Diffuse Lung Disease |

Validation of Portable Home Spirometry Measurements in Patients With Fibrotic Interstitial Lung Disease FREE TO VIEW

Kaitlin Fier; Jeffrey Swigris, MS; Amanda Belkin; Gregory Cosgrove; Brown Kevin; Amy Olson, MSPH
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National Jewish Health, Denver, CO

Chest. 2014;146(4_MeetingAbstracts):374A. doi:10.1378/chest.1993184
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SESSION TITLE: Interstitial Lung Disease Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Fibrotic interstitial lung (F-ILD) is typically a progressive condition with slow decline in lung function; however, acute respiratory decline immediately prior to death has been reported to occur in nearly all forms of F-ILD. Portable home spirometry (PHS) may provide a means for frequent assessment of lung function to more rapidly identify physiologic decline.

METHODS: Participants with F-ILD (as assessed by the treating physician and in accordance with standard guidelines) who had same-day institutional spirometry (IS) prior to a routine clinic appointment (Jaeger System, JLAB 5.2), were consecutively recruited from the Interstitial Lung Disease Program at National Jewish Health. After informed consent and PHS training, subjects were asked to perform forced vital capacity (FVC) maneuvers using the PHS unit (EasyOne™ Spirometry, NDD Medical Technologies) after their routine clinic appointment. PHS FVC values were compared to IS FVC values using the Pearson correlation coefficien, and linear regression was used to determine if there were differences between PHS and IS FVC values based on the severity of disease.

RESULTS: A total of 39 patients were consented; data from 31 patients were analyzed (8 patients were excluded due to either physiologic obstruction or bronchodilator use of less than 4 hours between IS and PHS testing). Underlying disease diagnoses included the following: idiopathic pulmonary fibrosis, n = 11; fibrotic non-specific interstitial pneumonia, n = 5; connective tissue disease-associated ILD, n = 8; fibrotic hypersensitivity pneumonitis, n = 2; and smoking-related ILD, n = 3. The mean age was 67.4 ± 10.4 years, 61.3% were men, and all subjects were Caucasian. The mean FVC value from IS was 2.72 ± 0.93 L, whereas the mean FVC value from PHS was 2.68 ± 0.89 L. The correlation of FVC between PHS and IS was excellent (Pearson's r = 0.97). No difference between PHS and IS FVC values was found based on the severity of disease (p = 0.44) .

CONCLUSIONS: In patients with F-ILD, PHS assessment of FVC is a reliable measure of physiology when compared to that performed within the institution, and may be a valid tool for patients to monitor their own FVC frequently over time.

CLINICAL IMPLICATIONS: Daily PSH measurement of FVC may allow for closer monitoring of physiologic deterioration, which ultimately may provide better insight into the natural history of these disease processes and allow for timelier interventions when deterioration is identified.

DISCLOSURE: The following authors have nothing to disclose: Kaitlin Fier, Jeffrey Swigris, Amanda Belkin, Gregory Cosgrove, Brown Kevin, Amy Olson

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