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FEV₁ Response to Bronchodilation in an Adult Urban Population^*

^* From the Division of Pulmonary Medicine (Dr. Kainu), and Research Unit of Pulmonary Diseases (Dr. Lindqvist), the Department of Medicine, and the Division of Clinical Physiology and Nuclear Medicine (Dr. Sovijärvi), Laboratory Department, Helsinki University Central Hospital, Helsinki, Finland; the Department of Public Health (Dr. Sarna), University of Helsinki, Helsinki, Finland; the Department of Medicine/Respiratory Medicine and Allergology (Dr. Lundbäck), University of Gothenburg, Gothenburg, Sweden; and the Division of Clinical Physiology and Nuclear Medicine (Dr. Sovijärvi), Laboratory Department, Helsinki University Central Hospital, Helsinki, Finland.

Correspondence to: Annette Kainu, MD, Division of Pulmonary Medicine, Department of Medicine, Helsinki University Central Hospital, PO Box 340, FIN-00029 HUS, Helsinki, Finland

Abstract

Background: Most studies evaluating bronchodilation in flow-volume spirometry have been conducted in patients with obstructive airways diseases, but less is known about bronchodilation responses in the general population or in healthy subjects.

Methods: We evaluated an urban population sample of 628 adults (260 men, 368 women) aged 25 to 74 years with flow-volume spirometry using inhalation of 0.4 mg of a salbutamol aerosol with a spacer device for bronchodilation. On the basis of a structured interview, a subgroup of 219 healthy, asymptomatic nonsmokers was selected.

Results: In the population sample, the average increase in FEV₁ from baseline after salbutamol inhalation was 77.2 mL (SD, 109.7 mL) or 2.5% (SD, 3.9%). In healthy asymptomatic nonsmokers, the mean change in FEV₁ was 62.0 mL (SD, 89.7 mL) or 1.8% (SD, 2.6%). In the whole population, the 95th percentile limit of the increase in FEV₁ was 8.5%, while it was 5.9% among healthy asymptomatic nonsmokers. The absolute change in FEV₁ correlated significantly with baseline FVC (p < 0.01). The FEV₁/FVC ratio at baseline was the strongest influencing factor for the bronchodilation response.

Conclusions: The results indicate that a significant increase in FEV₁ from baseline in a bronchodilation test is around 9% in an urban population. The level of the significant absolute increase in FEV₁ seems to depend on FVC. Low baseline FEV₁/FVC ratio, reflecting airflow limitation, is the strongest determinant for FEV₁ response to bronchodilation.

Key Words: bronchodilation • FEV₁ • flow-volume spirometry • lung function