Assessment Of Respiratory Function Research Articles

Diaphragm sniff ultrasound: Normal values, relationship with sniff nasal pressure and accuracy for predicting respiratory involvement in patients with neuromuscular disorders

BackgroundIn patients with neuromuscular disorders, assessment of respiratory function relies on forced vital capacity (FVC) measurements. Providing complementary respiratory outcomes may be useful for clinical trials. Diaphragm sniff ultrasound (US) is a noninvasive technique that can assess diaphragm function that may be affected in patients with neuromuscular disorders.PurposeWe aimed to provide normal values of sniff diaphragm ultrasound, to assess the relationship between sniff diaphragm US, vital capacity (VC) and sniff nasal pressure. Additionally, we aimed to evaluate the diagnostic accuracy of sniff diaphragm US for predicting restrictive pulmonary insufficiency.Materials and methodsWe included patients with neuromuscular disorders that had been tested with a sniff diaphragm US and functional respiratory tests. Healthy subjects were also included to obtain normal diaphragm sniff ultrasound. We performed diaphragm tissue Doppler imaging (TDI) and time movement (TM) diaphragm echography combined with sniff maneuver.ResultsA total of 89 patients with neuromuscular diseases and 27 healthy subjects were included in our study. In patients, the median age was 32 years [25; 50] and the median FVC was 34% of predicted [18; 55]. Sniff diaphragm motion using TM ultrasound was significantly associated with sniff nasal pressure, both for the right hemidiaphragm (r = 0.6 p <0.0001) and the left hemidiaphragm (r = 0.63 p = 0.0008). Right sniff peak TDI velocity was also significantly associated with FVC (r = 0.72, p<0.0001) and with sniff nasal pressure (r = 0.66 p<0.0001). Sniff diaphragm ultrasound using either TM mode or TDI displayed significant accuracy for predicting FVC<60% with an area under curve (AUC) reaching 0.93 (p<0.0001) for the right sniff diaphragm ultrasound in TM mode and 0.86 (p<0.001) for right peak diaphragm TDI velocity.ConclusionSniff diaphragm TM and TDI measures were significantly associated with sniff nasal pressure. Sniff diaphragm TM and TDI had a high level of accuracy to reveal respiratory involvement in patients with neuromuscular disorders. This technique is useful to assess and follow up diaphragm function in patients with neuromuscular disorders. It may be used as a respiratory outcome for clinical trials.

Validation of Respiratory Epithelial Functional Assessment to Predict Clinical Efficacy of Orkambi®.

Validation of Respiratory Epithelial Functional Assessment to Predict Clinical Efficacy of Orkambi®.

Comparison of therapeutic effects of inhaled corticosteroids on three subtypes of cough variant asthma as classified by the impulse oscillometry system

BackgroundCough variant asthma (CVA) is one of the most common causes of chronic persistent cough, and early treatment with inhaled corticosteroids (ICSs) is recommended to attenuate the inflammation and remodeling. The impulse oscillometry system (IOS) is a novel device for respiratory functional assessment that has not yet been assessed in terms of CVA. Therefore, we investigated the relationship between CVA and IOS, and the difference in therapeutic effects of ICSs among the subtype classifications by IOS.MethodsThe following ICSs were randomly prescribed in daily medical care: coarse-particle ICS (fluticasone propionate [FP]), fine-particle ICS (mometasone furoate [MF]), and moderate-particle ICS (budesonide [BUD]). Treatment effects were assessed by the Leicester cough questionnaire (LCQ) and were compared among three separated subtypes based on IOS measurements: central, peripheral, and resistless.ResultsRegarding LCQ scores, in the central type, the LCQ of the MF group was significantly lower than FP and BUD. In the peripheral type, the LCQ of the FP group was significantly lower than MF and BUD. In the resistless type, the LCQ of the MF group was significantly lower than BUD. Also, IOS factors were improved by 4 weeks of therapy with ICS. Thus, there was strong relationship between subtypes and particle size in terms of effectiveness.ConclusionsThere is a strong relationship between IOS subtype classification and ICS particle size in terms of therapeutic efficiency in CVA. It appears important to determine the ICS particle size, based on the IOS subtype classification, before treatment.

