Marc Meysman, MD(*); Marc Noppen, MD, PhD; Rika Van Herreweghe, MD; Daniel Schuermans and Walter Vincken, MD, PhD. Resp Division, Dept Medicine, University hospital, AZ-VUB, Brussels, Belgium.
PURPOSE: To determine the effect of body posture on the flow rates, FVL configuration and UAO indices (FEV1/FEV0.5,FEV1/PEF, FEF50/ FIF50, FEV1/FIV1)in patients with an euthyroid goiter.
METHODS: FVLs were measured in four different body postures (sit, supine and left, and right recumbent posture) using a spirometer according to ATS standards in 28 consecutive patients with an euthyroid goiter. Flow rates were derived from the envelope FVL. Visual analysis of the FVL was performed to detect flattening of the FVL. UAO indices and flow rates were compared in the different body postures using Repeated Measures Analysis and Scheffe post-hoc testing when appropiate.
RESULTS: 28 patients, 21 woman and 7 men, performed spirometry. Mean age was 50.3 years (range 26-72). A significant reduction was observed in all flow rates when recumbent compared to sit. In 9 patients a flattening of the FVL was observed in sit, suggesting functional upper airway obstruction. In five other patients with a normal FVL in sit, a flattening was observed in one or more of the supine postures, indicating UAO due to change in body posture. The UAO indices did not change significantly in the supine body postures.
CONCLUSION: Performing FVL testing in the supine body postures increases the likelehood of detecting a functional, variable UAO, not revealed in the sitting posture, in patients with an euthyroid goiter.
CLINICAL IMPLICATIONS: Earlier detection of functional UAO due to euthyroid tracheal compression may be achieved by FVL testing in different body postures.
GRANT SUPPORT: supported by grant 7.0062.94 FWO Flanders
COPYRIGHT 2000 American College of Chest Physicians
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