Expert Opinion

Boiselle, Phillip M.; Crapo, James D.; Han, MeiLan K.; Lynch, David A.; Tashkin, Donald P.

doi:10.1097/rti.0b013e3182a11afd

Cited by 1 publication

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“…(1–5) Such information contributes to the quantitative phenotyping of COPD patients, which has the potential to guide management strategies in order to improve symptom relief while minimizing the risk of acute exacerbations and progression of disease. (6,7)…”

Section: Introductionmentioning

confidence: 99%

Static end-expiratory and dynamic forced expiratory tracheal collapse in COPD

et al. 2014

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AIM: To determine the range of tracheal collapse at end-expiration among chronic obstructive pulmonary disease (COPD) patients and to compare the extent of tracheal collapse between static end-expiratory and dynamic forced-expiratory multidetector-row computed tomography (MDCT). MATERIALS AND METHODS: After institutional review board approval and obtaining informed consent, 67 patients meeting the National Heart, Lung, and Blood Institute (NHLBI)/World Health Organization (WHO) Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for COPD were sequentially imaged using a 64-detector-row CT machine at end-inspiration, during forced expiration, and at end-expiration. Standardized respiratory coaching and spirometric monitoring were employed. Mean percentage tracheal collapse at end-expiration and forced expiration were compared using correlation analysis, and the power of end-expiratory cross-sectional area to predict excessive forced-expiratory tracheal collapse was computed following construction of receiver operating characteristic (ROC) curves. RESULTS: Mean percentage expiratory collapse among COPD patients was 17±18% at end-expiration compared to 62±16% during forced expiration. Over the observed range of end-expiratory tracheal collapse (approximately 10–50%), the positive predictive value of end-expiratory collapse to predict excessive (≥80%) forced expiratory tracheal collapse was <0.3. CONCLUSION: COPD patients demonstrate a wide range of end-expiratory tracheal collapse. The magnitude of static end-expiratory tracheal collapse does not predict excessive dynamic expiratory tracheal collapse.

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