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Peripheral airways resistance in smokers.
E M Wagner1, E R Bleecker, S Permutt
1Department of Medicine, Johns Hopkins University, Baltimore, Maryland.
The American Review of Respiratory Disease
|July 1, 1992
Summary
Asymptomatic smokers show varied peripheral airways resistance (Rp), ranging from normal to asthma-like levels. This suggests underlying inflammatory changes in small airways, even with normal spirometry results.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
Background:
- Smokers often exhibit subclinical respiratory abnormalities.
- Peripheral airways resistance (Rp) is a sensitive indicator of small airway function.
Purpose of the Study:
- To quantify peripheral airways resistance (Rp) in asymptomatic smokers.
- To compare Rp in smokers to normal and asthmatic subjects.
Main Methods:
- Utilized a wedged bronchoscope technique in 19 active smokers (2-28 pack-years).
- Measured CO2-air infusion pressure via a double lumen catheter.
- Calculated Rp at multiple flow rates.
Main Results:
- Peripheral airways resistance (Rp) varied widely (0.003–0.075 cm H2O/ml/min).
- Smokers' Rp ranged from normal to levels seen in asthma (0.069 cm H2O/ml/min).
- Spirometry results remained normal in all subjects.
Conclusions:
- Asymptomatic smokers can have significantly elevated peripheral airways resistance.
- Elevated Rp in smokers suggests inflammatory changes in small airways.
- Rp measurement may detect early airway disease missed by spirometry.