Pulmonary function test in obese patients

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Introduction: Obesity interferes directly with pulmonary function by declining pulmonary compliance, with a shorter tidal volume, expiratory reserve volume, functional residual capacity and airway narrowing, generating a decreased forced expiratory volume in the first second (VEF1) and air trapping. Objectives: Settle the characteristics of pulmonary function test (PFT) in obese people and asses the behavior of the airway. Methods: Descriptive and retrospective study of PFT performed in obese patients during 2019. Medical records were revised and patients with restrictive diseases and obstructive studies were ruled out. The remaining studies were classified according to the degree of obesity. Forced vital capacity (FVC), VEF1, total lung capacity (TLC), residual volume (RV), RV/TLC ratio and alveolar volume (VA)/TLC ratio were evaluated. Results: 396 PFT were assessed. The media of FVC was 80% with a decrease as body mass index (BMI) rose. The media of TLC was 100%. The media of VEF1 was 84% with a statistically significant diminution as the severity of obesity worsens, with a similar positive response after Beta2 among the different degrees of obesity. The media of RV was 121%, RV/TLC ratio was 122% and the percentage of studies with air trapping increased as the BMI rose. The percentage of studies with a decreased VA/TLC ratio increased as BMI stepped up. Conclusion: Normal spirometric pattern prevailed in obese people. Decreased FVC is observed in severe obesity. TLC showed no variation according to BMI. The diminution of VEF1, the increased RV and RV/TLC ratio showed airway narrowing and air trapping associated with obesity. Small airway is affected, evidenced by a decreased VA/TLC ratio. There was no hyperresponsiveness associated with obesity.

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