The bronchodilator test in patients with airway obstruction: the responsiveness of lung function parameters
https://doi.org/10.33667/2078-5631-2021-5-57-61
Abstract
Interpretation of bronchodilator (BD) test based on reaction of forced expiratory in one second (FEV 1). For assessing bronchodilator responsiveness of lung volumes, airway resistance remains largely unexplored. Therefore, we assessed the response of pulmonary function parameters to BD to reveal the most responsive parameter. 90 patients with chronic airway obstruction (61 male and 29 female; aged 55±11; post- BD FEV 1 was 63.1+18.3 % predicted) performed spirometry and static lung volume measurements before and after inhalation of BD. We calculated effect size (ES) for each parameter from the difference between two means divided by the standard deviation of baseline score. There was a significant increase both FVC and FEV 1by 8.2 and 12.3 % from baseline (p<0.001). ES were 0.34 for FEV1 and 0.26 for FVC. The ES for lung volumes were from -0.07 (total lung capacity) to -0.31 (residual volume). The ES for sRtot (specific airway resistance) was -0.5 and ES for sGeff (specific effective airway conductance) was 0.95. The parameters of airway resistance and conductance were more responsive for the assessment of pulmonary function changes than spirometry and lung volumes parameters in patients with chronic airway obstruction.
About the Authors
M. I. Chushkin
Central research Institute of Tuberculosis, Moscow
Russian Federation
Russian Federation
L. A. Popova
Central research Institute of Tuberculosis, Moscow
Russian Federation
Russian Federation
E. A. Shergina
Central research Institute of Tuberculosis, Moscow
Russian Federation
Russian Federation
N. L. Karpina
Central research Institute of Tuberculosis, Moscow
Russian Federation
Russian Federation
References
1. Чучалин А. Г., Ай санов З.Р., Чикина С. Ю., Черняк А. В., Калманова Е. Н. Федеральные клинические рекомендации Российского респираторного общества по использованию метода спирометрии. Пульмонология. 2014;(6):11–24.
2. Черняк А. В., Авдеев С. Н., Пашкова Т. Л., Айсанов З. Р. Бронходилатационный тест у больных с хронической обструктивной болезнью легких. Пульмонология. 2003;1:51–56.
3. Newton M. F., O’Donnell D.E., Forkert L. Response of lung volumes to inhaled salbutamol in a large population of patients with severe hyperinflation. Chest. 2002;121(4):1042–50.
4. Ward H., Cooper B. G., Miller M. R. Improved criterion for assessing lung function reversibility. Chest. — 2015 — Vol. 148(4):877–886. doi: 10.1378/chest.14–2413
5. Chushkin M., Karpina N., Popova L., Shergina E., Kiryukhina L., Ots O., Nenasheva O. The bronchodilator test in patients with chronic airway obstruction: the responsiveness of lung function parameters. European Respiratory Journal, 2018; Volume 52, Suppl. 62, PA1391.
6. Miller M. R., Hankinson J., Brusasco V., Burgos F., Casaburi R., Coates A., Crapo R., Enright P., van der Grinten C. P., Gustafsson.P, Jensen R., Johnson D. C., MacIntyre N., McKay R., Navajas D., Pedersen O. F., Pellegrino R., Viegi G., Wanger J.; ATS/ERS Task Force. Standardisation of spirometry. // Eur Respir J. — 2005. — Vol. 26. — N 2. — P. 319–338.
7. Wanger J., Clausen J. L., Coates A. et al. Standardisation of the measurement of lung volumes. Eur Respir J. 2005;26(3):511–522.
8. Pellegrino R.., Viegi G, Brusasco V., Crapo R. O., Burgos F., Casaburi R., Coates A., van der Grinten C. P.M., Gustafsson P., Hankinson J., Jensen R., Johnson D. C., MacIntyre N., McKay R., Miller M. R., Navajas D.,. Pedersen OF and Wanger J. Interpretative strategies for lung function tests. Eur Respir J, 2005;26:948–968.
9. Quanjer P. H., Tammeling G. J., Cotes J. E., Pedersen O. F., Peslin R., Yernault J. C. Lung volumes and forced ventilatory flows. Eur Respir J. — 1993–6 (Suppl 16):5–40. doi: 10.1183/09041950.005s1693
10. Husted J. A., Cook R. J., Farewell V. T., Gladman D. D. Methods for assessing responsiveness: a critical review and recommendations. Journal of Clinical Epidemiology. 2000;53(5):459–168.
11. McCartney С.Е., Weis M. Т., Ruppel G. L. and Nayak R. P. Residual Volume and Total Lung Capacity to Assess Reversibility in Obstructive Lung Disease. Respir Care. — 2016;61(11):1505–1512.
12. Kaminsky D. A. What does airway resistance tell us about lung function? Respir Care. — 2012;57(1):85–96. doi: 10.4187/respcare.01411
13. Topalovic M., Derom E., Osadnik C. R., Troosters T., Decramer M., Janssens W.; Belgian Pulmonary Function Study Investigators. Airways resistance and specific conductance for the diagnosis of obstructive airways diseases. Respir Res. — 2015. — 22;16:88. doi: 10.1186/s12931-015-0252-0.
14. Cohen J. J. (1988). Statistical power analysis for the behavioral sciences (p. 8). Erlbaum: Hillsdale, NJ.
Review
For citations:
Chushkin M.I., Popova L.A., Shergina E.A., Karpina N.L. The bronchodilator test in patients with airway obstruction: the responsiveness of lung function parameters. Medical alphabet. 2021;(5):57-61. (In Russ.) https://doi.org/10.33667/2078-5631-2021-5-57-61
Views:
3191
Email this article 