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THE ROLE OF FEV 1 /FEV 6 IN THE DETECTION OF AIRWAY OBSTRUCTION

THE ROLE OF FEV 1 /FEV 6 IN THE DETECTION OF AIRWAY OBSTRUCTION. İlknur Başyiğit 1 , Haşim Boyacı 1 , Serap Argun Barış 1 , Cavit Işık Yavuz 2 , Füsun Yıldız 1 1 Kocaeli University Faculty of Medicine Chest Disease Department 2 Kocaeli University Faculty of Public Health Department.

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THE ROLE OF FEV 1 /FEV 6 IN THE DETECTION OF AIRWAY OBSTRUCTION

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  1. THE ROLE OF FEV1/FEV6 IN THE DETECTION OF AIRWAY OBSTRUCTION İlknur Başyiğit1, Haşim Boyacı1, Serap Argun Barış1, Cavit Işık Yavuz2, Füsun Yıldız1 1 Kocaeli University Faculty of Medicine Chest Disease Department 2 Kocaeli University Faculty of Public Health Department

  2. Introduction • Pulmonary function test has been used for the diagnosis and follow up the treatment of airway diseases. • FEV1/FVC < 70 % indicates airway obstruction.

  3. Introduction • Because of the difficulties of performing FVC manuever, it is suggested that exhaled volume in the first 6 second of forced expirium (FEV6) might be used instead of FVC.

  4. Aim • The aim of this study was to compare FEV1/FEV6 ratio which is offered as a new criteria with FEV1/FVC which is accepted as a gold standard in the detection of airway obstruction.

  5. Method • Prospective study • Patients who were admitted to our pulmonary function test (PFT) unit during a month were prospectively evaluated. • Mean age, gender, body mass index (BMI), the reason for PFT request and diagnosis were recorded. • PFT was performed using V max 20C spirometer. • FEV1, FVC, FEV1/FVC, FEV6 and FEV1/FEV6 values were determined.

  6. Results • 280 female, 290 male totally 570 patients were included in the study. • Mean age was 53±15 yrs, • BMI was 33.6±13.3 kg/m2.

  7. Table-1: Demographic characteristics

  8. Results • The most common reasons for PFT requests were as follows; • asthma in 103 • evaluation of dyspnea in 124 • preoperative evaluation in 108 • COPD in 89 patients

  9. Table-2: PFT resultsaccording to PFT requests (Based on FEV1/FVC) O:Normal, 1:Obstructive, 2:Restrictive, 3:Mixt, 4:Small airways disease

  10. Table-3:PFT parameters according to PFT requests

  11. Results • Patients were divided into 2 groups according to their FEV1/FVC values as obstructive (FEV1/FVC <70%) and non-obstructive; • 212 patients in the obstructive • 358 patients in the non-obstructive group.

  12. Results • When FEV1/FEV6 value was considered, • 176 patients were determined as obstructive • 394 as non-obstructive.

  13. Tablo-4: Number of obstructive and non-obstructive cases according to FEV1/FVC and FEV1/FEV6

  14. Graphic-1

  15. Results • FEV1 / FEV6had • sensitivity of 82.1% • specificity of 99.4% • positive predictive value of 98.9% • negative predictive value of 90.4%.

  16. Results • Mean difference between FVC and FEV6(FVC-FEV6) was found to be significantly higher in obstructive patients compare to others • 23.4±23.5 ml (max:122 ml) vs. • 3.3±14.7 ml (max: 114 ml), p=0.000

  17. Tablo-5:FVC-FEV6 in obstructive and non-obstructive groups

  18. Conclusion • It is suggested that FEV1/FEV6 ratio may not be as sensitive as FEV1/FVC in the detection of airway obstruction. • Since FVC-FEV6 found to be significantly higher in obstructive cases, diagnostic value of FEV6 in this subgroup is still controversial.

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