CHEST Board Review: SEEK Sessions (4 New Videos! October 2025)-SEEK Board Review Session 2025: Dr. Darcy Marciniuk

Video Transcription

Video Summary

This lecture discusses key clinical considerations for pulmonary function testing and COPD management. First, the six-minute walk test (6MWT) is a simple, reliable tool for assessing functional capacity but requires two baseline tests due to a learning effect, and should be standardized including oxygen use and encouragement. It provides limited physiological insight, so cardiopulmonary exercise testing (CPET) is preferred when underlying causes are needed. For COPD patients with chronic hypercapnia post-exacerbation, long-term nocturnal non-invasive ventilation (NIV) is beneficial if clinically stable around four weeks after discharge with elevated PCO2. In preoperative COPD assessment for lung cancer surgery, CPET peak VO2 >20 mL/kg/min indicates low surgical risk, often obviating need for other tests like stair climbing. Regarding therapy, triple inhaled therapy (ICS/LABA/LAMA) improves lung function, quality of life, reduces exacerbations and mortality versus dual therapy, with manageable pneumonia risk. Lastly, roflumilast is appropriate for patients with chronic bronchitis, FEV1 <50%, and prior exacerbations to reduce further episodes, highlighting nuanced personalized COPD treatment.

Keywords

pulmonary function testing

COPD management

six-minute walk test

cardiopulmonary exercise testing

non-invasive ventilation

triple inhaled therapy