Revisiting 'Respiratory Function in Emphysema in Relation to Prognosis'

BACKGROUND: The 1956 paper by DV Bates, JMS Knott and RV Christie, "Respiratory function in emphysema in relation to prognosis" Quart J Med 1956;97:137-157 is largely reprinted with a commentary by the first author, Dr David Bates. Although the pathology of emphysema was well recognized at...

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Main Author: David V Bates
Format: Article
Language:English
Published: Wiley 2000-01-01
Series:Canadian Respiratory Journal
Online Access:http://dx.doi.org/10.1155/2000/503510
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author David V Bates
author_facet David V Bates
author_sort David V Bates
collection DOAJ
description BACKGROUND: The 1956 paper by DV Bates, JMS Knott and RV Christie, "Respiratory function in emphysema in relation to prognosis" Quart J Med 1956;97:137-157 is largely reprinted with a commentary by the first author, Dr David Bates. Although the pathology of emphysema was well recognized at the time, the clinical diagnosis and assessment of its severity were known to be imprecise; physiological measurements assessing and following the clinical course had not been established. The study aimed to follow systematically a group of patients, selected by clinical criteria using standardized clinical and physiological techniques, over four years and correlate physiological and clinical changes in relation to prognosis and eventually to postmortem findings. Fifty-nine patients were recruited to an emphysema clinic at St Bartholomew's Hospital, London, England. Inclusion criteria were dyspnea without other causes and no cor pulmonale present. Patients' symptoms were assessed by a standardized questionnaire, and measurements were taken of lung volumes, maximal ventilatory volume, carbon monoxide diffusing capacity at rest, exercise and oxygen saturation by oximetry.  During the four years of the study, 17 patients died (actuarial expected - four) and 13 presented with signs of pulmonary heart failure. All postmortem examinations (n=9) showed advanced emphysema. A seasonal variation in dyspnea was established (the period included the infamous 1952 London smog). Four patients improved, and the remainder were unchanged or deteriorated. Close relationships were shown between dyspnea and function results, particularly for the diffusing capacity of lungs for carbon monoxide (DLCO. A comparison among a group of patients with chronic bronchitis without dyspnea showed that the DLCO discriminated between them. A loss of the normal increase in DLCO during exercise was shown in emphysema.
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spelling doaj-art-1301469153e243229fc899818a6f7c5e2025-02-03T01:00:40ZengWileyCanadian Respiratory Journal1198-22412000-01-017327127910.1155/2000/503510Revisiting 'Respiratory Function in Emphysema in Relation to Prognosis'David V BatesBACKGROUND: The 1956 paper by DV Bates, JMS Knott and RV Christie, "Respiratory function in emphysema in relation to prognosis" Quart J Med 1956;97:137-157 is largely reprinted with a commentary by the first author, Dr David Bates. Although the pathology of emphysema was well recognized at the time, the clinical diagnosis and assessment of its severity were known to be imprecise; physiological measurements assessing and following the clinical course had not been established. The study aimed to follow systematically a group of patients, selected by clinical criteria using standardized clinical and physiological techniques, over four years and correlate physiological and clinical changes in relation to prognosis and eventually to postmortem findings. Fifty-nine patients were recruited to an emphysema clinic at St Bartholomew's Hospital, London, England. Inclusion criteria were dyspnea without other causes and no cor pulmonale present. Patients' symptoms were assessed by a standardized questionnaire, and measurements were taken of lung volumes, maximal ventilatory volume, carbon monoxide diffusing capacity at rest, exercise and oxygen saturation by oximetry.  During the four years of the study, 17 patients died (actuarial expected - four) and 13 presented with signs of pulmonary heart failure. All postmortem examinations (n=9) showed advanced emphysema. A seasonal variation in dyspnea was established (the period included the infamous 1952 London smog). Four patients improved, and the remainder were unchanged or deteriorated. Close relationships were shown between dyspnea and function results, particularly for the diffusing capacity of lungs for carbon monoxide (DLCO. A comparison among a group of patients with chronic bronchitis without dyspnea showed that the DLCO discriminated between them. A loss of the normal increase in DLCO during exercise was shown in emphysema.http://dx.doi.org/10.1155/2000/503510
spellingShingle David V Bates
Revisiting 'Respiratory Function in Emphysema in Relation to Prognosis'
Canadian Respiratory Journal
title Revisiting 'Respiratory Function in Emphysema in Relation to Prognosis'
title_full Revisiting 'Respiratory Function in Emphysema in Relation to Prognosis'
title_fullStr Revisiting 'Respiratory Function in Emphysema in Relation to Prognosis'
title_full_unstemmed Revisiting 'Respiratory Function in Emphysema in Relation to Prognosis'
title_short Revisiting 'Respiratory Function in Emphysema in Relation to Prognosis'
title_sort revisiting respiratory function in emphysema in relation to prognosis
url http://dx.doi.org/10.1155/2000/503510
work_keys_str_mv AT davidvbates revisitingrespiratoryfunctioninemphysemainrelationtoprognosis