REVIEW   

Minerva Pneumologica 2020 June;59(2):27-32

DOI: 10.23736/S0026-4954.20.01872-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Impaired respiratory mechanics and the role of IL-6 in COPD investigated by end-inflation occlusion method

Alessandro RUBINI ✉

Studies have demonstrated that the mechanical properties of the respiratory system are constantly impaired in chronic obstructive pulmonary disease (COPD), leading to an increase in the system’s elastance and resistance, and, most importantly, affecting the work of breathing. The mechanical impairment characterizing COPD has long been an object of investigation, but the development of the end-inflation occlusion method has provided another effective instrument to evaluate the mechanics of breathing. In fact, it has made it possible to study not only the elastic and resistive properties of the respiratory system, but also its viscoelastic features, which represent a sizable part of the total inspiratory work of breathing. The current study’s primary aim was to review data describing impaired respiratory mechanics characterizing COPD obtained by the end-inflation occlusion method. Literature was analyzed consulting library data base (PubMed, Scopus), and relevant papers studied. Literature analysis has confirmed respiratory mechanics impairment in COPD. On the basis of the end-inflation occlusion method, recent work showed that, beside elastance and ohmic airway resistance, visco-elastic resistance is also increased. The most important feature of increased work of breathing in COPD is the derangement of respiratory mechanics, often leading to ventilator failure and the need for mechanical ventilation. By the end-inflation occlusion method, it was recently shown that interleukin-6 has a relevant effect per se in inflammatory responses and in increasing airway resistance in an animal model.

KEY WORDS: Chronic obstructive pulmonary disease; Interleukin-6, Respiratory mechanics; Work of breathing