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Bronchodilator response of advanced lung function parameters depending on COPD severity

Jarenbäck, Linnea LU ; Eriksson, Göran LU ; Peterson, Stefan; Ankerst, Jaro LU ; Bjermer, Leif LU and Tufvesson, Ellen LU (2016) In International Journal of COPD 11(1). p.2939-2950
Abstract

Background: COPD is defined as partly irreversible airflow obstruction. The response pattern of bronchodilators has not been followed in advanced lung function parameters. Purpose: The aim of this study was to investigate bronchodilator response pattern in advanced lung function parameters in a continuous fashion along forced expiratory volume in 1 second (FEV1) percent predicted (%p) in COPD patients and controls. Patients and methods: Eighty-one smokers/ex-smokers (41 controls and 40 COPD) performed spirometry, body plethysmography, impulse oscillometry and single-breath helium dilution carbon monoxide diffusion at baseline, after salbutamol inhalation and then after an additional inhalation of ipratropium. Results: Most... (More)

Background: COPD is defined as partly irreversible airflow obstruction. The response pattern of bronchodilators has not been followed in advanced lung function parameters. Purpose: The aim of this study was to investigate bronchodilator response pattern in advanced lung function parameters in a continuous fashion along forced expiratory volume in 1 second (FEV1) percent predicted (%p) in COPD patients and controls. Patients and methods: Eighty-one smokers/ex-smokers (41 controls and 40 COPD) performed spirometry, body plethysmography, impulse oscillometry and single-breath helium dilution carbon monoxide diffusion at baseline, after salbutamol inhalation and then after an additional inhalation of ipratropium. Results: Most pulmonary function parameters showed a linear increase in response to decreased FEV1%p. The subjects were divided into groups of FEV1%p<65 and >65, and the findings from continuous analysis were verified. The exceptions to this linear response were inspiratory capacity (IC), forced vital capacity (FVC), FEV1/FVC and expiratory resistance (Rex), which showed a segmented response relationship to FEV1%p. IC and FVC, with break points (BP) of 57 and 58 FEV1%p respectively, showed no response above, but an incresed slope below the BP. In addition, in patients with FEV1%p<65 and >65, response of FEV1%p did not correlate to response of volume parameters. Conclusion: Response of several advanced lung function parameters differs depending on patients’ baseline FEV1%p, and specifically response of volume parameters is most pronounced in COPD patients with FEV1%p<65. Volume and resistance responses do not follow the flow response measured with FEV1 and may thus be used as a complement to FEV1 reversibility to identify flow, volume and resistance responders.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Body plethysmography, Bronchodilation, COPD, IOS, Lung function, Reversibility
in
International Journal of COPD
volume
11
issue
1
pages
12 pages
publisher
Dove Press
external identifiers
  • scopus:85000366435
  • wos:000388480200002
ISSN
1176-9106
DOI
10.2147/COPD.S111573
language
English
LU publication?
yes
id
f833f528-e8ad-431c-a6cd-23fec15bf595
date added to LUP
2016-12-19 09:39:28
date last changed
2017-09-18 11:32:02
@article{f833f528-e8ad-431c-a6cd-23fec15bf595,
  abstract     = {<p>Background: COPD is defined as partly irreversible airflow obstruction. The response pattern of bronchodilators has not been followed in advanced lung function parameters. Purpose: The aim of this study was to investigate bronchodilator response pattern in advanced lung function parameters in a continuous fashion along forced expiratory volume in 1 second (FEV<sub>1</sub>) percent predicted (%p) in COPD patients and controls. Patients and methods: Eighty-one smokers/ex-smokers (41 controls and 40 COPD) performed spirometry, body plethysmography, impulse oscillometry and single-breath helium dilution carbon monoxide diffusion at baseline, after salbutamol inhalation and then after an additional inhalation of ipratropium. Results: Most pulmonary function parameters showed a linear increase in response to decreased FEV<sub>1</sub>%p. The subjects were divided into groups of FEV<sub>1</sub>%p&lt;65 and &gt;65, and the findings from continuous analysis were verified. The exceptions to this linear response were inspiratory capacity (IC), forced vital capacity (FVC), FEV<sub>1</sub>/FVC and expiratory resistance (R<sub>ex</sub>), which showed a segmented response relationship to FEV<sub>1</sub>%p. IC and FVC, with break points (BP) of 57 and 58 FEV<sub>1</sub>%p respectively, showed no response above, but an incresed slope below the BP. In addition, in patients with FEV<sub>1</sub>%p&lt;65 and &gt;65, response of FEV<sub>1</sub>%p did not correlate to response of volume parameters. Conclusion: Response of several advanced lung function parameters differs depending on patients’ baseline FEV<sub>1</sub>%p, and specifically response of volume parameters is most pronounced in COPD patients with FEV<sub>1</sub>%p&lt;65. Volume and resistance responses do not follow the flow response measured with FEV<sub>1</sub> and may thus be used as a complement to FEV<sub>1</sub> reversibility to identify flow, volume and resistance responders.</p>},
  author       = {Jarenbäck, Linnea and Eriksson, Göran and Peterson, Stefan and Ankerst, Jaro and Bjermer, Leif and Tufvesson, Ellen},
  issn         = {1176-9106},
  keyword      = {Body plethysmography,Bronchodilation,COPD,IOS,Lung function,Reversibility},
  language     = {eng},
  month        = {11},
  number       = {1},
  pages        = {2939--2950},
  publisher    = {Dove Press},
  series       = {International Journal of COPD},
  title        = {Bronchodilator response of advanced lung function parameters depending on COPD severity},
  url          = {http://dx.doi.org/10.2147/COPD.S111573},
  volume       = {11},
  year         = {2016},
}