Comparison of FEV<sub>1</sub> and specific airway conductance in assessing airway response to occupational agents

Larbanois, Alexandra; Delwiche, J P; Jamart, Jacques; Vandenplas, Olivier

doi:10.1046/j.1398-9995.2003.00313.x

Cited by 9 publications

(5 citation statements)

References 20 publications

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“…The clinical relevance of changes in sGaw is not widely documented. Larbanois et al considered a 20% change of sGaw to be clinically relevant in a study on airway responsiveness to occupational agents (15). The difference in sGaw in our study of 10% is lower, which can probably be explained by the relatively small power of our stimulus as compared to the study of Larbanois. A change in the contractility of bronchial smooth muscles can have effect on the level of bronchial responsiveness (6).…”

Section: Discussioncontrasting

confidence: 64%

Metabolic Acidosis Improves Airway Conductance in Patients with Asthma

Brijker¹,

Elshout²,

Bosch³

et al. 2009

Journal of Asthma

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The objective was to investigate whether acute metabolic acidosis could cause bronchodilation in patients with asthma. Twelve patients with asthma (8 females, mean age 39 (+/- SD 12) years, forced expiratory volume in 1 second [FEV(1)] 93 [+/-9] % predicted, PC(20) 1.9 (+/-1.0) mg/mL) participated in a double-blind, placebo-controlled trial. Subjects ingested calculated amounts of ammonium chloride to induce acidosis or saline as placebo, in random order, each on a separate day. Airway resistance (R(aw)), specific airway conductance (sG(aw)), FEV(1), and PEF were measured as primary variables. To evaluate the consequences of alterations in bronchial contractility on the airway responsiveness, the histamine provocation test (PC(20)) was measured as secondary variable. The intervention resulted in a mean (SD) decrease in base excess from -0.5 (+/-1.4) to -3.9 (+/-1.1) mmol/L (p < 0.01) and a decrease in pH from 7.41 (+/-0.02) to 7.36 (+/-0.02) (p < 0.01). This caused a statistically significant increase in sG(aw) from 1.15 (+/-0.16) to 1.26 (+/-0.13) 1/kPa.s) (p < 0.05). Tendencies towards increase were found in PEF (7.79 (+/-2.2) versus 8.09 (+/-1.9) (NS, p = 0.10) and in FEV(1) (2.98 (+/-0.9) versus 3.06 (+/-0.9) (NS, p = 0.15). PC(20) did not change significantly. It was concluded that acute metabolic acidosis has a modest bronchodilating effect in patients with asthma.

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Section: Discussioncontrasting

confidence: 64%

Metabolic Acidosis Improves Airway Conductance in Patients with Asthma

Brijker¹,

Elshout²,

Bosch³

et al. 2009

Journal of Asthma

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“…Measurements of airway resistance or conductance by body plethysmography [65,[72][73][74] and respiratory resistance by the forced oscillation technique [75] are not affected by inspiratory manoeuvres and are not effort-dependent, but they are less reproducible and require more expensive equipment. Nevertheless, these parameters may be useful in subjects who are not able to perform reproducible spirometric manoeuvres and may provide useful complementary evidence of a significant bronchial response during SICs that produce equivocal changes in FEV1 [76].…”

Section: Airway Obstructionmentioning

confidence: 99%

Specific inhalation challenge in the diagnosis of occupational asthma: consensus statement

et al. 2014

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This consensus statement provides practical recommendations for specific inhalation challenge (SIC) in the diagnosis of occupational asthma. They are derived from a systematic literature search, a census of active European centres, a Delphi conference and expert consensus. This article details each step of a SIC, including safety requirements, techniques for delivering agents, and methods for assessing and interpreting bronchial responses. The limitations of the procedure are also discussed.Testing should only be carried out in hospitals where physicians and healthcare professionals have appropriate expertise. Tests should always include a control challenge, a gradual increase of exposure to the suspected agent, and close monitoring of the patient during the challenge and for at least 6 h afterwards. In expert centres, excessive reactions provoked by SIC are rare.A positive response is defined by a fall in forced expiratory volume in 1 s o15% from baseline. Equivocal reactions can sometimes be clarified by finding changes in nonspecific bronchial responsiveness, sputum eosinophils or exhaled nitric oxide. The sensitivity and specificity of SIC are high but not easily quantified, as the method is usually used as the reference standard for the diagnosis of occupational asthma. @ERSpublications ERS Task Force: a statement on specific inhalation challenges in the diagnosis of occupational asthma

