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Employing the Forced Oscillation Technique for the Assessment of Respiratory Mechanics in Adults

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Bronchial responsiveness in patients with restrictive spirometry.

Jean I Keddissi¹, Marwan K Elya, Saif U Farooq

¹Division of Pulmonary/Critical Care Medicine, the Oklahoma City VA Medical Center and the University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, WP 1310, Oklahoma City, OK 73104-5020, USA.

Biomed Research International

|September 12, 2013

Summary

A restrictive lung defect that improves with bronchodilators may indicate an early form of obstructive lung disease. This finding suggests that bronchodilator therapy could benefit symptomatic patients with this pattern.

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A Reversible, Non-invasive Method for Airway Resistance Measurements and Bronchoalveolar Lavage Fluid Sampling in Mice

Published on: April 13, 2010

Area of Science:

Pulmonology
Respiratory Medicine
Clinical Investigation

Background:

Bronchodilator responsiveness is typical in obstructive airway diseases like COPD.
Restrictive lung patterns occasionally show improvement with bronchodilators, prompting further investigation.
The clinical significance of a bronchodilator-responsive restrictive defect requires clarification.

Purpose of the Study:

To investigate the clinical significance of a restrictive spirometry pattern that responds to bronchodilators.
To characterize patients exhibiting a reversible restrictive lung defect.

Main Methods:

Retrospective review of patients with restrictive spirometry and bronchodilator studies (Sept 2003-Dec 2009).
Restriction defined by decreased FVC/FEV1 with normal FEV1/FVC ratio.
Bronchodilator responsiveness defined as ≥12% and 200 mL improvement in FEV1/FVC.

Main Results:

Twenty-one patients were identified, predominantly current/former smokers on bronchodilators.
Average FVC and FEV1 were 65% and 62% of predicted, respectively.
Lung volume analysis (normal TLC, elevated RV/TLC) suggested an obstructive component.

Conclusions:

A reversible restrictive pattern on spirometry may represent an early variant of obstructive lung disease.
This pattern may involve early airway closure leading to air trapping and reduced FVC.
Bronchodilator therapy trial is recommended for symptomatic patients with this finding.