Medicus, Vol. 30 No. 2 Astma i KOPB, 2021.
Pregledni rad
Pragmatic Approach to Small Airways Diagnostics
Vladimir Žugić
Sažetak
Small airways have an inner diameter of 2 mm or less. They are characterized by lack of cartilage in their wall, sudden increase in total cross-section area, and by an abrupt switch from turbulent to laminar air flow, all of which cause minimal airflow resistance in healthy persons. Conversely, in patients with obstructive lung diseases, small airways are the primary site of airflow limitation. Small airways tests are numerous and they vary considerably in their diagnostic significance, complexity and availability. Currently, none of the existing tests represents the diagnostic “gold standard”, and none offer precise cut-off values to distinguish between small airway disease, healthy persons, and individuals with concomitant pathophysiological disorder. Negative results of these tests have significant negative predictive values, i.e. ruling out small airways as the cause of the clinical issue, while positive results of these tests should always be crosschecked to confirm the presence of small airways disorder by other methods. Results of small airways diagnostic tests do not mean much as isolated findings unless they are combined with other diagnostic methods (history, clinical findings, imaging, etc.) to elucidate any specific clinical case. On the other hand, if results are strongly suggestive of the presence of a small airways disease, that can have significant clinical implications, such as application of fine particle aerosols. The suggested diagnostic algorithm is based primarily on tests availability. It should not be implemented uncritically, but rather adapted to the healthcare system at hand.
Ključne riječi
small airways; diagnostic approach
Hrčak ID:
264143
URI
Datum izdavanja:
18.10.2021.
Posjeta: 849 *