Chest
Clinical InvestigationsASTHMAResponse of Lung Volumes to Inhaled Salbutamol in a Large Population of Patients With Severe Hyperinflation
Section snippets
Patients
A retrospective analysis was performed, deriving subjects from a large (ie, > 20,000 patients) database of patients who had undergone pulmonary function testing at the pulmonary function laboratory at Kingston General Hospital between 1982 and 1998. To be eligible, the patient was required to have undergone spirometry testing and a determination of static lung volumes before and after the administration of 200 μg salbutamol. All patients with a baseline TLC of > 115% of predicted, and airways
Patient Characteristics
Nine hundred fifty-seven individual patients who had been evaluated at the pulmonary function laboratory were included in the study. Of these, 534 were men and 423 were women. The mean age was 64.7 ± 0.37 years.
Of the 957 patients, 281 were classified as SH (ie, TLC, > 133% of predicted; FEV1/FVC ratio, < 85% of predicted), and the remaining 676 patients were classified as MH. The baseline characteristics of both groups are depicted in Figure 1.
The patients in the SH group had significant
Discussion
The relevant findings of this study are as follows. In hyperinflated patients, the measurement of IC, RV, or FVC before and after bronchodilator administration identifies a response that may not be uncovered by the standard measurement of FEV1. Indeed, the inclusion of IC, RV, or FVC with FEV1 suggests that up to three quarters of these patients improve with bronchodilator therapy. The improvements in lung volumes are largely independent of changes in maximal expiratory flow rates.
This was a
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