TY - JOUR T1 - A pilot study of CPAP therapy for excessive dynamic airway collapse during acute exacerbation of COPD JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - 3401 AU - Yee Tung (Eric) Kuo AU - Kenneth Lau AU - Garun Hamilton AU - Eunice Dai AU - Paul Leong AU - Philip Bardin Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/3401.abstract N2 - Background: Excessive dynamic airway collapse (EDAC) occurs in expiration when the posterior wall of the trachea bulges forward causing ≥ 50% cross sectional area reduction. EDAC can be diagnosed with four-dimensional dynamic volume 320-slice multi-detector computed tomography (4D-CT) and has been reported to occur in 20% of patients with COPD. Whether EDAC persists in stable COPD or occurs predominantly during exacerbations is unknown. Overall effectiveness of CPAP in EDAC has also not been assessed.Aims: To determine whether CPAP therapy reduced EDAC in patients with acute exacerbation of COPD (AECOPD) and if EDAC persisted after recovery from AECOPD.Methods: Patients with AECOPD requiring hospitalization (n = 11) were recruited. 4D-CT of the larynx and trachea (2-4 mSv) was performed within 48 hours of admission and repeated immediately after with 10-12cmH2O CPAP. CT was repeated at 6-8 weeks post discharge (without CPAP). EDAC was diagnosed if expiratory tracheal area was reduced by ≥ 50%.Results: Of the 11 patients recruited, four had EDAC detected. EDAC severity ranged from 60-64% (median = 63.5%). EDAC resolved with CPAP in all four patients (median narrowing = 39.5% [29%-49%]). EDAC was not evident in the three patients who completed follow-up CT (one CT not done).Conclusions: EDAC in AECOPD can be improved by CPAP. Larger studies are warranted to further evaluate the functional significance of EDAC and clinical benefits of CPAP treatment. ER -