Lung ventilation impairment in asthma patients with obesity

Authors

  • Yu. I. Feshchenko SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovsky NAMS of Ukraine”, Kyiv,
  • G.L. Gumeniuk SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovsky NAMS of Ukraine”, Kyiv,
  • M. I. Gumeniuk SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovsky NAMS of Ukraine”, Kyiv,
  • S. V. Zaikov National Medical Academy of Postgraduate Education named after P. L. Shupyk, Kyiv,
  • O. M. Rekalova SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovsky NAMS of Ukraine”, Kyiv,
  • S. H. Opimakh SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovsky NAMS of Ukraine”, Kyiv,

DOI:

https://doi.org/10.14739/2310-1210.2019.6.186486

Keywords:

asthma, obesity, capnometry

Abstract

 

BA is characterized by more severe course, worse response to standard therapy in obese patients, therefore asthma with obesity is considered not just as comorbidity but as a distinct BA phenotype.

Aim. To study the lung ventilation impairment in asthma patients with obesity using capnometry. The tasks are to study parameters of lung ventilation in asthma patients and healthy persons and to compare these parameters in asthma patients depending on the presence of obesity.

Materials and methods. The study involved 60 participants (29 men and 31 women) aged 24 to 74 years, the mean age was 52.3 ± 2.7 years, including 30 patients with asthma and 30 healthy subjects. For all participants, body plethysmography and capnometry were performed.

Results. The respiratory minute volume and alveolar ventilation volume were higher in asthma patients with obesity, and the volume of dead space ventilation and its fraction in the tidal volume were not substantially different among the groups of patients with BA. Specifically in relation to the gas exchange parameters, it was found that in obese asthmatics, the end-tidal carbon dioxide pressure was significantly increased – 4.8 ± 0.1 kPa compared with non-obese patients 4.3 ± 0.1 kPa, P < 0.05. The end-tidal oxygen concentration was significantly decreased – 15.3 ± 0.2 % compared to normal weight patients 16.0 ± 0.2 %, P < 0.05.

Conclusions. Asthma patients with obesity have characteristics that include reduced total lung capacity, inspiratory capacity and forced vital capacity with a higher degree of airways obstruction. These changes lead to lung ventilation impairment with a tendency to carbon dioxide retention, which may be an unfavorable factor for the process of gas exchange with increased oxygen demands for the entire organism in obesity.

References

Garcia-Rio, F., Alvarez-Puebla, M., Esteban-Gorgojo, I., Barranco, P., & Olaguibel, J. (2019). Obesity and Asthma: Key Clinical Questions. Journal Of Investigational Allergology And Clinical Immunology, 29(4), 262-271. doi: 10.18176/jiaci.0316

Feshhenko, Ju. I., Jashina, L. A., & Opimah S. G. (2014). Osobennosti bronhialnoj astmy u bolnyh s metabolicheskim sindromom [Bronchial asthma features in patients with metabolic syndrome]. Health of Ukraine, 2, 6-8. Retrieved from http://health-ua.com/article/25871-osobennosti-bronhialnoj-astmy-u-bolnyh-s-metabolicheskim-sindromom. [in Russian].

GINA Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. (2018). Retrieved from https://ginasthma.org/wp-content/uploads/2018/04/wms-GINA-2018-report-tracked_v1.3.pdf.

Grace, J., Mohan, A., & Lugogo, N. (2019). Obesity and adult asthma. Current Opinion In Pulmonary Medicine, 25(1), 44-50. doi: 10.1097/mcp.0000000000000531

Peters, U., Dixon, A., & Forno, E. (2018). Obesity and asthma. Journal Of Allergy And Clinical Immunology, 141(4), 1169-1179. doi: 10.1016/j.jaci.2018.02.004

Mohanan, S., Tapp, H., McWilliams, A., & Dulin, M. (2014). Obesity and asthma: Pathophysiology and implications for diagnosis and management in primary care. Experimental Biology And Medicine, 239(11), 1531-1540. doi: 10.1177/1535370214525302

Opimakh, S. H. (2014). Otsinka lehenevoi ventyliatsii u khvorykh na bronkhialnu astmu z nekontrolovanym perebihom [Lung ventilation evaluation in patients with uncontrolled asthma]. Asthma and allergy, 1, 13-17. [in Ukrainian].

(2013). Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry bronkhialnii astmi: nakaz MOZ Ukrainy vid 08.10.2013 roku №868. [On approval and implementation of medical technology documents on standardization of medical care in bronchial asthma: order of the Ministry of Health of Ukraine from October 08, 2013 №868]. Retrieved from https://zakon.rada.gov.ua/rada/show/v0868282-13?lang=uk. [in Ukrainian].

Melo, L., Silva, M., & Calles, A. (2014). Obesity and lung function: a systematic review. Einstein (São Paulo), 12(1), 120-125. doi: 10.1590/s1679-45082014rw2691

Bates, J. (2016). Physiological Mechanisms of Airway Hyperresponsiveness in Obese Asthma. American Journal Of Respiratory Cell And Molecular Biology, 54(5), 618-623. doi: 10.1165/rcmb.2016-0019ps

Gomez-Llorente, M., Romero, R., Chueca, N., Martinez-Cañavate, A., & Gomez-Llorente, C. (2017). Obesity and Asthma: A Missing Link. International Journal Of Molecular Sciences, 18(7), 1490. doi: 10.3390/ijms18071490

Egea-Santaolalla, C., & Javaheri, S. (2016). Obesity Hypoventilation Syndrome. Current Sleep Medicine Reports, 2(1), 12-19. doi: 10.1007/s40675-016-0035-2

Preiss, D., Azami, T., & Urman, R. (2015). Variations in Respiratory Excretion of Carbon Dioxide Can Be Used to Calculate Pulmonary Blood Flow. Journal Of Clinical Medicine Research, 7(2), 83-90. doi: 10.14740/jocmr1979w

Herdy, A., Ritt, L., Stein, R., Araújo, C., Milani, M., & Meneghelo, R. et al. (2016). Cardiopulmonary Exercise Test: Background, Applicability and Interpretation. Arquivos Brasileiros De Cardiologia, 107(5), 467-481 doi: 10.5935/abc.20160171

Baffi, C., Winnica, D., & Holguin, F. (2015). Asthma and obesity: mechanisms and clinical implications. Asthma Research And Practice, 1(1). doi: 10.1186/s40733-015-0001-7

Tashiro, H., & Shore, S. (2019). Obesity and severe asthma. Allergology International, 68(2), 135-142. doi: 10.1016/j.alit.2018.10.004

Downloads

How to Cite

1.
Feshchenko YI, Gumeniuk G, Gumeniuk MI, Zaikov SV, Rekalova OM, Opimakh SH. Lung ventilation impairment in asthma patients with obesity. Zaporozhye medical journal [Internet]. 2019Dec.11 [cited 2024Mar.29];(6). Available from: http://zmj.zsmu.edu.ua/article/view/186486

Issue

Section

Original research