Special Methods of Diagnosing and Treating Obstructive Diseases of the Central Airways

Herzog, H.; Keller, Roland; Allgöwer, M.

doi:10.1378/chest.60.1.49

Cited by 24 publications

(11 citation statements)

References 12 publications

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“…( 1 , 5 , 9 ) Likewise, our results confirm an association between the degree of dyspnea and that of obstruction. In addition, we found that there is an association between any given degree of dyspnea, as measured by the MRC scale, and the presence of obstruction in the upper third of the trachea.…”

Section: Discussionsupporting

confidence: 85%

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Contribution of flow-volume curves to the detection of central airway obstruction

Raposo¹,

Bugalho

Gomes

2013

J. bras. pneumol.

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OBJECTIVE: To assess the sensitivity and specificity of flow-volume curves in detecting central airway obstruction (CAO), and to determine whether their quantitative and qualitative criteria are associated with the location, type and degree of obstruction. METHODS: Over a four-month period, we consecutively evaluated patients with bronchoscopy indicated. Over a one-week period, all patients underwent clinical evaluation, flow-volume curve, bronchoscopy, and completed a dyspnea scale. Four reviewers, blinded to quantitative and clinical data, and bronchoscopy results, classified the morphology of the curves. A fifth reviewer determined the morphological criteria, as well as the quantitative criteria. RESULTS: We studied 82 patients, 36 (44%) of whom had CAO. The sensitivity and specificity of the flow-volume curves in detecting CAO were, respectively, 88.9% and 91.3% (quantitative criteria) and 30.6% and 93.5% (qualitative criteria). The most prevalent quantitative criteria in our sample were FEF50%/FIF50% ≥ 1, in 83% of patients, and FEV1/PEF ≥ 8 mL . L–1 . min–1, in 36%, both being associated with the type, location, and degree of obstruction (p < 0.05). There was concordance among the reviewers as to the presence of CAO. There is a relationship between the degree of obstruction and dyspnea. CONCLUSIONS: The quantitative criteria should always be calculated for flow-volume curves in order to detect CAO, because of the low sensitivity of the qualitative criteria. Both FEF50%/FIF50% ≥ 1 and FEV1/PEF ≥ 8 mL . L–1 . min–1 were associated with the location, type and degree of obstruction.

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Section: Discussionsupporting

confidence: 85%

“…Respiratory function testing, by means of analysis of flow-volume curves obtained from forced maneuvers, is the most appropriate method. ( 1 , 8 , 9 ) …”

Section: Introductionmentioning

confidence: 99%

Contribution of flow-volume curves to the detection of central airway obstruction

Raposo¹,

Bugalho

Gomes

2013

J. bras. pneumol.

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“…The study of the lumen of the bronchial tree in man includes, besides bronchoscopy, the measurement of the forced expiratory (FEVt ) and inspiratory (FIVT) volumes, the forced vital capacity (FVC) or one of its functions, body plethysmography or even more complex techniques such as the study of flow volume or transpulmonary pressure flow curves or the tracheal diameter/transmural pressure diagram [1,8,9,11,12,14].…”

mentioning

confidence: 99%

“…In animals, particularly in small ones, measurements requiring active cooperation are obviously impossible, so that rather complex apparatuses are required; it follows that so far relatively few in vivo experi ments of this kind have been reported [6,11,12],…”

mentioning

confidence: 99%

Resistance of Airways in Animals following Tracheal Plastic Surgery

Velluti¹,

Piacenza²,

Ferrara³

et al. 1979

Respiration

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“…Although antitussives had been thought to act centrally, their principal action is now believed to be peripheral, in reversing bronchospasm and aiding expectoration [4]. Coughing disrupts breathing, creates ventilatory imbalance and distorts upper airways dynamics [5,6]; the paroxysms, themselves, are initiated, or modified, by stimulation of sites in the upper airways [7,8], Knowledge of these interrelationships and of the utility of bronchodilating drugs as antitussive therapy [9][10][11], implies that older ventilatory indices, as well as newer measures of cough, be included in critical appraisal of treat ment. This study compared the relative responsivity of certain common spirometric and airway resistance variable with a direct estimate of cough resistance in an examination of the responses of ambulatory subjects with common colds to oral doses of active drug mixtures, and matched place bo, given in a double-blind protocol.…”

mentioning

confidence: 99%

Respiratory and Cough Mechanics in Antitussive Trials

Cohen¹

1975

Respiration

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The relative responsitivy of nine expirographic and airway indices to antitussive therapy was studied in a randomized double-blind trial in which 60 adults without bronchopulmonary disorders, but suffering from common colds, were given oral doses of five drug formulations placebo during their initial 48 h of symptoms. Thoracic gas volume (V_tg), nasal (R_n), lower (R_a), total ([R_n + R_a]) and specific (sR_a) airway resistances were determined plethysmographically; forced vital capacity (FVC), forced expiratory volume for the first second (FEV_1.0) and maximal mid-expiratory flow rate (MMEFR) were recorded spirometrically. Cough pressure at peak flow furnished an index of cough (CI). The measurements were made at baseline and for 4 h after drug; medication was continued for two additional doses and the indices determined again the following morning. Abnormal control means were noted for R_n and [R_n + R_a] (90.8%), cough resistance (83.3%), MMEFR (58.3%), R_a and sR_a (30.0%), but less often for FEV_1.0, V_tg and FVC (6.6, 5.1 and 0.0%, respectively). Nasal and total airways flow resistance means were as sensitive to active therapy and in discriminating the relative worth of medication as direct CI values, R_a and sR_a were less reliable, and the three spirometric functions were the least responsive. This ranking was consistent with the common central airways location of subepithelial receptors responsible for cough and the associated reflex bronchoconstriction. The greatest changes in cough resistance followed treatment with the most significant activity in the nasal, as well as the lower tract, component of total airway resistance.

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Special Methods of Diagnosing and Treating Obstructive Diseases of the Central Airways

Cited by 24 publications

References 12 publications

Contribution of flow-volume curves to the detection of central airway obstruction

Contribution of flow-volume curves to the detection of central airway obstruction

Resistance of Airways in Animals following Tracheal Plastic Surgery

Respiratory and Cough Mechanics in Antitussive Trials

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