Document Detail

Assessment of bronchodilator response through changes in lung volumes in chronic airflow obstruction.
MedLine Citation:
PMID:  14628645     Owner:  NLM     Status:  MEDLINE    
Although FEV1 improvement is routinely used to define bronchodilator (BD) response, it correlates poorly with clinical effects. Changes in lung volumes (LV) have shown better correlation with exercise tolerance and might be more sensitive to detect BD effects. We assessed the additional contribution of measuring LV before and after BD to detect acute improvement in lung function not demonstrated by FEV1, and the influence of the response criteria selected on this contribution. We analyzed 98 spirometries and plethismographies performed pre and post BD in patients with airflow obstruction (FEV1/FVC < 70%). BD response was defined for FEV1 and FVC as per ATS guidelines and for other LV as delta > or = 10% of baseline (delta > or = 5 and > or = 15% were also analyzed). FEV1 identified as responders 32% of patients. Greater proportions were uncovered by slow vital capacity (51%, p < 0.001), inspiratory capacity (43%, p < 0.05) and residual volume (54%, p < 0.001). Slow spirometry identified 11% of responders additional to those detected by FEV1 and FVC. Plethismography added 9% more. The magnitude of volume responses correlated with the degree of baseline hyperinflation. Percentages of responders varied greatly using different thresholds (delta > or = 5 and > or = 15%). Mean change and proportions of responders for each LV varied significantly (p < 0.05) whether change was expressed as percent of baseline or predicted values. A considerable proportion of patients with airflow obstruction shows acute response to bronchodilators identified by changes in lung volumes but not detected by an improvement in FEV1. The selection of LV response criteria has important influence on the magnitude of this additional detection.
Juan B Figueroa-Casas; Ana R Diez; María P Rondelli; Marcelo P Figueroa-Casas; Juan C Figueroa-Casas
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Medicina     Volume:  63     ISSN:  0025-7680     ISO Abbreviation:  Medicina (B Aires)     Publication Date:  2003  
Date Detail:
Created Date:  2003-11-21     Completed Date:  2004-02-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0204271     Medline TA:  Medicina (B Aires)     Country:  Argentina    
Other Details:
Languages:  eng     Pagination:  377-82     Citation Subset:  IM    
Departmento Medicina Respiratoria, Instituto Cardiovascular de Rosario.
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MeSH Terms
Administration, Inhalation
Airway Resistance
Bronchodilator Agents / pharmacology*,  therapeutic use
Forced Expiratory Volume
Lung Volume Measurements*
Middle Aged
Pulmonary Disease, Chronic Obstructive / drug therapy*,  physiopathology
Respiratory Mechanics / drug effects*
Retrospective Studies
Vital Capacity
Reg. No./Substance:
0/Bronchodilator Agents

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