handbook h a n d The European Respiratory Society (ERS) b Handbook of Respiratory Medicine, now in o its second edition, is a concise, compact and Respiratory o easy-to-read guide to each of the key areas in k respiratory medicine. Its 18 chapters, written by clinicians and researchers at the forefront R Medicine of the field, explain the structure and function e s of the respiratory system, its disorders and p how to treat them. i r a 2nd Edition t The Handbook is a must-have for anyone o r who intends to remain up to date in the y field, and to have within arm’s reach a M Editors reference that covers everything from the e basics to the latest developments in d Paolo Palange i respiratory medicine. c i n Anita K. Simonds e Paolo Palange is head of the Pulmonary Function and Research Unit in the Department of Clinical Medicine at the Sapienza University of Rome, and is the HERMES Director. Anita Simonds is Consultant in Respiratory & Sleep Medicine at NIHR Respiratory Biomedical Research Unit,Royal Brompton & Harefield NHS Trust, London, and is the ERS School Chair. handbook Respiratory Medicine 2nd Edition Editors Paolo Palange and Anita K. Simonds PUBLISHED BY THE EUROPEAN RESPIRATORY SOCIETY CHIEF EDITORS Paolo Palange (Rome, Italy) Anita K. Simonds (London, UK) ERS STAFF Alice Bartlett, Matt Broadhead, Neil Bullen, Alyson Cann, Jonathan Hansen, Sarah Hill, Fiona Marks, Elin Reeves, David Sadler, Claire Turner © 2013 European Respiratory Society Design by Claire Turner and Lee Dodd, ERS Typeset in China by Charlesworth Group Printed by Charlesworth Press All material is copyright to the European Respiratory Society. It may not be reproduced in any way including electronically without the express permission of the society. CONTACT, PERMISSIONS AND SALES REQUESTS: European Respiratory Society, 442 Glossop Road, Sheffield, S10 2PX, UK Tel: +44 114 2672860 Fax: +44 114 2665064 e-mail: [email protected] ISBN 978-1-84984-040-8 Table of contents Contributors xiv Preface xxix Get more from this Handbook xxx List of abbreviations xxxi Chapter 1 – Structure and function of the respiratory system Genetics 1 Gernot Zissel Molecular biology of the lung 7 Melanie Königshoff and Oliver Eickelberg Anatomy of the respiratory system 13 Pallav L. Shah Respiratory physiology 18 Susan A. Ward Cytology of the lung 29 Venerino Poletti, Giovanni Poletti, Marco Chilosi and Bruno Murer Immunology and defence mechanisms 39 Bruno Balbi, Davide Vallese, Alessandro Pitruzzella, Chiara Vicari and Antonino Di Stefano Chapter 2 – Signs and symptoms Cough and sputum 45 Alyn H. Morice Dyspnoea 51 Pierantonio Laveneziana and Giorgio Scano Chest pain 59 Matthew Hind Physical examination 61 Martyn R. Partridge Chapter 3 – Pulmonary function testing Static and dynamic lung volumes 66 Riccardo Pellegrino and Andrea Antonelli Respiratory mechanics 72 Daniel Navajas and Ramon Farré Gas transfer: TLCO and TLNO 77 J. Mike Hughes Control of ventilation 82 Brian J. Whipp and Susan A. Ward Arterial blood gas assessment 87 Paolo Palange, Alessandro Maria Ferazza and Josep Roca Exercise testing 94 Paolo Palange and Paolo Onorati Bronchial provocation testing 99 Kai-Håkon Carlsen Sputum and exhaled breath analysis 103 Patrizia Pignatti, Andrea Zanini, Sabrina Della Patrona, Federico Gumiero, Francesca Cherubino and Antonio