European Respiratory Society International Congress 2018: Allied Respiratory Professionals' report of highlighted sessions.

This article provides an overview of outstanding sessions that were supported by Assembly 9 during the recent European Respiratory Society International Congress in Paris, France. Session content was mainly targeted at allied health professionals such as respiratory physiologists, respiratory physiotherapists and respiratory nurses. Recent developments and novel findings related to pulmonary function testing, respiratory muscle function assessments and treatment, and multidimensional and multidisciplinary approaches to the assessment and management of dyspnoea were the focus of these sessions and are summarised here.

Research progress of weaning from mechanical ventilation guided by electrical impedance tomography

Weaning failure from mechanical ventilation is an important clinical problem, the traditional methods of assessing whether patients can be weaned from mechanical ventilation or not cannot meet the clinical needs. Finding more effective weaning indicators to determine the optimal timing of weaning has important clinical value for improving the outcome of weaning and reducing the mortality of patients. As a new method of assessing respiratory function of patients, electrical impedance tomography (EIT) is gradually applied to the clinic, and its guided assessment of respiratory function may open a new way for directing successful weaning. This article reviews the progress of EIT in ventilation weaning, in order to provide a new judgment method and theoretical basis for the successful weaning.

Functional Diagnostic Methods in Cardiac Prognosis in Major Abdominal Surgery in Patients with Heart Disease or Over 65 Years Old

Purpose of the study. Evaluation of the value of the results of the use of cardiac functional examination methods for the stratification of the risk of developing cardiovascular complications in planned abdominal surgical interventions in patients over 65 years of age or with cardiac pathology.Materials and methods. The study included 179 patients over 65 years of age or with a history of heart disease who underwent elective abdominal surgery. The median age was 70 years. During the operation and for 30 days after it, cardiac complications were recorded: severe (myocardial infarction, stroke, death from cardiovascular disease), others (strokes of exertional angina, ischemic dynamics of the ST segment on the electrocardiogram – ECG – rest, paroxysmal fibrillation / flutter atrial). All patients underwent basic examination – examination, anamnesis, ECG, blood test, assessment of respiratory function, ECG monitoring. Additionally, echocardiography (EchoCG) and ergospirometry (ESM) were performed.Results. In 30 (16.8 %) patients, various MTRs were detected: 6 (3.4 %) of fatal myocardial infarctions, 2 (1.1 %) of fatal strokes; 3 (1.7 %) cases of sudden cardiac death, angina attacks were recorded in 4 (2.2 %) patients, 7 (3.9 %) had ischemic ECG dynamics, 11 (6.1 %) had fibrillation episodes or atrial flutter. Chronic obstructive pulmonary disease, intervention on the colon, blood hemoglobin level &lt;100 g / l, serum creatinine &gt;103 μmol / l, presence of any pathological changes in the resting ECG were associated with the development of SSO; according to EchoCG – VTI (linear velocity integral) in the outflow tract of the left ventricle (LV) &lt;21.5 cm, volume of the left atrium&gt; 57 ml, global LV myocardial deformity is less than 18 %, increase in heart rate (HR) at the 1st minute load test&gt; 27 %, peak oxygen consumption at ESM &lt;15.8 ml / kg / min. The optimal plan for preoperative examination in men is to perform a basic model, and for women it is advisable to combine a basic examination with an ESM or an assessment of the degree of myocardial deformity using the speckle-tracking method for EchoCG.Conclusion. The risk of perioperative MTS during planned abdominal operations in patients older than 65 years or with a history of heart disease is relatively high – 16.8 %. When assessing the risk associated with the operation, it is advisable to additionally conduct echocardiography with VTI assessment in the LV outflow tract and myocardial deformity indicators, as well as ESM with the determination of HR increase in the 1st minute of the test and peak oxygen consumption.

