![]() ![]() When analysed in association with measurements of dynamic inspiratory constraints, a high V' E/ V' CO 2 is valuable to ascertain a role for the "lungs" in limiting dyspnoeic patients. As the disease progresses, a high nadir might help to unravel the cause of disproportionate breathlessness. ![]() The V' E/ V' CO 2 nadir, in particular, has been found to be an important predictor of dyspnoea and poor exercise tolerance, even in patients with largely preserved forced expiratory volume in 1 s. In most circumstances, an increased V' E/ V' CO 2 reflects an enlarged physiological dead space ("wasted" ventilation), although alveolar hyperventilation (largely due to increased chemosensitivity) may play an adjunct role, particularly in patients with coexistent cardiovascular disease. There is well established evidence that the minute ventilation ( V' E)/carbon dioxide output ( V' CO 2 ) relationship is relevant to a number of patient-related outcomes in COPD. ![]()
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