Hyperinflation and COPD exacerbations

Patients with COPD (chronic obstructive pulmonary disease) often suffer from periods with increased dyspnoea, especially during the influenza season. These periods are called exacerbations or lung attacks. Severe exacerbations require hospital admission. Wouter van Geffen is a consultant respiratory medicine who investigated these exacerbations. He concluded that dyspnoeic COPD patients admitted with an exacerbation of COPD often suffer from excess air in their lungs.

Van Geffen and his team observed that during these attacks breathing was more difficult, because exhaling rather than inhaling is compromised. Their research showed that during exacerbations entrapment of air in the lungs during expiration occurs, causing the lungs to hyperinflate. This might be caused by increased obstruction of the airways and alveoli. During exacerbations, especially the patients with this entrapped air are dyspnoeic. In his thesis Van Geffen and his colleagues also discovered that the cause of the exacerbations can be detected faster with an electronic nose (E-Nose).

Next steps were taken to find the most efficient way to remove the excess air during a lung attack. The most potential options to treat the hyperinflated lungs are stronger bronchodilators via inhalers and closure of the worst parts of the lungs e.g. via valves or airway bypasses.