderly</topic><topic>Epidemiologic Methods</topic><topic>Exhalation</topic><topic>Female</topic><topic>Forced Expiratory Volume</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Negative expiratory pressure</topic><topic>Pneumology</topic><topic>Pulmonary Ventilation</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Spirometry</topic><topic>Vital Capacity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vanpee, D.</creatorcontrib><creatorcontrib>Delwiche, J.P.</creatorcontrib><creatorcontrib>Swine, C.</creatorcontrib><creatorcontrib>Jamart, J.</creatorcontrib><creatorcontrib>Delaunois, L.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vanpee, D.</au><au>Delwiche, J.P.</au><au>Swine, C.</au><au>Jamart, J.</au><au>Delaunois, L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does negative expiratory pressure (NEP) during spontaneous breathing predict respiratory impairment in elderly?</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2005</date><risdate>2005</risdate><volume>99</volume><issue>1</issue><spage>66</spage><epage>69</epage><pages>66-69</pages><issn>0954-6111</issn><eissn>1532-3064</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Objective: The purpose of this study is to assess whether expiratory flow limitation (FL), as measured by applying a negative pressure at the mouth during tidal expiration, can evaluate the respiratory impairment in elderly patients.
Methods: The study was carried out in 67 consecutive elderly inpatients (24 men and 43 women). Negative expiratory pressure (NEP) of –5 (NEP 5) and –10 (NEP 10) cm H
2O were applied during spontaneous tidal expiration. According to the results of the NEP technique, the patients were stratified in two categories: not flow limited and flow limited. We realized then classic forced expiratory manœuvres (FEV
1, FVC) and clinical evaluation of dyspnea (NYHA). According to the values of the lung function data, elderly patients were then divided in 3 groups (normal, obstructive, restrictive).
Results: The sensitivity, the specificity, the positive and negative predictive values for the diagnosis of obstructive syndrome by the presence of flow limitation during NEP 5 were 53, 74, 45, 79% respectively and 58, 83, 58, 83% respectively during NEP 10. These findings show that the correlation between FL obtained by the NEP technique during spontaneous breathing and spirometry is not very good despite the fact that both were well correlated with dyspnea score.
Conclusions: In clinical practice, faced with an elderly dyspneic patient unable to perform maximal expiratory manoeuvres, the evaluation of flow limitation by NEP technique seems nor to be reliable to predict an obstructive functional impairment nor to be able to explain the origin of his dyspnea.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>15672851</pmid><doi>10.1016/j.rmed.2004.05.011</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Respiratory medicine, 2005, Vol.99 (1), p.66-69 |
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| source | BACON - Elsevier - GLOBAL_SCIENCEDIRECT-OPENACCESS; ScienceDirect Freedom Collection |
| subjects | Aged Aged, 80 and over Airways obstruction Anthropometry Biological and medical sciences Chronic obstructive pulmonary disease, asthma Dyspnea Dyspnea - diagnosis Dyspnea - etiology Dyspnea - physiopathology Elderly Epidemiologic Methods Exhalation Female Forced Expiratory Volume Humans Male Medical sciences Negative expiratory pressure Pneumology Pulmonary Ventilation Respiratory system : syndromes and miscellaneous diseases Spirometry Vital Capacity |
| title | Does negative expiratory pressure (NEP) during spontaneous breathing predict respiratory impairment in elderly? |
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