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Small Airway Obstruction in Chronic Obstructive Pulmonary Disease: Potential Parameters for Early Detection.
Adv Exp Med Biol. 2017; 980:75-82.AE

Abstract

The impulse oscillometry (IOS) is recognized as a complementary method to spirometry in the diagnostics of obstructive pulmonary disorders. The IOS enables to measure total respiratory resistance (R5) and proximal respiratory resistance (R20), with the R5-R20 difference reflecting small airway resistance. This study seeks to evaluate the usefulness of R5-R20, maximal mid-expiratory flow (MMEF), and forced expiratory volume in 3 s/forced vital capacity ratio (FEV3/FVC), in the assessment of small airway obstruction in chronic obstructive pulmonary disease (COPD). One hundred and six COPD patients and 43 control subjects, aged over 55, were investigated. Spirometry and IOS were used to assess pulmonary function. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were evaluated. The findings demonstrate significant reductions in FEV3/FVC and MMEF, and an increase in R5-R20 difference in COPD patients; the changes that depended on the severity of airway obstruction. The sensitivity of R5-R20 in reflecting the MMEF was 84%, specificity 44.2%, PPV 72.4%, and NPV 61.3%. We conclude that the R5-R20 difference is superior to spirometry in the assessment of small bronchi obstruction. A high sensitivity of R5-R20 in reflecting the MMEF makes the IOS method particularly useful for detection of mild lung injury, while a high specificity of the spirometric FEV3/FVC ratio makes it useful to exclude obstruction of small airways. Both methods are thus complimentary.

Authors+Show Affiliations

Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 84 Szamarzewskiego Street, 60-569, Poznan, Poland. t_piorun@op.pl.Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 84 Szamarzewskiego Street, 60-569, Poznan, Poland.Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 114-116 Arthurt-Scheunert Alee, Nuthetal, Germany. Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572, Poznan, Poland.Department of Human Nutrition and Hygiene, Poznan University of Life Sciences, 31 Wojska Polskiego Street, 60-624, Poznan, Poland.Department of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355, Poznan, Poland. Neuroimmunological Unit, Polish Academy of Sciences, 49 Przybyszewskiego Street, 60-355, Poznan, Poland.Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 84 Szamarzewskiego Street, 60-569, Poznan, Poland.Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 84 Szamarzewskiego Street, 60-569, Poznan, Poland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28197800

Citation

Piorunek, Tomasz, et al. "Small Airway Obstruction in Chronic Obstructive Pulmonary Disease: Potential Parameters for Early Detection." Advances in Experimental Medicine and Biology, vol. 980, 2017, pp. 75-82.
Piorunek T, Kostrzewska M, Stelmach-Mardas M, et al. Small Airway Obstruction in Chronic Obstructive Pulmonary Disease: Potential Parameters for Early Detection. Adv Exp Med Biol. 2017;980:75-82.
Piorunek, T., Kostrzewska, M., Stelmach-Mardas, M., Mardas, M., Michalak, S., Goździk-Spychalska, J., & Batura-Gabryel, H. (2017). Small Airway Obstruction in Chronic Obstructive Pulmonary Disease: Potential Parameters for Early Detection. Advances in Experimental Medicine and Biology, 980, 75-82. https://doi.org/10.1007/5584_2016_208
Piorunek T, et al. Small Airway Obstruction in Chronic Obstructive Pulmonary Disease: Potential Parameters for Early Detection. Adv Exp Med Biol. 2017;980:75-82. PubMed PMID: 28197800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Small Airway Obstruction in Chronic Obstructive Pulmonary Disease: Potential Parameters for Early Detection. AU - Piorunek,Tomasz, AU - Kostrzewska,Magdalena, AU - Stelmach-Mardas,Marta, AU - Mardas,Marcin, AU - Michalak,Sławomir, AU - Goździk-Spychalska,Joanna, AU - Batura-Gabryel,Halina, PY - 2017/2/16/pubmed PY - 2017/9/13/medline PY - 2017/2/16/entrez KW - Airflow Limitation KW - Airways Obstruction KW - Chronic Lung Disease KW - Lung Function KW - Respiratory Resistance SP - 75 EP - 82 JF - Advances in experimental medicine and biology JO - Adv. Exp. Med. Biol. VL - 980 N2 - The impulse oscillometry (IOS) is recognized as a complementary method to spirometry in the diagnostics of obstructive pulmonary disorders. The IOS enables to measure total respiratory resistance (R5) and proximal respiratory resistance (R20), with the R5-R20 difference reflecting small airway resistance. This study seeks to evaluate the usefulness of R5-R20, maximal mid-expiratory flow (MMEF), and forced expiratory volume in 3 s/forced vital capacity ratio (FEV3/FVC), in the assessment of small airway obstruction in chronic obstructive pulmonary disease (COPD). One hundred and six COPD patients and 43 control subjects, aged over 55, were investigated. Spirometry and IOS were used to assess pulmonary function. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were evaluated. The findings demonstrate significant reductions in FEV3/FVC and MMEF, and an increase in R5-R20 difference in COPD patients; the changes that depended on the severity of airway obstruction. The sensitivity of R5-R20 in reflecting the MMEF was 84%, specificity 44.2%, PPV 72.4%, and NPV 61.3%. We conclude that the R5-R20 difference is superior to spirometry in the assessment of small bronchi obstruction. A high sensitivity of R5-R20 in reflecting the MMEF makes the IOS method particularly useful for detection of mild lung injury, while a high specificity of the spirometric FEV3/FVC ratio makes it useful to exclude obstruction of small airways. Both methods are thus complimentary. SN - 0065-2598 UR - https://www.unboundmedicine.com/medline/citation/28197800/Small_Airway_Obstruction_in_Chronic_Obstructive_Pulmonary_Disease:_Potential_Parameters_for_Early_Detection_ L2 - https://dx.doi.org/10.1007/5584_2016_208 DB - PRIME DP - Unbound Medicine ER -