Internal Medicine
doi: 10.25005/2074-0581-2021-23-1-25-31
EVALUATION OF VENTILATION-PERFUSION RATIO IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE
1Department of Pathophysiology, Ryazan State Medical University named after Academician I .P. Pavlov, Ryazan, Russian Federation
2Department of Faculty Therapy with Course of Therapy, Faculty of Continuing Professional Education, Ryazan State Medical University named after Academician I .P. Pavlov, Ryazan, Russian Federation
Objective: To study ventilation-perfusion ratio (VPR) in patients with chronic obstructive pulmonary disease (COPD) using method of volumetric capnography.
Methods: 35 patients with COPD II-IV stages and 17 volunteers without pathology of the respiratory system (control group) were examined. Using SpiroScout (Ganshorn, Germany) with built-in function of volumetric capnography, spirography and volumetric capnography were implemented. Symptoms in patients with COPD were evaluated using mMRC and CAT.
Results: Statistically significant differences between the patients with COPD and the control group were identified in a number of parameters of volumetric capnography characterizing VPR. VDBohr, VDalv and their ratio to VT in patients with COPD were higher than in individuals of the control group (VDBohr – 361 [299-486] and 280 [215-463] ml, p=0.042; VDBohr/VT – 0.43 [0.40-0.51] and 0.35 [0.31-0.44], p=0.001; VDalv – 211 [142-290] and 81 [49.5-244.5] ml, p=0.012; VDalv/VT – 0.24 [0.20-0.34] and 0.13 [0.08-0.23], p=0.001). The slope of the 2nd phase of the capnogram in COPD was more smooth (dMM/dV2 – 2.0 [1.7-2.7] and 2.5 [2.2-3.2] g/mol×l, respectively; p=0.013), and the slope of the 3rd phase was steeper than in the individuals without pathology of the respiratory system (dMM/dV3 – 0.38 [0.29-0.51] and 0.22 [0.13-0.34] g/mol×l, respectively; p<0.001). Angle α in the group with COPD was increased in comparison with the control group (136
Conclusion: The conducted study identified derangement of VPR in patients with COPD. Volumetric capnography is an easy-to-use technique that allows evaluating VPR.
Keywords: Ventilation-perfusion ratio, dead space, chronic obstructive pulmonary disease, volumetric capnography.
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Authors' information:
Miroshkina Tatiana Aleksandrovna
Candidate of Medical Sciences, Associate Professor of the Department of Pathophysiology, Ryazan State Medical University named after Academician I.P. Pavlov
Researcher ID: AAG-5068-2020
ORCID ID: 0000-0002-9179-5181
Author ID: 966788
SPIN: 2779-0313
E-mail: mirta62@yandex.ru
Shustova Svetlana Aleksandrovna
Candidate of Medical Sciences, Associate Professor of the Department of Pathophysiology, Ryazan State Medical University named after Academician I.P. Pavlov
Researcher ID: AAG-50-64-2020
Scopus ID: 57201741897
ORCID ID: 0000-0002-5528-6742
Author ID: 988258
SPIN: 8866-5935
E-mail: sv_shustova@mail.ru
Ponomaryova Irina Borisovna
Candidate of Medical Sciences, Associate Professor of the Department of Faculty Therapy with Course of Therapy, Faculty of Continuing Professional Education, Ryazan State Medical University named after Academician I.P. Pavlov
Researcher ID: D-6849-2018
ORCID ID: 0000-0002-0273-4388
Author ID: 759667
SPIN: 3984-1944
E-mail: docib@yandex.ru
Information about support in the form of grants, equipment, medications
The authors did not receive financial support from manufacturers of medicines and medical equipment
Conflicts of interest: No conflict
Address for correspondence:
Miroshkina Tatiana Aleksandrovna
Candidate of Medical Sciences, Associate Professor of the Department of Pathophysiology, Ryazan State Medical University named after Academician I.P. Pavlov
390026, Russian Federation, Ryazan, Vysokovoltnaya Str., 9
Tel.: +7 (910) 5603646
E-mail: mirta62@yandex.ru
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