СРАВНИТЕЛЬНАЯ ОЦЕНКА СИЛЫ ДЫХАТЕЛЬНЫХ МЫШЦ У БОЛЬНЫХ БРОНХИАЛЬНОЙ АСТМОЙ, ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНЬЮ ЛЕГКИХ И С ИХ СОЧЕТАНИЕМ

The objective of the study : to compare the strength of respiratory muscle in the patients with asthma, chronic obstructive pulmonary disease (COPD) and the combination of these two conditions, to assure the informativeness of the indicators for verification of these diseases. Subjects and methods . In the in-patient unit, 130 patients with a severe course of asthma, COPD and combination of asthma + COPD were examined. The strength expiratory (MEP) and inspiratory (MIP, SNIP) indicators of respiratory muscles were registered using MicroRPM (CareFusion, United Kingdom), their due values were calculated. The logistic regression models were used to assure informativeness of MEP, MIP, and SNIP for verification of certain forms of bronchial obstruction. Results . The reduction in the strength of expiratory and inspiratory muscles was observed in the patients from all groups. Dysfunction of expiratory muscle dominated in asthma patients, while in COPD patients and those with both conditions it was diaphragm dysfunction. The correlation analysis demonstrated the dependence of respiratory muscle strength on the intensity of bronchial obstruction and lung hyperinflation, skeletal muscles mass, body mass index, respiratory discomfort, and functional state of the patients. It was found out that the ratio of MEP/MIP had a high prognostic value and significantly improved the accuracy of the models of stratification of those examined by nosologic groups. Conclusion . Testing respiratory muscle strength makes an informative tool for comprehensive assessment of respiratory functions in patients with different clinical variants of bronchial obstruction.

Efficacy of Multi-exon Skipping Treatment in Duchenne Muscular Dystrophy Dog Model Neonates

Duchenne muscular dystrophy (DMD) is caused by mutations in DMD, which codes for dystrophin. Because the progressive and irreversible degeneration of muscle occurs from childhood, earlier therapy is required to prevent dystrophic progression. Exon skipping by antisense oligonucleotides called phosphorodiamidate morpholino oligomers (PMOs), which restores the DMD reading frame and dystrophin expression, is a promising candidate for use in neonatal patients, yet the potential remains unclear. Here, we investigate the systemic efficacy and safety of early exon skipping in dystrophic dog neonates. Intravenous treatment of canine X-linked muscular dystrophy in Japan dogs with a 4-PMO cocktail resulted in ∼3%-27% in-frame exon 6-9 skipping and dystrophin restoration across skeletal muscles up to 14% of healthy levels. Histopathology was ameliorated with the reduction of fibrosis and/or necrosis area and centrally nucleated fibers, significantly in the diaphragm. Treatment induced cardiac multi-exon skipping, though dystrophin rescue was not detected. Functionally, treatment led to significant improvement in the standing test. Toxicity was not observed from blood tests. This is the first study to demonstrate successful multi-exon skipping treatment and significant functional improvement in dystrophic dogs. Early treatment was most beneficial for respiratory muscles, with implications for addressing pulmonary malfunction in patients.

In patients with unilateral pleural effusion, restricted lung inflation is the principal predictor of increased dyspnoea.

