Restrictive Lung Disease
Restrictive lung disease (RLD) is highly prevalent and frequently disabling and is caused by a myriad of both pulmonary and extrapulmonary conditions. It is defined as a reduction of total lung capacity (TLC) below the 5th percentile of the predicted value, with a preserved one second forced expiratory volume to forced vital capacity ratio (FEV1/FVC). Diagnosis therefore requires the use of less commonly available lung volume tests. The diffusion capacity of carbon monoxide (DLCO) can help distinguish between RLD due to intrinsic lung disease, in which DLCO is frequently reduced, and extrapulmonary restriction, in which DLCO is preserved. Because of the difficulty in diagnosis and variety of etiologies, the clinical impact of RLD is not well understood. Patients with RLD are thought to be at risk for exaggerated postoperative pulmonary complications, although the degree of risk has not been well studied. Underlying restrictive deficits may be worsened by perioperative atelectasis, loss of inspiratory muscle tone during anesthesia, pulmonary edema, or postoperative pneumonia.
KeywordsChronic Obstructive Pulmonary Disease Pulmonary Edema Forced Expiratory Volume Total Lung Capacity Hypersensitivity Pneumonitis
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