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“…It has been postulated that sGaw provides data on the large central airways. 19 – 21 Therefore, to give a comprehensive assessment of lung function and lung volumes, we also included the more traditional measurements of FEV 1 and FVC; these describe the more clinically relevant small airways. Improvements in these parameters reflected those of sGaw on day 28 and concurred with previous data using SFC250 11 and SFC 50/500.…”

Section: Discussionmentioning

confidence: 99%

Triple therapy with salmeterol/fluticasone propionate 50/250 plus tiotropium bromide improve lung function versus individual treatments in moderate-to-severe Japanese COPD patients: a randomized controlled trial – Evaluation of Airway sGaw after treatment with tripLE

Saito

Takeda

Hashimoto

et al. 2015

COPD

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PurposeTriple therapy using salmeterol/fluticasone propionate (FP) and tiotropium bromide is commonly used to treat chronic obstructive pulmonary disease (COPD), but sparse efficacy data exist in COPD patients with fewer symptoms and with a lower dose of inhaled corticosteroid in Japanese patients. The effects of of salmeterol/fluticasone propionate 50/250 μg (SFC250) twice daily plus tiotropium 18 μg (TIO) once daily and individual treatments on lung function were compared.Patients and methodsFifty three Japanese COPD patients participated in this randomized, double-blind, double-dummy, Williams square design crossover study. Lung function was assessed by plethysmography and spirometry.ResultsThe primary endpoint of postdose specific airway conductance area under the curve (AUC0–4h) on day 28 was significantly higher following SFC250 + TIO (0.854) compared with TIO (0.737, 15.8%) and SFC250 (0.663, 28.8%) alone. SFC250 + TIO significantly improved trough forced expiratory volume in 1 second from baseline versus TIO (0.161 L, P<0.001) and SFC250 (0.103 L, P=0.008). SFC250 + TIO significantly improved residual volume compared with TIO (P<0.001) and SFC250 (P=0.003) on day 28. Nonsignificant improvements were seen in trough inspiratory capacity, total lung capacity, and thoracic gas volume. There was no mean change seen in rescue medication.ConclusionTriple therapy using SFC250 + TIO was well tolerated and gave a greater improvement in bronchodilation compared with TIO and SFC250 alone in Japanese patients with COPD. There was improvement in few symptoms, but no mean change was seen in patient-reported outcomes measured by rescue medication use.

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Comparison of FEV₁ and specific airway conductance in assessing airway response to occupational agents

Abstract: A decline in SGaw of 50% or greater may provide useful complementary evidence of a bronchial response during challenges that produce equivocal results in FEV1.

Cited by 9 publications

References 20 publications

Metabolic Acidosis Improves Airway Conductance in Patients with Asthma

Metabolic Acidosis Improves Airway Conductance in Patients with Asthma

Specific inhalation challenge in the diagnosis of occupational asthma: consensus statement

Triple therapy with salmeterol/fluticasone propionate 50/250 plus tiotropium bromide improve lung function versus individual treatments in moderate-to-severe Japanese COPD patients: a randomized controlled trial – Evaluation of Airway sGaw after treatment with tripLE

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Comparison of FEV1 and specific airway conductance in assessing airway response to occupational agents

Abstract: A decline in SGaw of 50% or greater may provide useful complementary evidence of a bronchial response during challenges that produce equivocal results in FEV1.

Cited by 9 publications

References 20 publications

Metabolic Acidosis Improves Airway Conductance in Patients with Asthma

Metabolic Acidosis Improves Airway Conductance in Patients with Asthma

Specific inhalation challenge in the diagnosis of occupational asthma: consensus statement

Triple therapy with salmeterol/fluticasone propionate 50/250 plus tiotropium bromide improve lung function versus individual treatments in moderate-to-severe Japanese COPD patients: a randomized controlled trial &ndash; Evaluation of Airway sGaw after treatment with tripLE

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Comparison of FEV₁ and specific airway conductance in assessing airway response to occupational agents

Triple therapy with salmeterol/fluticasone propionate 50/250 plus tiotropium bromide improve lung function versus individual treatments in moderate-to-severe Japanese COPD patients: a randomized controlled trial – Evaluation of Airway sGaw after treatment with tripLE