Management of restrictive and obstructive lung disease in intensive care unit: a review

Dian Ayu Listiarini*  -  Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Islam Sultan Agung / RSI Sultan Agung, Semarang, Indonesia, Indonesia
Akhmad Yun Jufan  -  Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/ RSUP Dr. Sardjito, Yogyakarta, Indonesia, Indonesia
Calcarina Fitriani Retno Wisudarti  -  Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/ RSUP Dr. Sardjito, Yogyakarta, Indonesia, Indonesia

(*) Corresponding Author
DOI: 10.30659/sainsmed.v15i1.35660

Lung disease is broadly divided into obstructive lung disease (OLD) and restrictive lung disease (RLD). The latter is a disorder of the parenchyma, pleura, thorax, or neuromuscular walls of the lungs, characterized by decreased total lung capacity due to reduced lung distensibility. Meanwhile, OLD causes increased resistance to flow due to the blockage of part or all of the respiratory tract from the trachea to the terminal bronchioles. These two diseases' initial symptoms and signs are common, such as shortness of breath, coughing, cyanosis, respiratory muscle retractions, snoring, and fever. Early detection is needed to recognize differences in symptoms and signs, establish a diagnosis, and carry out appropriate treatment. It is essential to differentiate between RLD and OLD because they have different therapeutic management. This review aims to discuss the management of restrictive and obstructive lung disease in intensive care unit It is drawn upon various sources, including case reports, literature reviews, systematic reviews, and meta-analyses, to provide an overview of the difference between RLD and OLD to help clinicians differentiate between RLD and OLD and provide appropriate therapeutic management. Although RLD and OLD have similar signs and symptoms, they have different pathologic processes. The leading cause of RLD is a pathological condition that causes a decrease in lung compliance. Meanwhile, the primary pathological process of OLD is an increase in airway resistance, which causes typical obstructive symptoms. Addressing this area of interest can help clinicians to provide appropriate management of both pharmacotherapy and mechanical ventilation and monitoring of respiratory mechanisms

