[Significance of Expiratory Bronchiolar Collapse Symptoms in the Diagnosis of Emphysema]

A club-shaped resistance curve as recorded using wholebody plethysmography, as an expression of expiratory bronchial collapse is often interpreted as a sign of pulmonary emphysema. Within the framework of a prospective study involving 32 consecutive patients, a quantification of the resistance loops was carried out. The results obtained indicate that dynamic airway collapse is not specific to emphysema. Rather, there is a highly significant correlation between the degree of bronchial collapse and the elevation of total lung capacity irrespective of whether the latter is due to a reversible hyperinflation associated with bronchospasm or to emphysema of the lungs. It can, however, be seen that, in patients with reversible hyperinflation, intensive anti-obstructive treatment also leads to a decrease in, or the disappearance of, the signs of bronchiole collapse with simultaneous decrease in TLC. We conclude from this that a repeat wholebody plethysmographic examination following a lengthy period of treatment is suitable for distinguishing between bronchiole collapse in reversible hyperinflation and emphysema.