Excessive dynamic airway collapse in a small cohort of chronic obstructive pulmonary disease patients

Abstract

INTRODUCTION: The prevalence of EDAC (Excessive Dynamic Airway Collapse) has not been studied specifically in patients with chronic obstructive pulmonary disease (COPD). OBJECTIVE: The aim of this study was to investigate the prevalence of EDAC in COPD and to determine whether there are clinical factors or functional variables that could influence the degree of expiratory collapse of central airways. METHODS: Prospective observational study of a group of patients with COPD. The degree of tracheobronchial collapse was evaluated by low-dose dynamic airway computed tomography (CT). We recorded clinical and pulmonary function tests data, quality of life and BODE index. RESULTS: This study included 53 patients with COPD, 46 (87%) males, mean age 65 (SD, 9) years. The percentage of collapse at each anatomic level was as follows: Aortic arch, 16.1% (SD, 13.6%); carina, 19.4% (SD, 15.9%); and bronchus intermedius, 21.7% (SD, 16.1%). At the point of maximal collapse, the percentage of collapse was 26.8% (SD, 16%). EDAC was demonstrated at any of the three anatomical points in five patients, corresponding to 9.4% (95% CI, 3.1% to 20.6%) of the sample and affecting the three anatomical points in only two cases. A statistically significant correlation was only found with the total lung capacity (TLC). CONCLUSIONS: The prevalence of EDAC observed in a sample of patients with different levels of COPD severity is low. The degree of dynamic central airway collapse was not related to the patient′s epidemiological or clinical features, and did not affect lung function, symptoms, capacity for effort, or quality of life.

Keywords

• Chronic pulmonary obstructive disease
• central airways
• dynamic airway computed tomography
• excessive dynamic airway collapse