Keywords: Management; Intensive; Restrictive; Obstructive

  1. Apovian, C.M., Aronne, L.J, Bessesen, D.H., McDonnell, M.E., Murad, M.H., Pagotto, U., Ryan, D., & Still, C.D. (2015). Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 100 (2): 342-262. https://doi.org/10.1210/jc.2014-3415.
  2. Arnal, J. M., Garnero, A., Saoli, M., & Chatburn, R. L. (2018). Parameters for simulation of adult subjects during mechanical ventilation. Respiratory Care, 63(2): 158-168. https://doi.org/10.4187/respcare.05775.
  3. Agustí A., Celli, B.R., Criner, G.J., Halpin, D., Anzueto, A., Barnes P., et al. (2023). Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. American Journal of Respiratory and Critical Care Medicine. 207(7):819-837. https://doi.org/10.1164%2Frccm.202301-0106PP.
  4. Branson, R. (2014). Principles and Practice of Mechanical Ventilation, Third Edition. Critical Care Medicine, 42(6): e488. https://doi.org/10.1097/ccm.0000000000000286.
  5. Carbonara, P., & Nava, S. (2012). Noninvasive mechanical ventilation. Clinical Respiratory Medicine, page 431–436. Elsevier. https://doi.org/10.1016/B978-1-4557-0792-8.00033-7.
  6. Davidson, K. R., Ha, D. M., Schwarz, M. I., & Chan, E. D. (2020). Bronchoalveolar lavage as a diagnostic procedure: A review of known cellular and molecular findings in various lung diseases. Journal of Thoracic Disease, 12(9): 4991-5019. https://doi.org/10.21037/jtd-20-651.
  7. Dillane, D. (2021). Restrictive lungdisease Preoperative Assessment: A Case-Based Approach, page 101–106. Springer International Publishing. https://doi.org/10.1007/978-3-030-58842-7_16.
  8. Dsouza, K. G., Alexander, A. S., Watts Jr, J. R., & Kulkarni, T. (2022). Management of interstitial lung disease in patients with autoimmune disease-related interstitial lung disease. Multidisciplinary Respiratory Medicine, 18(1):1-10. https://doi.org/10.4081/mrm.2023.890.
  9. D’urzo, K. A., Mok, F., &D’Urzo, A.D. (2020). Variation among spirometry interpretation algorithms. Respiratory Care, 65(10): 1585-1590. https://doi.org/10.4187/respcare.07294.
  10. Kemenkes-RI. (2023). Survei Kesehatan Indonesia (SKI). https://www.badankebijakan.kemkes.go.id/hasil-ski-2023/. Accessed on 1 January 2024.
  11. Facchinetti, F., Civelli, M., Singh, D., Papi, A., Emirova, A., & Govoni, M. (2021). Tanimilast, A Novel Inhaled Pde4 Inhibitor for the Treatment of Asthma and Chronic Obstructive Pulmonary Disease. Frontiers in Pharmacology, 23(12): 1-18. https://doi.org/10.3389/fphar.2021.740803.
  12. Glick, D. R., Galvin, J. R., & Deepak, J. (2020). Complex obstructive lung disease – A diagnostic and management conundrum. Respiratory Medicine Case Reports, 31(101283): 1-4. https://doi.org/10.1016/j.rmcr.2020.101283.
  13. Gold. (2022). Global Initiative for Chronic Obstructive Lung Disease. Pocket Guide to COPD Diagnosis, Management, and Prevention. Global Initiative for Chronic Obstructive Lung Disease, Inc. https://goldcopd.org/wp-content/uploads/2023/03/POCKET-GUIDE-GOLD-2023-ver-1.2-17Feb2023_WMV.pdf. Accessed on 2 February 2024.
  14. Goligher, E.C., Ferguson, N.D., Brochard, L.J. (2016). Clinical challenges in mechanical ventilation. Lancet, 387(10030):1856-66. https://doi.org/10.1016/S0140-6736(16)30176-3.
  15. Gruden, J.F, Green, D.B., Girvin, F.G., Naidich, D.P. Current Imaging of Idiopathic Pulmonary Fibrosis. Radiol Clin North Am. 2022 Nov;60(6):873-888. doi: 10.1016/j.rcl.2022.06.012. Epub 2022 Aug 29. PMID: 36202475.. https://doi.org/10.1016/j.rcl.2022.06.012.
  16. Gulhane, A., & Chen, D. L. (2020). Imaging in Asthma. Molecular Imaging (Second Edition), 1433-1446. https://doi.org/10.1016/B978-0-12-816386-3.00081-8.
  17. Hariri, L. P., Roden, A.C., Chung, J.H., Danoff, S.K., Gomez, D.C, Hartwig, M., et al. (2021). The role of surgical lung biopsy in diagnosing fibrotic interstitial lung disease: Perspective from the pulmonary fibrosis foundation. Annals of the American Thoracic Society, 18 (10): 1601-1609. https://doi.org/10.1513/AnnalsATS.202009-1179FR.
  18. Hirai, T. (2021). Pulmonary Function Tests. In: Ohno, Y., Hatabu, H., Kauczor, HU. (eds) Pulmonary Functional Imaging. Medical Radiology. Springer, Cham. https://doi.org/10.1007/978-3-030-43539-4_2.
  19. Jentzer, J., Dezfulian, C., Emlet L.(2016). High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure: the FLORALI study. F1000Research, 5(41): . https://doi.org/10.12688/f1000research.7360.1.
  20. Koyauchi, T., Hasegawa, H., Kanata, K., Kakutani, T., Amano, Y., Ozawa, Y., et al. (2018). Efficacy and Tolerability of High-Flow Nasal Cannula Oxygen Therapy for Hypoxemic Respiratory Failure in Patients with Interstitial Lung Disease with Do-Not-Intubate Orders: A Retrospective Single-Center Study. Respiration, 96 (4): 323–329. https://doi.org/10.1159/000489890.
  21. Lutfi, M. F. (2017). The physiological basis and clinical significance of lung volume measurements. Multidisciplinary Respiratory Medicine, 12(3): 1-12 . https://doi.org/10.1186/s40248-017-0084-5.
  22. Mafort, T.T., Rufino, R., Costa, C.H. & Lopes, A.J. (2016). Obesity: systemic and pulmonary complications, biochemical abnormalities, and impairment of lung function. Multidisciplinary Respiratory Medicine 11(28): 1-11. https://doi.org/10.1186/s40248-016-0066-z.