Spanevello Chapter 4 – Other diagnostic tests Bronchoscopy 109 Pallav L. Shah Bronchoalveolar lavage 114 Patricia L. Haslam Fine-needle biopsy 122 Stefano Gasparini Medical thoracoscopy/pleuroscopy 124 Robert Loddenkemper Thoracentesis 128 Emilio Canalis and Mari Carmen Gilavert Interventional pulmonology 131 Marc Noppen Chapter 5 – Lung imaging Chest X-ray and fluoroscopy 136 Walter De Wever Lung CT and MRI 141 Johny A. Verschakelen HRCT of the chest 146 Johny A. Verschakelen Nuclear medicine of the lung 151 Antonio Palla and Duccio Volterrani Transthoracic ultrasound 154 Florin von Groote-Bidlingmaier, Coenraad F.N. Koegelenberg and Chris T. Bolliger Chapter 6 – Lung injury and respiratory failure Lung injury 159 Bernrd Schönhofer and Christian Karagiannidis Respiratory failure 162 Nicolino Ambrosino and Fabio Guarracino NIV in acute respiratory failure 166 Anita K. Simonds Acute oxygen therapy 171 Anita K. Simonds Assessment for anaesthesia/surgery 174 Macé M. Schuurmans, Chris T. Bolliger and Annette Boehler Long-term ventilation 178 Anita K. Simonds Chapter 7 – Respiratory Infections Microbiology testing and interpretation 183 Magareta Ieven Upper respiratory tract infections 190 Gernot Rohde Infective exacerbations of COPD 194 Marc Miravitlles Pneumonia 199 Mark Woodhead Hospital-acquired pneumonia 203 Francesco Blasi Opportunistic infections in the immunocompromised host 207 Thomas Fuehner, Mark Greer, Jens Gottlieb and Tobias Welte Pneumonia in the immunocompromised host 211 Santiago Ewig Pleural infection and lung abscess 215 Amelia Clive, Clare Hooper and Nick Maskell Influenza, pandemics and SARS 222 Wei Shen Lim Chapter 8 – Tuberculosis Pulmonary tuberculosis 229 Giovanni Sotigu and Giovanni Battista Migliori Extrapulmonary tuberculosis 241 Aik Bossink Tuberculosis in the immunocompromised host 245 Martina Sester Latent tuberculosis 248 Jean-Pierre Zellweger Nontuberculous mycobacterial diseases 251 Claudio Piersimoni Laboratory diagnosis of mycobacterial infections 255 Claudio Piersimoni Chapter 9 – Airway diseases Chronic rhinitis 261 Arnaud Bourdin and Pascal Chanez Asthma 264 Bianca Beghé, Leonardo M. Fabbri and Paul O’Byrne Vocal cord dysfunction 274 Adel H. Mansur Bronchitis 279 Gernot Rohde Gastro-oesophageal reflux 281 Lieven Dupont COPD and emphysema 287 Eleni G. Tzortaki and Nikolaos M. Siafakas Exacerbations of COPD 293 Alexander J. Mackay and Jadwiga A. Wedzicha Extrapulmonary effects of COPD 300 Yvonne Nussbaumer-Ochsner and Klaus F. Rabe Pharmacology of asthma and COPD 304 Peter J. Barnes Bronchiectasis 311 Nick ten Hacken Cystic fibrosis 315 Andrew Bush and Jane C. Davies Chapter 10 – Occupational and environmental lung Work-related and occupational asthma 327 Eleftherios Zervas and Mina Gaga Respiratory diseases caused by acute inhalation of gases, vapours and dusts 332 Benoit Nemery Hypersensitivity pneumonitis 337 Torben Sigsgaard and Anna Rask-Andersen Pneumoconiosis 341 Allan F. Henderson Indoor and outdoor pollution 345 Giovanni Viegi, Marzia Simoni, Sara Maio, Sonia Cerrai, Giuseppe Sarno and Sandra Baldacci Smoking-related diseases 352 Yves Martinet and Nathalie Wirth Treatment of tobacco dependence 357 Luke Clancy and Zubair Kabir High-altitude disease 361 Yvonne Nussbaumer-Ochsner and Konrad E. Bloch Diving-related diseases 366 Elinar Thorsen