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Dynamic hyperinflation is a phenomenon that occurs when a new breath begins before the lung has reached the static equilibrium volume. [1] In simpler terms, this means that a new breath starts before the usual amount of air has been breathed out, leading to a build-up of air in the lungs, and causing breathing in and out to take place when the lung is nearly full.
The increased total lung capacity (hyperinflation) can result in the clinical feature of a barrel chest – a chest with a large front-to-back diameter that occurs in some individuals with emphysematous COPD. Hyperinflation can also be seen on a chest X-ray as a flattening of the diaphragm. [citation needed]
Typically, infections cause 75% or more of the exacerbations; bacteria can roughly be found in 25% of cases, viruses in another 25%, and both viruses and bacteria in another 25%. Airway inflammation is increased during the exacerbation resulting in increased hyperinflation, reduced expiratory air flow and decreased gas exchange. [1] [2]
However, in asthma, the airflow limitation usually completely resolves after exacerbations, whereas in COPD it may not. [1] ACO presents with a chronic airflow limitation or obstruction (due to inflammation), with characteristics of both asthma and COPD. Inflammation of the large and medium airways (classically seen with asthma) is seen in ACO. [1]
Reduced oxygen saturation levels (but above 92%) are often encountered. Examination of the lungs with a stethoscope may reveal reduced air entry and/or widespread wheeze. [6] The peak expiratory flow can be measured at the bedside; in acute severe asthma, the flow is less than 50% of a person's normal or predicted flow. [6]
It is also preferred due to the former term giving the false impression that asthma is caused by exercise. In a patient with EIB, exercise initially follows the normal patterns of bronchodilation. However, by three minutes, the constriction sets in, which peaks at around 10–15 minutes, and usually resolves itself by an hour.
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