Spirometric Indices after Bronchodilator Test in Obstructive Lung Disease
Bronchial responsiveness to bronchodilator medications is usually tested to establish reversibility of airflow obstruction. Among the various tests to establish bronchodilator response, FEV1, FEF25-75% or FEF50%, and FVC are the most widely used. In a cross-sectional study, we assessed spirometric responses after administration of bronchodilator in 187 workers with obstructive pattern in spirometry. Considering responsiveness to bronchodilator (200cc and 12% increase in FEV1 or FVC), the study cases were divided into responsive or non-responsive groups, and the average increase in spirometric indices were measured and compared between two groups. 35.8% of cases were responsive to bronchodilator. Among responsive cases, FEV1 was the most frequent index increased significantly; And PEF and FVC were the least frequent ones. The highest mean increase from baseline after administration of bronchodilator was observed in FEF75%. Increases in all indices were significantly higher in responsive group. The increase in FEV1% predicted was inversely correlated with baseline FEV1. In conclusion, we consider that FEV1 is the most reliable spirometric index for assessing bronchodilator response. And Bronchial reversibility has an inverse relationship with baseline measures.
American Thoracic Society. Standardization of Spirometry 1994 Update. Am J Respir Crit Care Med 1995;152(3):1107-36.
Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J 2005;26(5):948-68.
Garay SM. Pulmonary function testing. In: Rom WN, Markowitz SB, editors. Environmental and Occupational Medicine. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007. p. 200-35.
Weir NA, Gulati M, Redlich CA. Diseases of the lung and pleura. In: Rosenstock L, Cullen MR, Brodkin CA, Redlich CA, editor. Textbook of Clinical Occupational and Environmental Medicine. 2nd ed. Philadelphia, PA: ElseviermSaunders; 2005. p. 289-91.
Shim C. Response to bronchodilators. Clin Chest Med 1989;10(2):155-64.
Neukirch F, Cartier A. Measure of bronchial hyperreactivity in epidemiology. Rev Mal Respir 1994;11(2):101-9.
Teculescu D, Racineux JL. The analysis of bronchial obstruction and its reversibility after bronchodilators using a study of "density-effect" on maximum flow. Rev Mal Respir 1991;8(1):29-37.
Kabondo P, Orehek J. Reversibility of airway obstruction in asthma and chronic bronchitis. Bull Eur Physiopathol Respir 1977;13(6):829-36.
Ninković M, Ranković B, Plavec G. Evaluation of the bronchodilator test. Vojnosanit Pregl 1991;48(1):19-22.
Tweeddale PM, Alexander F, McHardy GJ. Short term variability in FEV1 and bronchodilator responsiveness inmpatients with obstructive ventilatory defects. Thorax 1987;42(7):487-90.
Brand PL, Quanjer PH, Postma DS, Kerstjens HA, Koëter GH, Dekhuijzen PN, et al. Interpretation of bronchodilator response in patients with obstructive airways disease. The Dutch Chronic Non-Specific Lung Disease (CNSLD) Study Group. Thorax 1992;47(6):429-36.
Chhabra SK, Vijayan VK, Gupta R, De S. Expression of bronchodilator response: comparison of four indices. Respir Med 2002;96(8):611-4.
Schermer T, Heijdra Y, Zadel S, van den Bemt L, Boonman-de Winter L, Dekhuijzen R, et al. Flow and volume responses after routine salbutamol reversibility testing in mild to very severe COPD. Respir Med 2007;101(6):1355-62.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.