What's the main thing to look at on the spriromity test results. Is it the FEV1% result. Can narrowing of the small air ways get better?

[1968]

[Hidden]

Ad say yes can but depends on your condition also using in halers nebulisers will help might not feel like it

But thats lung diease for you

[droo32]

The percent predicted of your FEV1, often noted as FEV1%, has classically been the most commonly cited parameter when assessing lung function however this is mostly an indicator of the efficiency of the airways and therefore gives little insight to other aspects of pulmonary mechanics. It is incorrect to assume that if someone has a good FEV1%, their lungs are in perfect health although the likelihood is that they are in at least relatively good health with a good FEV1%. According to the GOLD standards, a COPD diagnosis is made when the FEV1, as measured in liters, is less than 70% of the FVC, as measured in liters. If you divide the FEV1 liters value by the FVC liters value the result should be above 0.70 to be considered "normal". This measurement may be noted as FEV1%FVC, FEV1/FVC, or FEV1/FVC%, not to be confused with the percent predicted of FEV1/FVC. It is also worth noting that someone can have a fair degree of emphysema with relatively normal FEV1%. The most sensitive indicator for emphysema is the percent predicted diffusing capacity, noted as the DLCO or TLCO. The worst percent predicted diffusing capacity in a COPD patient the more emphysema they are likely to have. This is also tricky since the diffusing capacity is not specific for emphysema however in those with a smoking history and/or COPD diagnosis, the diffusing capacity is a much better indicator of emphysema rather than FEV1%. When assessing COPD it is also important to look at lung volumes since these will be shifted with regard to normal. In COPD the total lung capacity (TLC), functional residual capacity (FRC), and residual volume (RV) will all be increased compared to normal. On the other hand, the insipratory capacity (IC) and inspiratory reserve volume (IRV) will be reduced. In more advanced COPD the vital capacity, either forced (FVC) or slow, will also be reduced. These shifts are due to air trapping and loss of elasticity within the alveoli.

With regards to the improvement of lung mechanics, the potential is dependent upon the underlying pathology. All forms of COPD will demonstrate similar results in lung function test and therefore it is sometimes a challenge to tell exactly which variety of COPD someone may have. Emphysema COPD, which as stated is best correlated to diffusing capacity, does not get better and is slowly progressive with the current medical therapies. Late stage chronic bronchitis is also progressive however early or intermittent bronchitis can variably improve or wax and wane depending on whether or not one avoids irritants. Someone can have chronic bronchitis and not necessarily end up developing COPD if they avoid lung irritants. Asthmatic bronchitis or small airway disease can also improve or wax and wane depending on how one treats the condition. Again, this is dependent on the specific nature of the problem: If the small airways are narrowed due to emphysema it's permanent, if the are narrowed due to fibrosis it's permanent , however if acute inflammation is the culprit there is the possibility of partially reversing the situation if treated early and promptly. In general however, once the diagnosis of COPD is made it is progressive since the impairments upon measurable lung function represent cellular and structural changes within the lung tissue due to chronic inflammation, increased oxidative stress, premature senescence, and failure to repair damage. This cellular damage cannot be repaired or reversed with current medical therapies and usually gets worse with age. The best that can be achieved in COPD today is slowing the pace of destruction to one that is not measurably different than the normal physiological decline related to aging.

[Sohara in reply to droo32]

Droo Thank you SO MUCH for this very informative and interesting reply , it has been really helpful

Thanks again

Love Sohara

[undine in reply to droo32]

thank you - depressing though it is - better to know the truth - I now have the lungs of a 90 year old and I'm only 60 not good outlook .....

[hufferpuffer in reply to droo32]

Thank you Droo, such a good article! huff x

[Hidden]

thank you a lot, now I understand mi results,and there ok,fev1 66%,i was reading them wrong,and the gps nurse never corrected me,blf was right,happy easter to you, xxx

[Hidden]

Hi I am confused now. I thought chronic bronchitis and emphysema came under the unbrella of copd? You are talking of them as separate.

[coastal1]

Hi 1968,

My GP said that lung damage can never be repaired but that a good level of general fitness is helping me compensate for a fairly poor fev1/fvc of 55%.

Can do most things and possibly more than people of a similar age.

Coughalot

They do come under the same umbrella ....however many people still refer to them separately. Personally I find that most people have never heard the term COPD but they have emphysema.

Cheers Coastal