Évaluation non-invasive de la mécanique respiratoire au repos chez les adultes atteints de mucoviscidose

Background: alteration of lung mechanics in adults with cystic fibrosis has been poorly investigated. Using an impulse oscillometry system (IOS), we aim to characterize the impedance parameters of these patients and in order to assess their clinical relevance. Methods: IOS measurements were performe...

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Auteur principal : Beurnier Antoine (Auteur)
Collectivités auteurs : Université de Nantes (Organisme de soutenance), Université de Nantes -- Unité de Formation et de Recherche de Médecine et des Techniques Médicales (Organisme de soutenance)
Autres auteurs : Chambellan Arnaud (Directeur de thèse)
Format : Thèse ou mémoire
Langue : français
anglais
Titre complet : Évaluation non-invasive de la mécanique respiratoire au repos chez les adultes atteints de mucoviscidose / Antoine Beurnier; sous la direction de Arnaud Chambellan
Publié : 2018
Description matérielle : 1 vol. (44 f.)
Note de thèse : Thèse d'exercice : Médecine. Pneumologie : Nantes : 2018
Contenu : La thèse contient 1 article p. 22
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Documents associés : Reproduit comme: Évaluation non-invasive de la mécanique respiratoire au repos chez les adultes atteints de mucoviscidose
Description
Résumé : Background: alteration of lung mechanics in adults with cystic fibrosis has been poorly investigated. Using an impulse oscillometry system (IOS), we aim to characterize the impedance parameters of these patients and in order to assess their clinical relevance. Methods: IOS measurements were performed before spirometry to consecutive non-transplanted CF adults with a one-year longitudinal follow-up. Correlation with relevant clinical data was assessed. Results: 90 patients were included (mean age 29 years, FEV1=56% predicted). Overall, the major anomaly that we found was a profound alteration of X5 (z-score median value = -2.7; first quartile = -5.4). Moderate elevation of R5 was also observed, whereas R20 was within the normal range. Good correlations were observed between X5 and FEV1 ( =0.81, p<10-3), mMRC dyspnea scale ( =-0.57, p<10-3), severity of bacterial colonization ( =-0.55, p<10-3) and number of exacerbations ( =-0.57, p<10-3). Among patients with FEV1 less than 30% predicted, only X5 was able to discriminate those who underwent lung transplantation during the following year (p=0.04). Conclusions: advanced CF in adulthood leads to a marked decrease in X5. This parameter has clinical relevance and can be routinely assessed using IOS, especially in the context of severe lung function impairment. More studies are needed to validate X5 as a new diagnostic and prognostic index for adults with CF.
Bibliographie : Bibliogr. f. 37-44, 144 réf.