Abstract
Introduction: Currently there is a lack of sensitive and specific tools which can objectively identify exacerbations and assess their progress or treatment response. FEV1 is often reported as a study outcome, but this forced manoeuvre has significant limitations. Studies have suggested that small airways measures might provide physiological biomarkers during exacerbations.
Aims and Objectives: to assess which physiological tests of small airways function have been used in the acute setting during exacerbations of COPD and the evidence to support their use.
Methods: Following PRISMA guidelines, a systematic review was conducted using several databases for relevant published studies of >10 participants which compared at least one small airway test with FEV1 at both exacerbation and a follow-up measurement up to and including two months after exacerbation onset to assess response to treatment.
Results: From 1436 screened articles, seven studies were found to be eligible for inclusion. There was heterogeneity in which tests of small airways were used. Four different measures were reported (Impulse oscillometry (IOS), Maximal mid-expiratory flow (MMEF), Forced oscillation technique (FOT) and airway resistance (Raw) by body plethysmography). Studies were small (including 20 to 87 subjects). Six articles reported improvements in small airway measurements during the recovery from exacerbation which correlated with FEV1.
Conclusion: There is some evidence to support the use of small airway tests in exacerbations of COPD; however, studies have been small with different tests being utilized. Further pilot studies to determine the usefulness of each test may be of interest
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 156.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020