Background and objectiveThe mechanism of dyspnoea associated with pleural effusion is uncertain. A cohort of patients requiring thoracoscopy for unilateral exudative effusion were investigated for associations between dyspnoea and suggested predictors: impaired ipsilateral diaphragm movement, effusion volume and restricted lung inflation.MethodsBaseline Dyspnoea Index, respiratory function, and ultrasound assessment of ipsilateral diaphragm movement were assessed prior to thoracoscopy, when effusion volume was measured. Transitional Dyspnoea Index (change from baseline) was assessed 4 and 8 weeks after thoracoscopy. Pearson product moment assessed bivariate correlations and a general linear model examined how well total lung capacity (measuring restricted lung inflation), effusion volume and impaired diaphragm movement predicted Baseline Dyspnoea Index. Un-paired t tests compared the groups with normal and impaired diaphragm movement.Results19 patients were studied (14 malignant etiology). Total lung capacity was associated with Baseline Dyspnoea Index (r = 0.68, P = 0.003). Effusion volume (r = -0.138, P = 0.60) and diaphragm movement (P = 0.09) were not associated with Baseline Dyspnoea Index. Effusion volume was larger with impaired diaphragm movement compared to normal diaphragm movement (2.16 ±SD 0.95 vs.1.16 ±0.92 L, P = 0.009). Total lung capacity was lower with impaired diaphragm movement compared to normal diaphragm movement (65.4 ±10.3 vs 78.2 ±8.6% predicted, P = 0.011). The optimal general linear model to predict Baseline Dyspnoea Index used total lung capacity alone (adjusted R2 = 0.42, P = 0.003). In nine participants with controlled effusion, baseline effusion volume (r = 0.775, P = 0.014) and total lung capacity (r = -0.690, P = 0.040) were associated with Transitional Dyspnoea Index.ConclusionsRestricted lung inflation was the principal predictor of increased dyspnoea prior to thoracoscopic drainage of effusion, with no independent additional association with either effusion volume or impaired ipsilateral diaphragm movement. Restricted lung inflation may be an important determinant of the dyspnoea associated with pleural effusion.

The influence of bronchial asthma control level on the quality of life indices

Objective: to study the indices of general and specific quality of life in schoolchildren, depending on the level of bronchial asthma control. Materials and methods: Quality of life parameters of 189 in-patients with BA, aged 6–17 years and 95 controls were studied. Parallel questioning with subsequent analysis of quality of life indices in 189 parents of BA children and 95 parents of the control group children was performed. General QL was evaluated using РedsQL (Pediatric Quality of Life Inventory 4.0). Specific quality of life was evaluated using specific quality of life questionnaire for the children ill with bronchial asthma – PAQLQ (Pediatric Asthma Quality of Life Questionnaire). Statistical analysis of the data obtained was done by variance statistical methods using the standard program package of multivariate statistical analysis Statistica 6.0 Results. The study found the index of physical functioning to be 43.6 [31.3–62.5] points in the children with UC BA, 53.1 [37.5–68.2] points in those with PC BA, being significantly lower as compared to the control group children – 79.6 [56.0–100.0] points (P 0.05). The cumulative index of QL was dependent on the level of BA control. It was 2.5 [1.4–3.6] points in the children with UC BA, being significantly lower as compared to those with PC BA – 3.9 [2.8–4.9] points, and C BA – 6.2 [5.6–6.8] points (р<0.001); and in the children with PC BA this index was significantly lower as compared to those with C BA (P < 0.01). Conclusions . Along with traditional methods of assessment of respiratory function and laboratory indices of inflammatory process activity in bronchial asthma, study of physical and mental health, social activity, general well-being and many other parameters of quality of life, as well as the influence of treatment on these parameters should be carried out.

