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COMPARISON OF GAS EXCHANGE BETWEEN PATIENTS WITH TUBERCULOSIS ASSOCIATED LUNG DESTRUCTION AND EMPHYSEMA FREE TO VIEW

Sei Won Lee, MD*; Young Ae Kang, MD; Sang Min Lee, MD; Young Whan Kim, MD; Sung Koo Han, MD; Young-Soo Shim, MD; Chul-Gyu Yoo, MD
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Armed Forces Yanju Hospital, Seoul, South Korea


Chest


Chest. 2007;132(4_MeetingAbstracts):643c-644. doi:10.1378/chest.132.4_MeetingAbstracts.643c
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Abstract

PURPOSE: Tuberculosis associated lung destruction and emphysema are common chronic debilitating lung diseases and have similar clinical manifestation especially when they are severe. We conduct the comparison of gas exchange between two diseases because different pathogenesis can make difference in gas exchange.

METHODS: We reviewed the medical records of patients who visited Seoul national university hospital with the diagnosis of tuberculosis associated lung destruction and emphysema.

RESULTS: We enrolled 35 of tuberculosis associated lung destruction and 33 of emphysema patients. They had similar FEV1 (0.86±0.22L in tuberculosis associated lung destruction and 0.90±0.20L in emphysema, P=0.38), but PaO2 was significantly higher in tuberculosis associated lung destruction (83.9±7.0mmHg in tuberculosis associated lung destruction and 75.0±8.6mmHg in emphysema, P<0.001), even after correction for age. Alveolar-arterial oxygen gradient was significantly lower in emphysema and pathologic finding showed relatively well-preserved vascular structure in affected portion of emphysema patients and narrowed and destroyed vessels in tuberculosis associated lung destruction.

CONCLUSION: Patients with tuberculosis associated lung destruction have better gas exchange status than those with emphysema. The difference in ventilation-perfusion mismatch between two diseases can be explanation for this.

CLINICAL IMPLICATIONS: Although tuberculosis associated lung destruction and emphysema have similar clinical manifestation in severe cases, the degree of hypoxemia is milder in tuberculosis associated lung destruction.

DISCLOSURE: Sei Won Lee, None.

Wednesday, October 24, 2007

12:30 PM - 2:00 PM


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