  23. McCauley, P., & Datta, D. (2012). Management of COPD Patients in the Intensive Care Unit. Critical Care Nursing Clinics of North America, 24(3): 419-430. https://doi.org/10.1016/j.ccell.2012.06.001.
  24. Mittal, K. (2019). OH’s intensive care manual. Journal of Pediatric Critical Care, 6(2): 80. https://doi.org/10.21304/2019.0602.00497.
  25. Myc, L. A., Shim, Y. M., Laubach, V. E., & Dimastromatteo, J. (2019). Role of medical and molecular imaging in COPD. Clinical and Translational Medicine, 8(12: 1-11. https://doi.org/10.1186/s40169-019-0231-z.
  26. Novelli, M., et al. (2022). Chronic Obstructive Pulmonary Disease (COPD). In Noninvasive Mechanical Ventilation in Anesthesiology and Perioperative Medicine. https://doi.org/10.29309/tpmj/2016.23.09.1701.
  27. Otsuka, H., Sano, A., Azuma, Y., Sakai, T., Koezuka, S., Sugino, K., Sakamoto, S., Tochigi, N., Homma, S., & Iyoda, A. (2022). Surgical lung biopsy for interstitial lung diseases—A single center study of 129 patients. Journal of Thoracic Disease, 14(6): 1972-1979. https://doi.org/10.21037/jtd-21-1773.
  28. Porsbjerg, C., & Westergaard, C. (2021). Asthma—Clinical Features and Diagnosis. Encyclopedia of Respiratory Medicine (Second Edition), 269-277. https://doi.org/10.1016/B978-0-08-102723-3.00068-8.
  29. Praud, J., & Redding, G. J. (2018). Chest Wall and Respiratory Muscle Disorders. Kendig's Disorders of the Respiratory Tract in Children (Ninth Edition), 1044-1061.e2. https://doi.org/10.1016/B978-0-323-44887-1.00072-9.
  30. Ren, J., Chen, W., Zhong, Z., Wang, N., Chen, X., Yang, H., Li, J., Tang, P., Fan, Y., Lin, F., Bai, C., & Wu, J. (2023). Bronchoalveolar Lavage Fluid from Chronic Obstructive Pulmonary Disease Patients Increases Neutrophil Chemotaxis Measured by a Microfluidic Platform. Micromachines, 14(1740): 1-14. https://doi.org/10.3390/mi14091740.
  31. Restrepo, R. D., & Khusid, F. (2022). Essentials of ventilator graphics. Indian Journal of Respiratory Care, 3(1): 396-404. https://doi.org/10.5005/ijrc-3-1-396.
  32. Rittner, F., & Döring, M. (2015). Curves and Loops in Mechanical Ventilation. Dranger Technology for Life. https://www.draeger.com/Content/Documents/Products/curves-loops-booklet-9097421-en.pdf. Accessed 3 March 2024.
  33. Rodrigo, Gustavo J.. (2018). Anticholinergics for asthma: a long history. Current Opinion in Allergy and Clinical Immunology, 18(1): 38-43. https://doi.org/10.1097/aci.0000000000000408.
  34. Sarkar, M., et al. (2022). Use of flow-volume curve to evaluate large airway obstruction. Monaldi Archives for Chest Disease 92(1947): 1-7. https://doi.org/10.4081/monaldi.2022.1947
  35. Shorr, A. F & William, M.D. (2009). Venous thromboembolism in critically ill patients. Observations from a randomized trial in sepsis. Thrombosis and Haemostasis, 101(1): 139–144. https://doi.org/10.1160/TH08-07-0468.
  36. Singh, M., Agarwal, S.K., Meena, M., & Singh, S. (2016). Effect of low dose theophylline as adjunct in treatment of COPD. European Respiratory Journal, 48(60): https://doi.org/10.1183/13993003.congress-2016.PA303.
  37. Spagnolo, P., Distler, O., Ryerson, C. J., Tzouvelekis, A., Lee, J. S., Bonella, F., Bouros, D., Hoffmann-Vold, M., Crestani, B., & Matteson, E. L. (2021). Mechanisms of progressive fibrosis in connective tissue disease (CTD)-associated interstitial lung diseases (ILDs). Annals of the Rheumatic Diseases, 80(2): 143-150. https://doi.org/10.1136/annrheumdis-2020-217230.
  38. Sparling, J. L., & Melo, M. F. V. (2021). Pulmonary Pathophysiology and Lung Mechanics in Anesthesiology. Cohen's Comprehensive Thoracic Anesthesia, 66-87. https://doi.org/10.1016/B978-0-323-71301-6.00005-6.
  39. Tawfik. P, Syed, M.K.H., Elmufdi, F.S., Evans, M.D,, Dries, D.J., and Marini, J.J. (2022). Static and Dynamic Measurements of Compliance and Driving Pressure: A Pilot Study. Frontiers in Physiology, 13(773010): 1-8. https://doi.org/10.3389/fphys.2022.773010
  40. Tsukahara, K., & Mayer, O. H. (2022). Thoracic insufficiency syndrome: Approaches to assessment and management. Paediatric Respiratory Reviews, 44, 78-84. https://doi.org/10.1016/j.prrv.2022.02.003.
  41. Vincent, J.-L., et al. (2023). Textbook of critical care (8 Edition). Elsevier. https://www.us.elsevierhealth.com/textbook-of-critical-care-9780323759298.html. Accessed 16 January 2024.
  42. Wang, H. Y., & Sharma, M. M. (2017). A new variable compliance method for estimating closure stress and fracture compliance was developed from DFIT data in arXiv. https://arxiv.org/pdf/1710.06464. Accessed 16 March 2024.
  43. Weiss, C. H., David, B., Shyna, W., Meagan., B., Margaret, Alfred, R., et al. (2016). Low tidal volume ventilation use in acute respiratory distress syndrome. Critical Care Medicine, 44(8). https://doi.org/10.1097/CCM.0000000000001710.
  44. Wijsenbeek, M., et al. (2022). Interstitial lung diseases. The Lancet, 400(10354): 769–786. Elsevier B.V. https://doi.org/10.1016/S0140-6736(22)01052-2.
  45. Winter, R., & Dakin, J. (2020). The flow volume loop. Making Sense of Lung Function Tests. https://doi.org/10.1201/b13508-10.

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