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Related Experiment Videos

The relationship between pulmonary function and dyspnea in obstructive lung disease.

N Wolkove1, E Dajczman, A Colacone

  • 1Department of Medicine, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Canada.

Chest
|December 1, 1989
PubMed
Summary

Breathlessness in obstructive lung disease (OLD) patients improved after bronchodilator use, but this subjective dyspnea response did not correlate with objective spirometry measures like FEV1. Dyspnea ratings offer insights into bronchodilator responsiveness beyond spirometry alone.

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Area of Science:

  • Pulmonary Medicine
  • Respiratory Physiology

Background:

  • Evaluating dyspnea (breathlessness) is crucial for patients with obstructive lung disease (OLD).
  • Routine spirometry is standard for assessing lung function in OLD.
  • The relationship between subjective dyspnea and objective spirometry is not fully understood.

Purpose of the Study:

  • To assess the correlation between subjective dyspnea ratings and objective spirometry measurements before and after bronchodilator administration in patients with OLD.
  • To determine if dyspnea ratings provide additional information on bronchodilator responsiveness not captured by spirometry alone.

Main Methods:

  • Ninety-three patients with OLD underwent spirometry and completed the Borg Scale Dyspnea Index (BSDI) at rest before and after inhaling 200 micrograms of albuterol (salbutamol).

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  • Correlation analyses were performed between BSDI scores and spirometry parameters (e.g., FEV1).
  • Patients were categorized based on subjective dyspnea response and objective bronchodilator response.

    • Main Results:

    • The median BSDI decreased from 3 to 1 post-bronchodilator, indicating subjective improvement in dyspnea.
    • No significant correlation was found between initial or post-bronchodilator spirometry results and BSDI scores.
    • The change in FEV1 did not correlate with the change in BSDI (r = 0.05).
    • While a large bronchodilator response often improved dyspnea, the reverse was not true; many patients with significant dyspnea improvement showed minimal FEV1 changes.
    • In a subgroup of 65 dyspneic patients, 43% showed both subjective and objective responses, 17% had only a bronchodilator response, 26% had only a dyspnea response, and 14% had neither.

    Conclusions:

    • Subjective dyspnea ratings in patients with obstructive lung disease are poorly correlated with routine spirometry results.
    • Dyspnea assessment using scales like BSDI can reveal bronchodilator responsiveness that may not be evident from spirometry alone.
    • Integrating subjective dyspnea evaluation with objective spirometry may provide a more comprehensive understanding of patient response to bronchodilators.