Tags

Type your tag names separated by a space and hit enter

Characterization of lung function impairment in adults with bronchiectasis.
PLoS One 2014; 9(11):e113373Plos

Abstract

BACKGROUND

Characteristics of lung function impairment in bronchiectasis is not fully understood.

OBJECTIVES

To determine the factors associated with lung function impairment and to compare changes in spirometry during bronchiectasis exacerbation and convalescence (1 week following 14-day antibiotic therapy).

METHODS

We recruited 142 patients with steady-state bronchiectasis, of whom 44 with acute exacerbations in the follow-up were included in subgroup analyses. Baseline measurements consisted of chest high-resolution computed tomography (HRCT), sputum volume, purulence and bacteriology, spirometry and diffusing capacity. Spirometry, but not diffusing capacity, was examined during acute exacerbations and convalescence.

RESULTS

In the final multivariate models, having bronchiectasis symptoms for 10 years or greater (OR = 4.75, 95%CI: 1.46-15.43, P = 0.01), sputum culture positive for Pseudomonas aeruginosa (OR = 4.93, 95%CI: 1.52-15.94, P<0.01) and HRCT total score being 12 or greater (OR = 7.77, 95%CI: 3.21-18.79, P<0.01) were the major variables associated with FEV1 being 50%pred or less; and the only variable associated with reduced DLCO was 4 or more bronchiectatic lobes (OR = 5.91, 95%CI: 2.20-17.23, P<0.01). Overall differences in FVC and FEV1 during exacerbations and convalescence were significant (P<0.05), whereas changes in other spirometric parameters were less notable. This applied even when stratified by the magnitude of FEV1 and DLCO reduction at baseline.

CONCLUSION

Significant lung function impairment should raise alert of chest HRCT abnormality and sputum culture positive for Pseudomonas aeruginosa, in patients with predominantly mild to moderate steady-state bronchiectasis. Acute exacerbations elicited reductions in FVC and FEV1. Changes of other spirometric parameters were less significant during exacerbations.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01761214.

Authors+Show Affiliations

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.Department of Geriatrics, Guangzhou First People's Hospital, Guangzhou, Guangdong, China.State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25405614

Citation

Guan, Wei-jie, et al. "Characterization of Lung Function Impairment in Adults With Bronchiectasis." PloS One, vol. 9, no. 11, 2014, pp. e113373.
Guan WJ, Gao YH, Xu G, et al. Characterization of lung function impairment in adults with bronchiectasis. PLoS ONE. 2014;9(11):e113373.
Guan, W. J., Gao, Y. H., Xu, G., Lin, Z. Y., Tang, Y., Li, H. M., ... Zhong, N. S. (2014). Characterization of lung function impairment in adults with bronchiectasis. PloS One, 9(11), pp. e113373. doi:10.1371/journal.pone.0113373.
Guan WJ, et al. Characterization of Lung Function Impairment in Adults With Bronchiectasis. PLoS ONE. 2014;9(11):e113373. PubMed PMID: 25405614.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterization of lung function impairment in adults with bronchiectasis. AU - Guan,Wei-jie, AU - Gao,Yong-hua, AU - Xu,Gang, AU - Lin,Zhi-ya, AU - Tang,Yan, AU - Li,Hui-min, AU - Lin,Zhi-min, AU - Zheng,Jin-ping, AU - Chen,Rong-chang, AU - Zhong,Nan-shan, Y1 - 2014/11/18/ PY - 2014/03/14/received PY - 2014/10/20/accepted PY - 2014/11/19/entrez PY - 2014/11/19/pubmed PY - 2016/1/23/medline SP - e113373 EP - e113373 JF - PloS one JO - PLoS ONE VL - 9 IS - 11 N2 - BACKGROUND: Characteristics of lung function impairment in bronchiectasis is not fully understood. OBJECTIVES: To determine the factors associated with lung function impairment and to compare changes in spirometry during bronchiectasis exacerbation and convalescence (1 week following 14-day antibiotic therapy). METHODS: We recruited 142 patients with steady-state bronchiectasis, of whom 44 with acute exacerbations in the follow-up were included in subgroup analyses. Baseline measurements consisted of chest high-resolution computed tomography (HRCT), sputum volume, purulence and bacteriology, spirometry and diffusing capacity. Spirometry, but not diffusing capacity, was examined during acute exacerbations and convalescence. RESULTS: In the final multivariate models, having bronchiectasis symptoms for 10 years or greater (OR = 4.75, 95%CI: 1.46-15.43, P = 0.01), sputum culture positive for Pseudomonas aeruginosa (OR = 4.93, 95%CI: 1.52-15.94, P<0.01) and HRCT total score being 12 or greater (OR = 7.77, 95%CI: 3.21-18.79, P<0.01) were the major variables associated with FEV1 being 50%pred or less; and the only variable associated with reduced DLCO was 4 or more bronchiectatic lobes (OR = 5.91, 95%CI: 2.20-17.23, P<0.01). Overall differences in FVC and FEV1 during exacerbations and convalescence were significant (P<0.05), whereas changes in other spirometric parameters were less notable. This applied even when stratified by the magnitude of FEV1 and DLCO reduction at baseline. CONCLUSION: Significant lung function impairment should raise alert of chest HRCT abnormality and sputum culture positive for Pseudomonas aeruginosa, in patients with predominantly mild to moderate steady-state bronchiectasis. Acute exacerbations elicited reductions in FVC and FEV1. Changes of other spirometric parameters were less significant during exacerbations. TRIAL REGISTRATION: ClinicalTrials.gov NCT01761214. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/25405614/Characterization_of_lung_function_impairment_in_adults_with_bronchiectasis_ L2 - http://dx.plos.org/10.1371/journal.pone.0113373 DB - PRIME DP - Unbound Medicine ER -