[Diagnosis and therapy of chronic cough].
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Biomedical subjects
Publications and source records attributed to J A Barberà Mir.
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Vocal cord dysfunction is a respiratory condition characterized by anomalous adduction of the vocal cords during inspiration, causing significant air flow limitation in the larynx. Few such cases have been described in which dysfunction is triggered by exercise. We report the case of a young women with severe dyspnea appearing as a result of physical activity. We first deal with issues of differential diagnosis in relation to several other diseases, particularly exercise-induced asthma and then discuss therapeutic approaches.
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We measured pulmonary parenchymal tissue volume (Vt) and pulmonary capillary blood flow (Qc) in 11 normal subjects by a rebreathing technique and end-tidal, dead-space correction (ETDS) method, using two soluble gases, acetylene (C2H2) and dimethyl ether (DME). We assessed the results using different intervals of measurement, inspired volumes and rebreathing frequencies. The mean values +/- SD of Vt were 559 +/- 58 and 511 +/- 52 ml, with C2H2 and DME, and of Qc were 3.67 +/- 0.44 and 4.18 +/- 0.54 liter/min/m2, respectively. Measurements with the interval between the 1st and the 6th end-tidal points and within the first 15 s yielded the best reproducibility. Data obtained from two satisfactory recordings from the same subject are sufficient to calculate Vt and Qc. Inspired volume shows a significant correlation with Vt values measured with both tracer gases, especially with DME. Rebreathing frequency also affects this latter gas. Despite some problems which are not easily explainable (dependence upon the inspired volume, rebreathing frequency and test gas species), we conclude that the methods allow measurements of Vt and Qc with acceptable reproducibility but that different variables may affect the results.