Abstract
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.
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.
- Copyright ©the authors 2016