Features of the etiology of chronic cough in a population of male smokers

The оbjective: determination of the etiological structure of long-term cough in male smokers.Materials and methods. 73 men aged from 47 to 57 years with the symptom of a prolonged cough and the experience of smoking for 20–30 years were examined. Underwent clinical examination, spirometry with assessment of respiratory function, chest radiography, otolaryngologist’s consultation, esophagus manometry and RNZ monitoring, in the presence of symptoms of gastroesophageal reflux disease (GERD) performed endoscopy.Results. Spirometry was instrumental in the early detection of chronic obstructive pulmonary disease (COPD) in 30,1% of patients, and bronchial asthma (BA) in 10,9%. Cough of post-infection etiology was detected in 16,5% of patients. In 19,4% of the examined contingent GERD was diagnosed. Cough associated with the use of angiotensinconverting enzyme (ACE inhibitors) inhibitors was registered in 6,8% of patients. 6,8% of those surveyed had a cough of mixed etiology. Postnasal drip as the cause of chronic cough was registered in 9,5%.Conclusions. In men who smoke between the ages of 47 and 57, the most common cause of chronic cough is COPD (30,1%); BA is diagnosed in 10,9% of patients. In 19,4% of men who smoke the cause of cough is GERD, postinfection cough is observed in 16,5%. Standard spirometry in smokers is the most important diagnostic method that facilitates early diagnosis of COPD and asthma, as well as an additional method in differential diagnosis of GERD.

Assessment of Respiratory Function in Conscious Mice by Double-chamber Plethysmography

Air volume changes created by a conscious subject breathing spontaneously within a body box are at the basis of plethysmography, a technique used to non-invasively assess some features of the respiratory function in humans as well as in laboratory animals. The present article focuses on the application of the double-chamber plethysmography (DCP) in small animals. It provides background information on the methodology as well as a detailed step-by-step procedure to successfully assess respiratory function in conscious, spontaneously breathing animals in a non-invasive manner. The DCP can be used to monitor the respiratory function of multiple animals in parallel, as well as to identify changes induced by aerosolized substances over a chosen time period and in a repeated manner. Experiments on control and allergic mice are used herein to demonstrate the utility of the technique, explain the associated outcome parameters, as well as to discuss the related advantages and shortcomings. Overall, the DCP provides valid and theoretically sound readouts that can be trusted to evaluate the respiratory function of conscious small animals both at baseline and after challenges with aerosolized substances.

Assessment of Respiratory Function in Conscious Mice by Double-chamber Plethysmography.

Air volume changes created by a conscious subject breathing spontaneously within a body box are at the basis of plethysmography, a technique used to non-invasively assess some features of the respiratory function in humans as well as in laboratory animals. The present article focuses on the application of the double-chamber plethysmography (DCP) in small animals. It provides background information on the methodology as well as a detailed step-by-step procedure to successfully assess respiratory function in conscious, spontaneously breathing animals in a non-invasive manner. The DCP can be used to monitor the respiratory function of multiple animals in parallel, as well as to identify changes induced by aerosolized substances over a chosen time period and in a repeated manner. Experiments on control and allergic mice are used herein to demonstrate the utility of the technique, explain the associated outcome parameters, as well as to discuss the related advantages and shortcomings. Overall, the DCP provides valid and theoretically sound readouts that can be trusted to evaluate the respiratory function of conscious small animals both at baseline and after challenges with aerosolized substances.

Clinical and functional variables associated to long-term mortality in COPD patients

Background: Identifying risk factors for long-term mortality in patients with chronic obstructive pulmonary disease (COPD) could improve their clinical management. Aim: To examine the clinical variables associated to long-term mortality in a cohort of COPD patients. Patients and methods: A clinical and respiratory functional assessment, chest computed tomography and clinical follow up for five years was carried out in 202 COPD patients aged 66 ± 9 years (59% males), active or former smokers of 10 or more pack-years. Results: Thirty four percent of patients were active smokers, consuming 46 ± 23 packs/year, 86% had comorbidities, especially chronic cardiovascular and metabolic diseases. Forty-six patients died in the five years follow up (5-year mortality was therefore 22.8%). In the univariate analysis, the main risk factors associated to long-term mortality were an older age, male sex, dyspnea severity, severe exacerbation risk, chronic respiratory failure, magnitude of lung emphysema, airflow obstruction and lung hyperinflation, reduction of thigh muscle cross-sectional area and physical activity limitation. In the multivariate analysis, the three independent risk factors for long-term mortality were dyspnea severity, chronic hypoxemia and exercise limitation measured with the six minutes’ walk test. Conclusions: Systematic clinical assessment allowed to identify the main risk factors associated with long-term mortality in patients with COPD, which could be used in planning preventive and management programs aimed at the high-risk population.

