Kısa Etkili Bronkodilatör Yanıtı Değerlendirmede %MMEF ile sGaw, Kısmi Reversibilite ile Reversibilite Arasında Belirleyici Tanısal Bir Parametre Olabilir mi?

Amaç: Spirometre testi ile bronkodilatör yanıtı değerlendirmede maksimum ekspiryum ortası akım (MMEF) ve spesifik havayolu iletimi (sGaw) parametrelerindeki değişikliklerin FEV1 değişimi ile ilişkisi inceleyerek, FEV1’e kısmi yanıtlılarda bronkodilatör yanıtına yaptıkları tanısal katkıyı araştırdık. Yöntem: Çalışma örneklemi göğüs hastalıkları solunum fonksiyon laboratuvarına 1 Haziran 20019 - 1 Şubat 2021 tarihleri arasında bronş hiperreaktivitesi ön tanısı ile başvurmuş ve reversibilite testi ile birlikte body pletismografik inceleme de yapılmış 112 hastanın retrospektif taranmasından oluşmaktadır. Bulgular: sMMEF% ve ssGaw, sFEV1 ile doğrusal yönde korelasyon göstermekteydi. (sırasıyla r=0.752; p

Could Be % MMEF and sGaw Determinant Diagnostic Parameters Between Partial Reversibility and Reversibility in Evaluating Short-Acting Bronchodilator Response?

Objective: By examining the relationship between changes in maximum mild-expiratory flow( MMEF) and specific airway conductance (sGaw), parameters with the change in FEV1 when evaluating the spirometer test and the bronchodilator response, we investigated their diagnostic contribution to the bronchodilator response in those with partial responses to FEV1. Method: The retrospective study sample consists of data from 112 patients between Jun 1, 2019, and Feb 1, 2020 who applied to the pulmonary function laboratory with a pre-diagnosis of bronchial hyperreactivity as well as body plethysmography test performed together with the reversibility test. Results: MMEF% and ssGaw were linearly correlated with sFEV1 (respectively r=0.752; p

