Determination of Bronchodilation in the Clinical Pulmonary Function Laboratory

Improved airway resistance following bronchodilator inhalation is not always accompanied by improvement in forced expiratory flow. We studied 241 patients with airways obstruction to learn whether changes in static lung volumes (vital capacity and function residual capacity measured by body plethysmography [FRCB]) would reveal bronchodilation not demonstrated by expiratory flow rates (the ratio of forced vital capacity at one second to the total forced vital capacity [FEV1/FVC]), and the forced expiratory flow for the midportion of the forced vital capacity (FEF25–75%). A significant fall in Rawoccurred in 129 patients, 46 of whom had a significant increase in vital capacity (mean of + 465 ml ± 43, P < 0.001) and a fall in FRCB(mean of −763 ml ± 78 P < 0.001) with no change in FEV1/FVC% or FEF25–75%. We interpret these data to indicate that improvement in static lung volumes can reflect bronchodilation in the absence of improved expiratory flow.