Source: Annual Congress 2003 - Respiratory structure and mechanisms: current concepts
Disease area: Airway diseases

Abstract

There are studies in certain patients with irreversible airway obstruction claiming superiority of changes of static volume such as in TLC, RV and VC for the assessment of reversibility instead of the ²golden standard² FEV1. We compared the magnitude and frequency of the changes in static and dynamic volumes in 396 consecutive patients undergoing bodyplethysmography and reversibility testing. Improvements in static lung volumes after bronchodilation were compared with improvements in dynamic lung volumes. Reversibility was defined as improvement of FEV1 >200ml and >12% after inhalation of salbutamol. So-called ²volume responders² were patients with higher improvement in static volumes after bronchodilation than FEV1 improvement. A reversibility was found in 99 patients, 297 patients had no reversibility. ²Volume responders² could be identified in all subgroups of patients with irreversible airway obstruction: In 5 out of 51 (9,8%) patients with mild obstruction, in 38 out of 226 (16,8%) patients with moderate obstruction and in 3 out of 20 (15%) patients with severe obstruction. However, volume response was found only in one of 99 patients with reversible airway obstruction. This one had a severe airway obstruction. We conclude, that the phenomenon of ²volume response² to bronchodilation clearly exists; however, mainly in patients with irreversible airway obstruction. Our results show that in patients with irreversible airway obstruction, volume response should be assessed. Improvement in static volumes such as TLC, RV and VC decrease the work breathing.

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Citations should be made in the following way:
A. M. Balestra, R. Bingisser, M. Brustsche, J. D. Leuppi (Basel, Switzerland). Are ²volume responders² more common in patients with irreversible airway obstruction?. Eur Respir J 2003; 22: Suppl. 45, 166

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