___

  • 1. Pellegrino R, Rodarte JR, Brusasco V. Assessing the reversibility of airway obstruction. Chest. 1998;114(6):1607- 1612. https://doi.org/10.1378/chest.114.6.1607
  • 2. Barnes PJ, Gribbin HR, Osmanliev D, Pride NB. Partial flow-volume curves to measure bronchodilator dose response curvesin normal humans. J Appl Physiol. 1981;50:1193-7. https://doi.org/10.1152/jappl.1981.50.6.1193
  • 3. O’Donnell DE. Assessment of bronchodilator efficacy in symptomatic COPD: is spirometry useful? Chest. 2000;117:42S-7S. https://doi.org/10.1378/chest.117.2_suppl.42S
  • 4. Tse SM, Gold DR, Sordillo JE, Hoffman EB, Gillman MW,Rifas-Shiman SL, et al. Diagnostic accuracy of the bronchodilator response in children. J Allergy Clin Immunol. 2013;132,554-559.e5.13. https://doi.org/10.1016/j.jaci.2013.03.031
  • 5. Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J 2005; 26:948. https://doi.org/10.1183/09031936.05.00035205
  • 6. Hansen JE, Casaburi R, Goldberg AS. A statistical approach for assessment of bronchodilator responsiveness in pulmonary function testing. Chest 1993;104:1119- 1126. https://doi.org/10.1378/chest.104.4.1119
  • 7. Hansen JE, Porszasz J. Rebuttal from Drs Hansen and Porszasz. Chest 2014;146:542-4. https://doi.org/10.1378/chest.14-0618
  • 8. Hansen JE, Sun XG, Adame D, Wasserman K. Argument for changing criteria for bronchodilator responsiveness. Respir Med. 2008;102:1777-83. https://doi.org/10.1016/j.rmed.2008.06.019
  • 9. Helen K, Reddel J. FitzGerald M, Bateman ED, et al. European Respiratory Journal Jun 2019;53(6): 1901046. https://doi.org/10.1183/13993003.01046-2019
  • 10. Parker AL, McCool FD. Pulmonary function characteristics in patients with different patterns of methacholine airway hyperresponsiveness. Chest. 2002;121(6):1818-23. https://doi.org/10.1378/chest.121.6.1818
  • 11. Simon MR, Chinchilli VM, Phillips BR, et al. Forced expiratory flow between 25% and 75% of vital capacity and FEV1/forced vital capacity ratio in relation to clinical and physiological parameters in asthmatic children with normal FEV1 values. J Allergy Clin Immunol. 2010;126(3):527- 34.e521-528. https://doi.org/10.1016/j.jaci.2010.05.016
  • 12. Rosen JB, Smith EO, Schecter MG, Mallory GB, Elidemir O. Decline in 25% to 75% forced expiratory flow as an early predictor of chronic airway rejection in pediatric lung transplant recipients. J Heart Lung Transplant 2012;31(12):1288-92. https://doi.org/10.1016/j.healun.2012.09.010
  • 13. Ulubay G, Dilektaşlı AG, Börekçi Ş, et al. Turkish Thoracic Society Consensus Report: Interpretation of Spirometry. Turk Thorac J. 2019;20(1):69-89. Published 2019 Jan 1. https://doi.org/10.5152/TurkThoracJ.2018.180175
  • 14. Mahut B, Peiffer C, Bokov P, Delclaux C, Beydon N. Use of specificairway resistance to assess bronchodilator response in children. Respirology. 2011;16:666-71 https://doi.org/10.1111/j.1440-1843.2011.01953.x
  • 15. Smith HR, Irvin CG, Cherniack RM. The utility of spirometry in the diagnosis of reversible airways obstruction. Chest. 1992;101(6):1577-81. https://doi.org/10.1378/chest.101.6.1577
  • 16. Mottram C, editor. Ruppel’s Manual of Pulmonary Function Testing. 11th Ed. Elsevier; USA: 2017.
  • 17. Graham BL, Steenbruggen I, Miller MR, et al. Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med 2019; 200:e70. https://doi.org/10.1164/rccm.201908-1590ST
  • 18. Stocks J, Godfrey S, Beardsmore C, Bar-Yishay E, Castile R; ERS/ATS Task Force on Standards for Infant Respiratory Function Testing. European Respiratory Society/American Thoracic Society. Plethysmographic measurements of lung volume and airway resistance. ERS/ATS Task Force on Standards for Infant Respiratory Function Testing. European Respiratory Society/ American Thoracic Society. Eur Respir J. 2001;17(2):302-12. https://doi.org/10.1183/09031936.01.17203020
  • 19. Saetta M, Timens W, Jeffery PK. Pathology. In: Postma DS, Siafakas NM, editors. Management of chronic obstructive pulmonary disease. Sheffield, UK: ERS Journals Ltd; 1998. p. 92-111.
  • 20. Rodriguez-Roisin R, MacNee W. Pathophysiology of chronic obstructive pulmonary disease. In: Postma DS, Siafakas NM, editors. Management of chronic obstructive pulmonary disease. Sheffield, UK: ERS Journals Ltd; 1998. p. 107-126.
  • 21. Borrill ZL, Houghton CM, Woodcock AA, Vestbo J, Singh D. Measuring bronchodilation in COPD clinical trials. Br J Clin Pharmacol. 2005;59(4):379-84. https://doi.org/10.1111/j.1365-2125.2004.02261.x
  • 22. Topalovic M, Derom E, Osadnik CR, et al. Airways resistance and specific conductance for the diagnosis of obstructive airways diseases. Respir Res. 2015;16(1):88. Published 2015 Jul 22. https://doi.org/10.1186/s12931-015-0252-0
  • 23. Tavares e Castro A, Matos P, Tavares B, Matos MJ, Segorbe-Luís A. Alternative functional criteria to assess airflow-limitation reversibility in asthma. Rev Port Pneumol (2006). 2015;21(2):69-75. https://doi.org/10.1016/j.rppnen.2014.08.002
  • 24. Houghton CM, Woodcock AA, Singh D. A comparison of lung function methods for assessing dose-response effects of salbutamol. Br J Clin Pharmacol. 2004;58(2):134- 141. https://doi.org/10.1111/j.1365-2125.2004.02105.x
  • 25. Linares Passerini M, Meyer Peirano R, Contreras Estay I, Delgado Becerra I, Castro-Rodriguez JA: Utility of bronchodilator response for asthma diagnosis in Latino preschoolers. Allergol Immunopathol (Madr) 2014;42:553-9. https://doi.org/10.1016/j.aller.2014.02.004