Reversibility of airway obstruction in relation to prognosis in chronic obstructive pulmonary disease. 1988

Y Kawakami, and F Kishi, and K Dohsaka, and Y Nishiura, and A Suzuki
First Department of Medicine, School of Medicine, Hokkaido University, Sapporo, Japan.

Whether reversibility in airway obstruction with beta-adrenergic stimulant is a significant determinant for the outcome was tested in 59 patients with pulmonary emphysema and chronic bronchitis. During four years of follow-up, 43 (73 percent) patients survived and 16 (27 percent) died. Initial VC. FVC, FEV1, and PaO2 were significantly smaller, and PaCO2 was significantly larger in nonsurvivors than those in survivors. After orciprenaline sulfate (10 mg in 0.5 ml solution) inhalation, VC and FEV1 increased in comparable amount between the two groups. Airway reversibility as estimated by percentage changes in FEV1 before and after the bronchodilator (reversibility index) was similar between the two groups. In the 16 nonsurvivors, hypoxemic patients had similar FEV1, FEV1/FVC, and reversibility indices as normoxemic patients. These results indicate that not airway reversibility per se but a fixed or irreversible component of airway obstruction is one of the determinants of the prognosis in pulmonary emphysema and chronic bronchitis. Chronic hypoxemia is related to neither airway obstruction nor its reversibility, while it does influence the prognosis.

UI MeSH Term Description Entries
D008173 Lung Diseases, Obstructive Any disorder marked by obstruction of conducting airways of the lung. AIRWAY OBSTRUCTION may be acute, chronic, intermittent, or persistent. Obstructive Lung Diseases,Obstructive Pulmonary Diseases,Lung Disease, Obstructive,Obstructive Lung Disease,Obstructive Pulmonary Disease,Pulmonary Disease, Obstructive,Pulmonary Diseases, Obstructive
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009921 Metaproterenol A beta-2 adrenergic agonist used in the treatment of ASTHMA and BRONCHIAL SPASM. Orciprenaline,Alotec,Alupent,Astmopent,Metaprel,Metaproterenol Polistirex,Metaproterenol Sulfate,Orciprenaline Sulfate,Polistirex, Metaproterenol
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011656 Pulmonary Emphysema Enlargement of air spaces distal to the TERMINAL BRONCHIOLES where gas-exchange normally takes place. This is usually due to destruction of the alveolar wall. Pulmonary emphysema can be classified by the location and distribution of the lesions. Emphysema, Pulmonary,Centriacinar Emphysema,Centrilobular Emphysema,Emphysemas, Pulmonary,Focal Emphysema,Panacinar Emphysema,Panlobular Emphysema,Pulmonary Emphysemas,Centriacinar Emphysemas,Centrilobular Emphysemas,Emphysema, Centriacinar,Emphysema, Centrilobular,Emphysema, Focal,Emphysema, Panacinar,Emphysema, Panlobular,Emphysemas, Centriacinar,Emphysemas, Centrilobular,Emphysemas, Focal,Emphysemas, Panacinar,Emphysemas, Panlobular,Focal Emphysemas,Panacinar Emphysemas,Panlobular Emphysemas
D012123 Pulmonary Ventilation The total volume of gas inspired or expired per unit of time, usually measured in liters per minute. Respiratory Airflow,Ventilation Tests,Ventilation, Pulmonary,Expiratory Airflow,Airflow, Expiratory,Airflow, Respiratory,Test, Ventilation,Tests, Ventilation,Ventilation Test
D001980 Bronchi The larger air passages of the lungs arising from the terminal bifurcation of the TRACHEA. They include the largest two primary bronchi which branch out into secondary bronchi, and tertiary bronchi which extend into BRONCHIOLES and PULMONARY ALVEOLI. Primary Bronchi,Primary Bronchus,Secondary Bronchi,Secondary Bronchus,Tertiary Bronchi,Tertiary Bronchus,Bronchi, Primary,Bronchi, Secondary,Bronchi, Tertiary,Bronchus,Bronchus, Primary,Bronchus, Secondary,Bronchus, Tertiary
D001991 Bronchitis Inflammation of the large airways in the lung including any part of the BRONCHI, from the PRIMARY BRONCHI to the TERTIARY BRONCHI. Bronchitides
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

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