Loading...
Please wait, while we are loading the content...
Similar Documents
Bronchodilator reversibility testing in chronic obstructive pulmonary disease.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Calverley, Peter M. A. Burge, Peter Spencer, Shannon Anderson, Julie Anne Jones, Paul W. |
| Copyright Year | 2003 |
| Abstract | BACKGROUND A limited or absent bronchodilator response is used to classify chronic obstructive pulmonary disease (COPD) and can determine the treatment offered. The reliability of the recommended response criteria and their relationship to disease progression has not been established. METHODS 660 patients meeting European Respiratory Society (ERS) diagnostic criteria for irreversible COPD were studied. Spirometric parameters were measured on three occasions before and after salbutamol and ipratropium bromide sequentially or in combination over 2 months. Responses were classified using the American Thoracic Society/GOLD (ATS) and ERS criteria. Patients were followed for 3 years with post-bronchodilator FEV(1) and exacerbation history recorded 3 monthly and health status 6 monthly. RESULTS FEV(1) increased significantly with each bronchodilator, a response that was normally distributed. Mean post-bronchodilator FEV(1) was reproducible between visits (intraclass correlation 0.93). The absolute change in FEV(1) was independent of the pre-bronchodilator value but the percentage change correlated with pre-bronchodilator FEV(1) (r=-0.44; p<0.0001). Using ATS criteria, 52.1% of patients changed responder status between visits compared with 38.2% using ERS criteria. Smoking status, atopy, and withdrawing inhaled corticosteroids were unrelated to bronchodilator response, as was the rate of decline in FEV(1), decline in health status, and exacerbation rate. CONCLUSION In moderate to severe COPD bronchodilator responsiveness is a continuous variable. Classifying patients as "responders" and "non-responders" can be misleading and does not predict disease progression. |
| Starting Page | 193 |
| Ending Page | 194 |
| Page Count | 2 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://thorax.bmj.com/content/thoraxjnl/58/8/659.full.pdf |
| PubMed reference number | 12885978v1 |
| Volume Number | 58 |
| Issue Number | 8 |
| Journal | Thorax |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Adrenal Cortex Hormones Albuterol Amelogenesis imperfecta nephrocalcinosis Atopy Bronchodilator Agents Chronic Obstructive Airway Disease Classification Extended Rotated Sidebent Inspiration function Ipratropium Lung Diseases, Obstructive Lung diseases Patients Progressive Disease Status Epilepticus Thoracic Outlet Syndrome diagnostic criteria |
| Content Type | Text |
| Resource Type | Article |
