Chest
Preliminary ReportAerosol-Derived Airway Morphometry and Aerosol Bolus Dispersion in Patients With Lung Fibrosis and Lung Emphysema
Section snippets
Subjects
Twenty patients with chronic interstitial pulmonary fibrosis (IPF; 13 men, 7 women) and 20 patients with pulmonary emphysema (PE; 13 men, 7 women) participated in the study (Table 1). Anamnestic data were evaluated by a questionnaire based on American Thoracic Society recommendations.12 The smoking habits of the patients were quantified by using the cumulative cigarette consumption expressed as pack-years.
The diagnosis of chronic IPF was based on clinical, histologic, and radiographic (CT of
Results
Patients with IPF and PE showed no differences in anthropometric data (age, weight, height; Table 1).
In patients with IPF, lung volumes VC and TLC were mild to moderately reduced. RV was relatively well preserved. Because 50% of the patients were current or former smokers, a moderate airflow obstruction with decreased FEV1, MEF25, and MEF50 was observed. The Tlco was reduced.
Patients with PE showed chronic irreversible hyperinflation inferred from elevated levels of TLC and ITGV, clear signs of
Discussion
AD is increased in patients with PE, but is normal in patients with IPF. In both patient groups, ADAM showed increased airspace dimensions compared with the control group. However, the pattern of increased airspace dimensions was different between the two patient groups. Patients with PE showed normal EAD values in proximal lung depth. Inasmuch as this lung depth (Vp,r = 0.04) is, for the patients with PE, on average about 200 to 250 cm3, this likely represents the most peripheral parts of the
Conclusions
The presence of PE can be detected with ADAM and AD. IPF can be distinguished from PE by differences in AD and a different pattern of changes in ADAM. Therefore, in epidemiologic studies and in occupational medicine, both techniques seem to be useful for the detection of PE in humans. The specificity of the aerosol tests is not impaired by subjects with changes in lung morphometry caused by fibrosis. The practical value of these results should be confirmed by further prospective studies.
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