RT Journal Article
SR Electronic
T1 Pulmonary Function and Flow Volume Loop Patterns in Patients with Tracheobronchomalacia.
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.02277
DO 10.4187/respcare.02277
A1 Adnan Majid
A1 Andres F. Sosa
A1 Armin Ernst
A1 David Feller-Kopman
A1 Erik Folch
A1 Anup Singh
A1 Sidhu Gangadharan
YR 2013
UL http://rc.rcjournal.com/content/early/2013/03/12/respcare.02277.abstract
AB Background: Patterns of pulmonary function tests (PFTs) and flow-volume loops (FVLs) among patients with clinically significant tracheobronchomalacia (TBM) are not well described. Small studies suggest four main FVL morphologies: low maximal forced expiratory flow (FEFmax), biphasic expiratory curve, flow oscillations and notching. Objective: To describe common pulmonary function test (PFT) and FVL patterns among the largest prospective series of patients to date undergoing clinical evaluation for symptomatic moderate to severe TBM. Methods: We conducted a retrospective analysis of prospectively collected data from patients who were referred to the Chest Disease Center from January 2002 to December 2008 with respiratory symptoms that were attributed primarily to TBM. PFT results of 90 patients with symptomatic moderate to severe TBM were evaluated. Results: By PFTs, 40 (44.4%) patients had an obstructive ventilatory defect, 16 (17.8%) had a definite or highly likely restrictive ventilatory defect, 15 (16.7%) had a mixed defect, and 19 (21.1%) were within normal limits. Among 76 patients with available FVLs, the most frequent finding was low FEFmax in 62 (81.6%) cases, followed by biphasic morphology 15 (19.7%), notched expiratory loop 7 (9.2%) and expiratory oscillations 2 (2.6%).The balance of 13 patients (17.1%) had no distinctive FVL abnormality. Conclusion: PFTs and FVLs are normal in a significant number of patients with moderate to severe TBM and should not be used to decide whether tracheobronchomalacia is present or clinically significant.