Faculty of Medicine
Library of the School of Health Sciences

2023-03-05

2023

Kossyvaki Vasiliki

Γρηγόριος Στρατάκος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Κουλούρης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πέτρος Μπακάκος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αντωνία Κουτσούκου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Καλομενίδης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Παρασκευή Κατσαούνου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Νικολέττα Ροβίνα, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ

Μελέτη της μηχανικής της αναπνοής σε καλοήθεις στενώσεις των μεγάλων αεραγωγών

Greek

Study of lung mechanics in benign upper airways stenosis

Background: Benign upper airways stenosis may relapse after initial management. Objectives: This study aimed to assess the value of dyspnea and spirometry in detecting relapse of stenosis in patients with benign upper airways stenosis, with the majority of patients presenting with post-intubation/post-tracheostomy tracheal stenosis. Methods: Patients with benign tracheal stenosis were evaluated following initial management, at regular follow-up and emergency visits, with the Medical Research Council (MRC) dyspnea scale, spirometry and flexible bronchoscopy. Patient visits were categorized and compared, in terms of change in clinical and functional parameters, in 2 groups: visits with relapse (case group) and visits with no relapse (control group). The ability of the MRC dyspnea scale and spirometry to predict relapse was evaluated. Results: Thirty-five patients with benign tracheal stenosis were included. Mean follow-up duration was 3.2 years (standard deviation = 3.3). Spirometry data were analyzed from 43 relapse visits (23 patients) versus 90 non-relapse visits. The MRC dyspnea score and most spirometric indices were associated with relapse. In the analysis with receiver operating characteristic (ROC) curves, forced expiratory volume in the first second (FEV1), forced expiratory flow when 25% of forced vital capacity has been expired (FEF25%), peak expiratory flow (PEF) and total peak flow (TPF, TPF = PEF + |PIF|) were superior to the MRC dyspnea score in predicting relapse. Among spirometric indices, >10.8% of PEF reduction has been a very sensitive and specific marker. Conclusions: This study supports the role of dyspnea and spirometry in monitoring benign upper airways stenosis, with spirometry predicting relapse even in clinically stable patients. PEF being a very sensitive index has the additional advantage of being assessed by a portable peak flow meter and could potentially be used for remote monitoring (telemedicine).

Health Sciences

Lung mechanics, Benign upper airways stenosis, Post-intubation tracheal stenosis, Spirometry, Peak expiratory flow

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https://pergamos.lib.uoa.gr/uoa/dl/object/3279609