Source: Annual Congress 2013 –Diagnosis and management of respiratory diseases
Disease area: Airway diseases

Abstract

The inflammatory process in COPD affects the whole respiratory tract, from central to peripheral airways, the so-called small airways. To assess the small airway obstruction involvement in COPD and its relationship with the severity of the disease, we report a retrospective study including 55 COPD patients managed between 2010 and 2013. Eighty-five per cent of our patients were men with an average age of 62,45 years, mainly smokers (90%). COPD was diagnosed at an advanced stage in 79% of cases (Stage III or IV) and at an early stage in only 19% of cases (stage I or II). Spirometric data showed that an involvement of the small airways was present in all cases. Considering the stage of the disease, we found that the average MEF 25%, MEF 50% and MEF 75% for stage I patients were respectively 0.65 L (52% of predicted values: pred), 1.44 L(41% of pred) and 3.11 L (48% of pred). For stage II patients, the mean MEF 25 % was at 0.47 L (37% of pred), the average MEF 50% was at 0.97 L (27% of pred) and the mean DEM 75 % was at 1.15 L (34%). For stage III and IV patients, the small airway’s obstruction was more important: average MEF 25 % was respectively at 0.32 L (26% of pred) and 0.2 L (16% of pred), the average MEF 50% was respectively at 0.84 L (19% of pred) and 0.45 L (8.6% of pred). The mean MEF 75% was at 1.36 L (26% of pred) in stage III patients and at 0.61 L (12% of pred) in stage IV patients. We found a positive association between small airways obstruction importance and COPD stage.(p=0.03). The reversibility after B2 agonist of the small airways was inversely proportional to disease severity. Inhaled bronchodilatators with small particles can have an important role in improving the pulmonary function of these patients.

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E. Tangour, S. Mhamdi, Z. Moatameri, S. Dabboussi, A. Sellami, H. Zaibi, A. Jary, C. Aichaouia, M. Khadhraoui, R. Cheikh (Tunis, Tunisia). Small airway obstruction involvement in COPD severity. Eur Respir J 2013; 42: Suppl. 57, 4175

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