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Exercise capacity and limiting factors in older patients with post infectious bronchiolitis obliterans

Luiz Felipe Frohlich, Danilo C. Berton, Paulo J.C. Vieira, Jorge P. Ribeiro, Paulo J.Z. Teixeira, Fernando A.A. Silva
European Respiratory Journal 2012 40: P4440; DOI:
Luiz Felipe Frohlich
1Internal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Danilo C. Berton
1Internal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Paulo J.C. Vieira
1Internal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Jorge P. Ribeiro
1Internal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Paulo J.Z. Teixeira
2Internal Medicine, Health Science Federal University of Porto Alegre, Brazil
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Fernando A.A. Silva
1Internal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Abstract

Exercise capacity has been poorly studied in patients with post-infectious bronchiolitis obliterans (PBO) and main studies evaluated children with follow-up in older subjects lacking.

We evaluated exercise capacity in older patients with PBO and mechanisms of exercise limitation.

This was a cross-sectional study including the oldest patients of our tertiary care center. Cycle incremental cardiopulmonary exercise tests with investigation of dynamic hyperinflation and exercise induced bronchoconstriction (EIB) were performed.

Sixteen patients were studied with a mean age of 15.3±3.9 (range 10-23) years, and post-bronchodilator (BD) resting lung function (%pred): FVC 88.9±19.3; FEV1 67.4±27.5, TLC 115.3±10.7; RV 234.3±87.1, DLCO 73.6±11.9. Only 7 patients (43.8%) had reduced exercise capacity (VO2peak<84%pred), of these 5 (71.4%) was <16 years-old. VO2peak was only correlated with age (r=0.58; p=0.01) and DLCO% pred (r=0.66; p=0.01).

Patients with reduced exercise capacity tended to be younger (13.4±3.3 vs 16.8±3.9 years; p=0.09), with greater FEV1 response to BD (18.9±12.8 vs 7.0±11.9 %; p=0.08) and lower DLCO (67.8±12.9 vs 81.2±9.2%; p=0.053). No difference were found in relation to ventilatory reserve and dynamic hyperinflation during exercise. Of the 4 patients who presented EIB, 3 (75%) had reduced exercise capacity. Nevertheless, FEV1 alteration post-exercise was not significantly different from those with preserved exercise capacity (-17.0±20.3 vs -5.7±6.7%, p=0.20).

In conclusion, it seems that functional alterations of POB tend to ameliorate with aging. Those with reduced exercise capacity present lower lung diffusion capacity and greater airway obstruction variability.

  • Bronchiolitis
  • Exercise
  • Physiological diagnostic services
  • © 2012 ERS
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Exercise capacity and limiting factors in older patients with post infectious bronchiolitis obliterans
Luiz Felipe Frohlich, Danilo C. Berton, Paulo J.C. Vieira, Jorge P. Ribeiro, Paulo J.Z. Teixeira, Fernando A.A. Silva
European Respiratory Journal Sep 2012, 40 (Suppl 56) P4440;

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Exercise capacity and limiting factors in older patients with post infectious bronchiolitis obliterans
Luiz Felipe Frohlich, Danilo C. Berton, Paulo J.C. Vieira, Jorge P. Ribeiro, Paulo J.Z. Teixeira, Fernando A.A. Silva
European Respiratory Journal Sep 2012, 40 (Suppl 56) P4440;
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