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Bronchodilator Response Assessment of the Small Airways Obstructive Pattern
Plamen Bokov1,2, Clémence Martin1, Sémia Graba1
1AP-HP ; Hôpital Européen Georges Pompidou ; Service de Physiologie, Paris. France.
The Open Respiratory Medicine Journal
|August 26, 2017
Summary
Small airways obstructive pattern (SAOP) shows frequent bronchodilator reversibility, particularly in inspiratory capacity (IC). Impulse oscillometry has limited value for diagnosing SAOP reversibility.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
Background:
- Small airways obstructive pattern (SAOP) is defined by decreased FEV1 and FVC with a normal FEV1/FVC ratio and TLC.
- SAOP can be a diagnostic challenge in pulmonary function testing.
Purpose of the Study:
- To determine the prevalence of bronchodilator response in patients with SAOP, assessing flow, volume, and combined responses.
- To evaluate if impulse oscillometry (IOS) can diagnose SAOP and its reversibility.
Main Methods:
- Fifty adult patients with SAOP underwent spirometry, plethysmography, and reversibility testing with salbutamol.
- Assessment included changes in FEV1, FVC, inspiratory capacity (IC), and IOS parameters.
Main Results:
- COPD and asthma were the most common associated diseases.
- 70% of patients showed a significant bronchodilator response, primarily indicated by IC improvement.
- IOS parameters showed limited correlation with spirometric improvements, suggesting it primarily assesses proximal airways.
Conclusions:
- Significant bronchodilator reversibility is common in SAOP, especially when assessed by IC.
- Impulse oscillometry demonstrates low sensitivity and limited utility for diagnosing SAOP and its reversibility.
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