Chest
Hyperinflation in Asthma and Emphysema: Assessment by Pulmonary Function Testing and Computed Tomography
Section snippets
Subjects
Ten patients with asthma who were life-long nonsmokers were studied. The diagnosis of asthma was based on a history of wheezing and/or shortness of breath and presence of variability of air flow obstruction, ie, 20 percent improvement in forced expiratory volume in one second (FEV1) after bronchodilation. They were included in the study if they had asthma for a minimum period of ten years and were more than 45 years of age in an effort to age match them with the chronic smokers. The other ten
RESULTS
The pulmonary function data in the two groups of subjects are summarized in Table 2. There was no statistically significant difference in the level of pulmonary function between the two groups of subjects. The range of total lung capacity (TLC) in the patients with asthma was from 80 percent to 136 percent of predicted. Four of these subjects had a TLC greater than 120 percent of predicted. The range of TLC in the smokers was from 75 percent to 141 percent of predicted. Three of them had a TLC
DISCUSSION
Patients with severe asthma often have persistent hyperinflation between attacks and it is not possible clinically or functionally to separate this group of patients or to rule out associated emphysema. In patients with chronic bronchitis and hyperinflation, the presence of coexisting emphysema is a poor prognostic sign; therefore it is important clinically to assess how much the emphysema contributes to the hyperinflation.
Auerbach et al9 showed that the prevalence of emphysema was much higher
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Manuscript received June 8; revision accepted January 25.