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Ventilation distribution and small airway function in patients with systemic sclerosis.

B R A Silva1, R Rufino2, C H Costa2

  • 1Laboratory of Respiratory Physiology, State University of Rio de Janeiro, and Postgraduate Programme in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil.

Revista Portuguesa De Pneumologia
|March 5, 2017
PubMed
Summary

The nitrogen single-breath washout (N2SBW) test effectively detects ventilation heterogeneity in systemic sclerosis (SSc) patients, correlating with lung function and CT findings. This method aids in diagnosing SSc-related lung disease, even with normal traditional pulmonary function tests.

Keywords:
Nitrogen single-breath washout testRespiratory function testsSystemic sclerosis

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Area of Science:

  • Pulmonary Medicine
  • Radiology
  • Diagnostic Testing

Background:

  • Traditional pulmonary function tests (PFTs) are crucial for managing systemic sclerosis (SSc).
  • However, many SSc patients with pulmonary disease evident on CT scans exhibit normal PFTs, highlighting a diagnostic gap.

Purpose of the Study:

  • To assess the efficacy of the nitrogen single-breath washout (N2SBW) test in diagnosing SSc.
  • To correlate N2SBW parameters with established PFT indices, clinical data, and CT findings in SSc patients.

Main Methods:

  • A cross-sectional study involving 52 consecutive SSc patients.
  • Patients underwent spirometry, body plethysmography, diffusing capacity for carbon monoxide (DLCO) analysis, respiratory muscle strength testing, N2SBW testing, and CT analysis.

Main Results:

  • The N2SBW test revealed ventilation heterogeneity in a significant portion of SSc patients.
  • Phase III slope (Phase III slopeN2SBW) and closing volume/vital capacity (CV/VC) parameters showed significant correlations with FVC and DLCO, as well as with CT patterns like traction bronchiectasis and honeycombing.

Conclusions:

  • Ventilation heterogeneity is common in SSc patients and is linked to restrictive lung damage, impaired diffusion, and specific CT findings.
  • The N2SBW test is a valuable tool for identifying small airway disease in approximately one-third of SSc patients, complementing traditional PFTs.