Chest Infections: Chest Infections: Bronchieactasis |

Impulse Oscillometry and Spirometry Small Airway Parameters in Mild to Moderate Bronchiectasis FREE TO VIEW

Wei-jie Guan, PhD; Jing-jing Yuan, MB; Yong-hua Gao; Hui-min Li, MB; Jin-ping Zheng, MD; Rongchang Chen, MD; Nanshan Zhong, MD
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State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A102. doi:10.1016/j.chest.2016.02.107
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SESSION TITLE: Chest Infections: Bronchieactasis

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Both impulse oscillometry (IOS) and spirometry could reflect small airway disorders. We aimed to investigate the diagnostic value of IOS and spirometric small airway parameters (SAPs) and their correlation with radiology, disease severity and sputum bacteriology in mild-to-moderate bronchiectasis [Bronchiectasis Severity Index (BSI) <9], and to validate these findings in sensitivity analyses (mild bronchiectasis).

METHODS: We recruited 70 (discovery set) and 24 bronchiectasis patients (validation set), and 26 healthy subjects. The diagnostic value of small airway parameters was compared with the receiver operation characteristic curve. Chest high-resolution computed tomography (HRCT), IOS measurement, spirometry, and sputum culture were performed. Correlation between SAPs and clinical indices was determined, adjusting for age, sex, body-mass index and smoking history. Sensitivity analyses were repeated when excluding patients with BSI ≥9 or HRCT score ≥7.

RESULTS: IOS and spirometric SAPs could discriminate mild-to-moderate bronchiectasis from healthy subjects, and correlated significantly with HRCT score and the number of bronchiectatic lobes, but not BSI, both in discovery and validation set. SAPs were independent of Pseudomonas aeruginosa isolation, dyshomogeneity, the location of predominant bronchiectatic lobes, or cystic bronchiectasis (all P>0.05). Subgroup analyses yielded similar findings, except for the lack of significant correlation between SAPs and HRCT score or the number of bronchiectatic lobes.

CONCLUSIONS: IOS and spirometric SAPs have comparable value to reflect peripheral airway disorders, and correlate with HRCT scores in mild-to-moderate bronchiectasis. SAPs are independent of clinical variables in milder forms of bronchiectasis, suggesting that their roles for disease assessment in future clinical practice.

CLINICAL IMPLICATIONS: Our findings highlighted that small airway disorders, as revealed by spirometry and IOS, is partially associated with the severity of bronchiectasis. This called for attention of small airway disorders, including future medications that specifically focus on them, in adults with bronchiectasis.

DISCLOSURE: The following authors have nothing to disclose: Wei-jie Guan, Jing-jing Yuan, Yong-hua Gao, Hui-min Li, Jin-ping Zheng, Rongchang Chen, Nanshan Zhong

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