The relationship between early reversibility test and maximal inspiratory pressure in patients with airway obstruction

Abstract

Sevket Ozkaya,1 Adem Dirican,2 Sule Ozbay Kaya,3 Rabia C Karanfil,3 Merve G Bayrak,4 Ozgür Bostancı,5 Ferah Ece1 1Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, 2Department of Pulmonary Medicine, 3Department of Physical Therapy and Rehabilitation Clinic, Samsun Medicalpark Hospital, 4Department of Pulmonary Medicine, Samsun Chest Diseases and Thoracic Surgery Hospital, 5Academy of Sports, Ondokuzmayis University, Samsun, Turkey Abstract: Maximal inspiratory pressure (MIP) is a marker for assessing the degree of respiratory muscle dysfunction. Muscle dysfunction represents a pathophysiological feature of chronic obstructive pulmonary disease. We aimed to determinate the MIP value in patients with airway obstruction, to evaluate the change in MIP with bronchodilator drug, and to show the relationship between the changes in MIP and disease characteristics. We evaluated 21 patients with airway obstruction at the Department of Pulmonary Medicine, Samsun Medicalpark Hospital, Samsun, Turkey. We performed pulmonary function tests, measurement of MIP values, and reversibility tests with salbutamol. The baseline spirometry results were: mean forced vital capacity (FVC), 3,017±1,020 mL and 75.8%±20.8%; mean forced expiratory volume in 1 second (FEV1), 1,892±701 mL and 59.2%±18.2%; FEV1/FVC, 62.9%±5.5%; peak expiratory flow, 53%±19%. The pre-bronchodilator MIP value was 62.1±36.9 cmH2O. The reversibility test was found to be positive in 61.9% of patients with salbutamol. The absolute change and percentage of change in FEV1 were 318±223 mL and 19.8%±16.7%, respectively. The MIP value was increased by 5.5 cmH2O (8.8%) and was 67.7±30.3 cmH2O after bronchodilation. There was no significant relationship between age, FEV1, reversibility, and change in MIP with bronchodilator. However, the increase in MIP with bronchodilator drug was higher in patients with low body mass index (<25 kg/m2). We noted a 13.1% increase in FVC, a 19.8% increase in FEV1, a 20.2% increase in peak expiratory flow, and an 8.8% increase in MIP with salbutamol. In conclusion; MIP increases with bronchodilator therapy, regardless of changes in lung function, in patients with airway obstruction. The reversibilty test can be used to evaluate change in MIP with salbutamol. Keywords: asthma, COPD, maximal inspiratory pressure, MIP, reversibility test, salbutamol