Identification of sleep hypoventilation in young individuals with Becker muscular dystrophy: A pilot study

AimTo report on sleep hypercapnia in Becker muscular dystrophy (BMD) at earlier stages than ever recognized. Subjects and methodsThis retrospective study examined nocturnal hypercapnia in six young Becker muscular dystrophy (BMD) patients with deletions of one or more exons of DMD gene. Clinical information, consecutive data on forced vital capacity (FVC%), forced expiratory volume in one second (FEV1%), peak expiratory flow (PEF%), peak cough flow (PCF), average PCO2 in all-night monitoring, and left ventricular ejection fraction (LVEF) were reviewed. ResultsIn five BMD patients, including three who were still ambulant, nocturnal average PCO2 was elevated to >45 mmHg at 12–31 years of age. Noninvasive positive pressure ventilation was initiated in four patients. Gradual declines in FVC% and PEF% were evident in one BMD patient with exon 3–7 deletion, whereas these functions did not change in the remaining BMD patients. PCF, FEV1%, and LVEF were less informative for the assessment of respiratory function in this patient series. ConclusionSleep hypercapnia was present in certain BMD patients, which was unexpected from the routine pulmonary function tests. Individualized assessment of nocturnal PCO2, partly based on the deletion types, should be further explored in the clinical practice of BMD patients.

Sleep disordered breathing in motor neurone disease.

Motor neurone disease (MND) is a neurodegenerative disease defined by axonal loss and gliosis of upper and lower motor neurones in the motor cortex, lower brainstem nuclei and ventral horn of the spinal cord. MND is currently incurable and has a poor prognosis, with death typically occurring 3 to 5 years after disease onset. The disease is characterised by rapidly progressive weakness leading to paralysis, fasciculations, bulbar symptoms (including dysarthria and dysphagia) and respiratory compromise. Respiratory complications arise as a result of weakness of upper airway (pharyngeal and laryngeal) muscles and respiratory muscles (diaphragm, intercostal and accessory muscles) leading to respiratory failure. Due to early involvement of respiratory muscles in MND, sleep disordered breathing (SDB) occurs at a higher frequency than compared to the general population. SDB usually precedes daytime respiratory symptoms and chronic respiratory failure. It significantly impacts upon patients' quality of life and survival and its presence may predict prognosis. Managing SDB in MND with non-invasive ventilation (NIV) improves quality of life and survival. Early identification and management of SDB in MND patients is therefore crucial. This update will review assessments of respiratory muscle function, types of SDB and the effects of NIV in patients with MND.

Decreased Respiratory Muscle Function Is Associated with Impaired Trunk Balance among Chronic Stroke Patients: A Cross-sectional Study.

The abdominal muscles play a role in trunk balance. Abdominal muscle thickness is asymmetrical in stroke survivors, who also have decreased respiratory muscle function. We compared the thickness of the abdominal muscles between the affected and less affected sides in stroke survivors. In addition, the relationship between respiratory muscle function and trunk balance was evaluated. Chronic stroke patients (18 men, 15 women; mean age, 58.94 ± 12.30 years; Mini-Mental Status Examination score ≥ 24) who could sit without assist were enrolled. Abdominal muscle thickness during rest and contraction was measured with ultrasonography, and the thickening ratio was calculated. Respiratory muscle function assessment included maximum respiratory pressure, peak flow, and air volume. Trunk function was evaluated using the Trunk Impairment Scale, and trunk balance was estimated based on the center of pressure velocity and path length within the limit of stability in sitting posture. Abdominal muscles were significantly thinner on the affected side, and the thickening ratio was lower in the affected side (P < 0.05). In addition, the higher thickening ratio of the affected side showed significant relationship with higher trunk function. Moreover, higher respiratory muscle function was significantly correlated with higher level of trunk function and balance in stroke patients (P < 0.05). Thus, chronic stroke survivors have decreased abdominal muscle thickness on the affected side, and respiratory muscle function has positive correlation with trunk function and balance. We propose that respiratory muscle training should be included as part of trunk balance training in chronic stroke patients.

