Difference between restrictive and obstructive lung disease

Q: What are restrictive lung diseases?

What is restrictive lung disease? Restrictive lung disease, a decrease in the total volume of air that the lungs are able to hold, is often due to a decrease in the elasticity of the lungs themselves or caused by a problem related to the expansion of the chest wall during inhalation.

Respiration Laboratory Table of Contents Show What is the difference between an obstructive lung disease and a restrictive lung disease name an example of each disease? How do you differentiate obstructive and restrictive lung disease by spirometry? What are restrictive lung diseases?	Theory> Lung Diseases
	In a restrictive lung disease, the compliance of the lung is reduced, which increases the stiffness of the lung and limits expansion. In these cases, a greater pressure ( P) than normal is required to give the same increase in volume ( V). Common causes of decreased lung compliance are pulmonary fibrosis, pneumonia and pulmonary edema. In an obstructive lung disease, airway obstruction causes an increase in resistance. During normal breathing, the pressure volume relationship is no different from in a normal lung. However, when breathing rapidly, greater pressure is needed to overcome the resistance to flow, and the volume of each breath gets smaller. Common obstructive diseases include asthma, bronchitis, and emphysema.
Changes in Lung Volumes
Observe the changes in lung volumes from normal for restrictive and obstructive lung disorders. In the obstructed lung, respiration ends prematurely, thus increasing RV and FRC. In the restricted lung, volumes are small because inspiration is limited due to reduced compliance.

The FVC test allows one to clearly distinguish between the two disease types. Notice in the obstructed lung (below left), how FVC is smaller than normal, but also that FEV1 is much smaller than normal. This is because it is very difficult for a person with an obstructive disease (eg. asthma) to exhale quickly due to the increase in airway resistance. As a result, the FEV1/FVC ratio will be much lower than normal, for example 40% as opposed to 80%.
In the restricted lung, the FVC is again smaller than normal, but the FEV1 is relatively large in comparison. i.e. the FEV1/FVC ratio can be higher than normal, for example 90% as opposed to 80%. This is because it is easy for a person with a restricted lung (e.g fibrosis) to breathe out quickly, because of the high elastic recoil of the stiff lungs.

To continue to the next section: pneumotachometry, click here

Respiratory diseases are among the most serious ailments humans face, and they potentially have symptoms that can create emergency situations in a matter of moments. In these scenarios if treatment does not begin just as quickly, the results can be fatal.

For first responders and medical personnel, forewarning of what to expect from a patient experiencing an emergency caused by a respiratory disease – including their specific diagnosis– can make a substantial difference in speed of treatment and the outcome.

Respiratory diseases largely fall into one of two categories – obstructive or restrictive. These conditions can vary significantly in causes and symptoms, but anyone with a respiratory disease may require airway suction and intubation during an emergency.

Read on for a breakdown of how the categories differ – and their similarities when it comes to emergency treatment.

Obstructive Respiratory Diseases

These are conditions that, as you might expect from the name, obstruct a patient’s ability to exhale air from the lungs. As patients struggle to get air out, the trapped air can affect lung volumes and capacities. Typical symptoms include wheezing, coughing up mucus, persistent cough, tightness in the chest and shortness of breath.

Among the most common diseases in this category are chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis and cystic fibrosis.

COPD – which is typically caused by tobacco smoke or other air pollutants and affects almost 16 million Americans (plus millions more who have not been diagnosed) – includes other lung conditions. These include emphysema or chronic bronchitis, and are good examples of how an obstructive respiratory disease can work. Without treatment or lifestyle changes, COPD is progressive, gradually causing your lungs to lose their natural elasticity and over-expand. Eventually, some air will be trapped in the lungs during exhalation.

Sometimes, a patient with an obstructive respiratory disease may have an exacerbation of their symptoms that requires emergency attention. This scenario may require intubation preceded by suction to clear the airway of excess mucus or sputum.

Restrictive Respiratory Diseases

The opposite of obstructive respiratory diseases, restrictive respiratory diseases prevent a patient’s ability to get air into the lungs. Instead of over-expanding the lungs, volume and capacities shrink.

Restrictive diseases can be further broken down into two types — intrinsic and extrinsic conditions. Intrinsic conditions stem from issues within the lungs, such as pulmonary fibrosis and conditions caused by inhaling dangerous pollutants. Extrinsic conditions are caused by issues occurring outside of the lungs, such as obesity, scoliosis and pleural effusion.

Symptoms can include shortness of breath, wheezing and a persistent cough. Depending on their specific diagnosis, a patient’s cough may include excess mucus, or they may experience excess fluid in their lungs (pneumonia or advanced lung cancers, for example). Again, a crisis scenario may necessitate suction and intubation. What’s the best way to go about that? Let’s take a look.

SALAD and Suction

Intubation is often necessary for a patient with a serious respiratory disease, but without proper airway management before the procedure, it may be difficult or create more harm to the patient.

As described, patients suffering an emergency caused by their respiratory disease may have excess mucus, sputum, fluid or another substance creating a blockage in their airway. Quick, safe suction is required before intubation.

Having a suction aspirator with a pressure level that can be regulated is vital for first responders and hospital personnel. In addition, the SSCOR DuCanto Catheter has a large diameter, is curved to mimic the shape of a patient’s airway and is specifically designed for the SALAD (Suction Assisted Laryngoscopy and Airway Decontamination) technique to facilitate safe, effective suctioning.

No matter the patient’s condition, in an emergency, the proper tools make all the difference.

Editor's Note: This blog was originally published in August 2022. It has been re-published with additional up-to-date content.

Topics: airway obstruction

What is the difference between an obstructive lung disease and a restrictive lung disease name an example of each disease?

While both types can cause shortness of breath, obstructive lung diseases, such as asthma and chronic obstructive pulmonary disorder (COPD), cause more difficulty with exhaling air, while restrictive lung diseases (such as pulmonary fibrosis) can cause problems by restricting a person's ability to inhale air.

How do you differentiate obstructive and restrictive lung disease by spirometry?

Spirometry and the calculation of FEV1/FVC allows the identification of obstructive or restrictive ventilatory defects. A FEV1/FVC < 70 % where FEV1 is reduced more than FVC signifies an obstructive defect (Figure 2).

What are restrictive lung diseases?

What is restrictive lung disease? Restrictive lung disease, a decrease in the total volume of air that the lungs are able to hold, is often due to a decrease in the elasticity of the lungs themselves or caused by a problem related to the expansion of the chest wall during inhalation.