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Assessment of lung volumes and capacities in bronchodilator reversibility changes of hyperinflation of COPD
PDPI Surakarta, 06 Mar 2018 15:00:37

Wafaa Gadallah1, Atef Farouk1, Abd Elazeem Aboelfadl1 and Manal Alkhawaga1
1Chest, Assiut University, Assiut, Egypt

 

Background: Bronchodilator reversibility in COPD patients traditionally used FEV1 as the marker of reversibility but FEV1 has been demonstrated to lack sensitivity in some cases and is generally a poor predictor of improvement in patients with advanced COPD.

Objective: Validate the use of lung volumes and capacities as a noninvasive technique capable of assessment of bronchodilator reversibility changes in hyperinflated patients with COPD. Study design and intervention: Randomized controlled study included 110 hyperinflated stable COPD patients (TLC >120% predicted) They were classified into mild (n= 46) moderate (n= 32) and severe hyperinflation (n= 32).Main outcome measures: Measurement of IC, RV, FRC or TLC before and after bronchodilator administration together with standard FEV1 and FVC.


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Results:
Salbutamol resulted in a significant increase in FEV1 (p=0.045), FVC, IC and a significant reduction in TLC, FRC, and RV (p=0.002). The magnitude of changes was greater in the severe group. There was a significant positive correlation betweenImageIC andImageFEF 25-75% (r=0.373&p=0.036) and similarly between ImageIC andImageFEV1 (r=0.675&p=0.000). However, the correlations ofImageFVC,ImageIC, andImageRV withImageFEF 25-75% % were non significant (p=0.612, p=0.723, p=767).

Conclusion: lung volumes and capacities along with the standard spirometric indexes be measured when determining bronchodilator responsiveness in patients with baseline hyperinflation should have closer attention.