Functional evaluation of trachea in patients with COPD

Abstract

Severe cough associated with COPD can induce dynamic instability of trachea. It is important to investigate large airways in COPD patients and to create diagnostic program for evaluation of this dynamic changes. Aim: to investigate sensitivity and specificity of different methods for detection of dynamic tracheal instability in COPD patients. Of fifty five patients involved in this study 30 ones were selected according to inclusion criteria. They were divided into 2 groups: 20 COPD stage 2 patients with dynamic tracheal instability detected by fiberoptic bronchoscopy (the 1-st group; 14 females, 6 males; the mean age, 60.9 ± 7.9 yrs; BMI, 28.2 ± 4.3 kg / m2; the smoking history, 35.4 ± 5.2 pack-year) and 10 COPD stage 2 patients without dynamic tracheal instability according to fiberoptic bronchoscopy findings (the 2nd group; 2 females and 8 males; the mean age, 55.2 ± 4.8 yrs; BMI, 26.8 ± 2.6 kg/m2; the smoking history, 28.2 ± 3.4 pack-year). Clinical examination, flow-volume curve, body plethysmography, impulse oscillometry, X-ray examination of trachea, fiberoptic bronchoscopy, and electron-beam tomography were used in our work. As a result, the most sensitive functional method was impulse oscillometry (Se = 85 %). Electron-beam tomography is more sensitive (Se = 90 %) than X-ray examination of trachea (Se = 65 %) while diagnosing dynamic tracheal instability in the COPD patients.