Integrated Animal Model in CD1 Mice for Simultaneous Assessment of Cardiovascular and Respiratory Functions

Integrated Animal Model in CD1 Mice for Simultaneous Assessment of Cardiovascular and Respiratory Functions

Efficacy of Vaccine Prophylaxis for Pneumococcal Infection in Patients with Chronic Obstructive Pulmonary Disease with Various Comorbidity Indix

Actuality. Modern medicine shows a sharp growth of patients with comorbid and concurrent chronic diseases, involving not only the mature and older persons but also the young people. Combined diseases of the circulatory and respiratory systems are the main cause of death, disability of the population and major labor losses. The aim of this work was to study the vaccine prophylaxis effectiveness for chronic obstructive pulmonary disease (COPD) patients having the different Charlson comorbidity index. Material and methods: This study covered 174 patients with COPD and IHD. All patients were subject to the complex clinical research, including the medical assessment, patient complaints, medical history, physical and instrumental examinations and pathology tests Assessment of respiratory function and general Body plethysmography were performed Degree of dyspnea was assessed using a scale provided by Medical Research Center. Number of COPD exacerbations, hospitalizations and pneumonia development cases were analyzed. Modified Charlson comorbidity index was calculated for all patients Results and conclusions: Among the patients with comorbidity the severe manifestations of chronic obstructive pulmonary disease correspond to the more pronounced functional classes of angina pectoris. With the comorbidity index growth the number of exacerbations, hospitalizations and pneumonia cases were increasing. Vaccine prophylaxis is the most effective for the patients having the lower comorbidity indices and shows a tendency to stabilize these indicators for the patients having the moderate & high levels of comorbidity, and therefore, are to be recommended for all COPD and CVD patients. Changes in clinical and functional parameters of respiratory function for COPD patients are statistical-significantly different for the patients having the low and high levels of comorbidity.

Prospects of FEV6 using as alternative indicator of respiratory function assessment

The aim of the study was to establish a correlation between the changes of external respiratory function leading indicators in patients with COPD and the presence of a positive response to the bronchodilator over an extended period of observation and the value of the FEV 6 index in assessment of bronchial obstruction reversibility. Materials and methods. The study included 29 patients with confirmed diagnosis of COPD with II and III degree of ventilation disorders according to the GOLD classification and an increase in FEV 1 more than 200 ml (12 %) when carrying out a test with a bronchodilator. With the help of the patients’ spirograms retrospective analysis over the long period of observation an evaluation and comparison of the external respiration function parameters was performed: FVC, FEV 1 and FEV 6 . Results. All patients were divided into 2 groups: group I included patients with a moderate degree of ventilation disorders severity by GOLD, group II – with severe impairment of external respiratory function. A reliable direct correlation between increments of FEV 1 and FEV 6 , FVC and FEV 6 (p < 0.05) was confirmed, which indicates a logical increase in FEV 6 increment in parallel with the increase of FVC and FEV 1 increments. When comparing the increase in FEV 1 and FEV 6 in group I it also was not noted significant differences. However, in group II FEV 6 increment is two times higher than FEV 1 increment with high probability (p < 0.05), which may be caused by the presence of more severe obstruction and longer expiration. Conclusions. It has been found a significant positive correlation of FEV 6 with FEV 1 and FVC and significant relationship between the FEV 6 and FVC increments in both study groups, between the FEV 6 and FEV 1 increments in the group with grade III ventilation disorders by GOLD classification. Thus, FEV 6 can be considered as a perspective indicator of the external respiration function evaluation, especially in patients with more severe course of the disease.