Biomedical subjects
Publications and source records attributed to Michael I Polkey.
This article explores the hypothesis that dyspnea in patients with COPD arises from an imbalance between the load placed on the respiratory muscle pump and its capacity. Evidence to support this concept is presented, and possible therapeutic approaches are discussed.
Bronchoscopic lung volume reduction (BLVR) is emerging as a new technique to palliate symptoms in patients with severe emphysema. Several devices and techniques are being developed to occlude airways resulting in collapse and reduced lung volume. Here we present in detail the methodological aspects of one such interventional bronchoscopic approach.
Chronic obstructive pulmonary disease (COPD) is the commonest respiratory cause of mortality and morbidity in adults in the UK. Although the condition is initially a pulmonary one, data exist to support the concept that factors associated with COPD, including immobility, gives rise to secondary effects, including a quadriceps myopathy, which in turn cause anaerobic metabolism at low work rates. This, through bicarbonate buffering, leads to CO2 retention which, because of constraints imposed by pulmonary mechanics, cause acidosis and dyspnoea. Various therapeutic strategies to reverse this spiral may be employed including pulmonary rehabilitation, quadriceps strength training and surgical or bronchoscopic lung volume reduction.