Breathlessness during exercise in COPD: how do the drugs work?

Calverley, P. M. A.
June 2004
Thorax;Jun2004, Vol. 59 Issue 6, p455
Academic Journal
The inability to exercise because of distressing breathlessness is one of the most frequent problems experienced by patients with chronic obstructive pulmonary disease (COPD) and is a major determinant of impaired quality of life. Scientists understanding of why this occurs and how best to treat it has improved significantly in the last decade. At one level the problem appears relatively straightforward. Exercise invariably involves an increase in whole body oxygen consumption and carbon dioxide production, which requires an appropriate rise in alveolar ventilation if arterial carbon dioxide tension is to remain constant. In patients with COPD the ability to increase minute ventilation is restricted as is the capacity to empty their lungs quickly, hence exercise limitation occurs at a lower workload than in age matched healthy subjects.


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