case_images: PMC10948428_01
case_images: (A) Flow-volume curves before BDP/FF/G (blue line for baseline curve and red line for post-bronchodilator test curve), showing the reversibility of airflow limitation. (B) Flow-volume curve after BDP/FF/G.
case_images: fmed-11-1357362-g001.jpg
case_images: PMC10948428_01_fmed-11-1357362-g001.jpg
case_images: fig1
case_images: Lung function tests performed during ICS/LABA therapy evidenced the following values (Figure 1A): forced expiratory volume in 1 s (FEV1), 0.88 L (41% of predicted); forced vital capacity (FVC), 1.34 L (48% of predicted); FEV1/FVC ratio, 65.67%; peak expiratory flow (PEF), 2.54 L/s (44% of predicted); residual volume (RV), 2.59 L (113% of predicted); total lung capacity (TLC), 3.93 L (74% of predicted); Motley index (RV/TLC ratio), 65.85%; forced expiratory flow at 75% of FVC (FEF75), 2.07 L/s (41% of predicted); forced expiratory flow at 50% of FVC (FEF50), 0.66 L/s (39% of predicted); forced expiratory flow at 25% of FVC (FEF25), 0.22 L/s (56% of predicted); forced expiratory flow at 25-75% of forced vital capacity (FEF25-75), 0.54 L/s (32% of predicted); and total airway resistance (Rtot), 0.42 kPa x s/L (140% of predicted). After a week of therapy, the ACQ-5 score decreased to 1.2, and follow-up functional lung tests yielded the following results (Figure 1B): FEV1, 1.20 L (56% of predicted; +0.32 L/+36.4%); FVC, 1.78 L (63% of predicted; +0.44 L/+32.8%); FEV1/FVC ratio, 67.43% (+2.7%); PEF, 3.77 L/s (65% of predicted; +48.4%); RV, 1.48 L (65% of predicted; -1.11 L/-42.9%); TLC, 3.26 L (61% of predicted; -0.67 L/-17.0%); RV/TLC ratio, 45.49 (-30.9%); FEF75, 3.30 L/s (65% of predicted; +59.4%); FEF50, 1.35 L/s (80% of predicted; +104.5%); FEF25, 0.32 L/s (83% of predicted; +45.5%); FEF75-25, 0.75 L/s (45% of predicted; +38.9%); and Rtot, 0.39 kPa x s/L (130% of predicted; -7.1%).
case_images: (A) D1: deep breathing motion before BDP/FF/G. (B) D1: deep breathing motion after BDP/FF/G.
case_images: fmed-11-1357362-g002.jpg
case_images: PMC10948428_01_fmed-11-1357362-g002.jpg
case_images: fig2
case_images: We detected the following ultrasound baseline parameters (Figures 2A, 3A): tidal volume excursion, 3.1 cm (normal range: 0.9-2.5 cm); tidal volume inspiratory time, 0.98 s (normal range: 0.5-1.7 s); tidal volume inspiratory velocity, 3.5 cm/s (normal range: 0.7-2.6 cm/s); tidal volume expiratory time, 2.7 s (normal range: 0.4-1.6 s); tidal volume expiratory velocity, 1.2 cm/s (normal range: 0.2-2.8 cm/s); tidal volume duration of motion, 3.8 s (normal range: 1.1-3.4 s); deep breathing excursion, 8.26 mm (normal range: 3.3-7.5 mm); deep breathing inspiratory time, 1.7 s (normal range: 0.4-2.4 s); deep breathing inspiratory velocity, 4.2 cm/s (normal range: 1.5-7.3 cm/s); thickness at end-expiration (FRC), 1.1 mm (normal range: 1.1-2.7 mm); thickness at end-inspiration, 2.0 mm (normal range: 1.3-3.7 mm); tidal volume thickening fraction (TF), 81% (normal range: 30-36%); and thickness at deep breathing, 3.6 mm (normal range: 2.4-5.4 mm). Diaphragmatic ultrasound was also performed, thereby evidencing the following measures (Figures 2B, 3B): tidal volume excursion, 1.6 cm (normal range: 0.9-2.5 cm); tidal volume inspiratory time, 1.12 s (normal range: 0.5-1.7 s); tidal volume inspiratory velocity, 1.6 cm/s (normal range: 0.7-2.6 cm/s); tidal volume expiratory time, 1.2 s (normal range 0.4-1.6 s); tidal volume expiratory velocity, 1.6 cm/s (normal range: 0.2-2.8 cm/s); tidal volume duration of motion, 2.3 s (normal range: 1.1-3.4 s); deep breathing excursion, 5.86 mm (normal range: 3.3-7.5 mm); deep breathing inspiratory time, 2.3 s (normal range: 0.4-2.4 s); deep breathing inspiratory velocity, 2.5 cm/s (normal range: 1.5-7.3 cm/s); thickness at end-expiration (FRC), 1.1 mm (normal range: 1.1-2.7 mm); thickness at end-inspiration, 1.6 mm (normal range: 1.3-3.7 mm); tidal volume thickening fraction (TF), 45% (normal range: 30-36%), and thickness at deep breathing, 2.8 mm (normal range: 2.4-5.4 mm).
case_images: (A) D1: tidal volume inspiratory thickness before BDP/FF/G. (B) D1: tidal volume inspiratory thickness after BDP/FF/G.
case_images: fmed-11-1357362-g003.jpg
case_images: PMC10948428_01_fmed-11-1357362-g003.jpg
case_images: fig3
case_images: We detected the following ultrasound baseline parameters (Figures 2A, 3A): tidal volume excursion, 3.1 cm (normal range: 0.9-2.5 cm); tidal volume inspiratory time, 0.98 s (normal range: 0.5-1.7 s); tidal volume inspiratory velocity, 3.5 cm/s (normal range: 0.7-2.6 cm/s); tidal volume expiratory time, 2.7 s (normal range: 0.4-1.6 s); tidal volume expiratory velocity, 1.2 cm/s (normal range: 0.2-2.8 cm/s); tidal volume duration of motion, 3.8 s (normal range: 1.1-3.4 s); deep breathing excursion, 8.26 mm (normal range: 3.3-7.5 mm); deep breathing inspiratory time, 1.7 s (normal range: 0.4-2.4 s); deep breathing inspiratory velocity, 4.2 cm/s (normal range: 1.5-7.3 cm/s); thickness at end-expiration (FRC), 1.1 mm (normal range: 1.1-2.7 mm); thickness at end-inspiration, 2.0 mm (normal range: 1.3-3.7 mm); tidal volume thickening fraction (TF), 81% (normal range: 30-36%); and thickness at deep breathing, 3.6 mm (normal range: 2.4-5.4 mm). Diaphragmatic ultrasound was also performed, thereby evidencing the following measures (Figures 2B, 3B): tidal volume excursion, 1.6 cm (normal range: 0.9-2.5 cm); tidal volume inspiratory time, 1.12 s (normal range: 0.5-1.7 s); tidal volume inspiratory velocity, 1.6 cm/s (normal range: 0.7-2.6 cm/s); tidal volume expiratory time, 1.2 s (normal range 0.4-1.6 s); tidal volume expiratory velocity, 1.6 cm/s (normal range: 0.2-2.8 cm/s); tidal volume duration of motion, 2.3 s (normal range: 1.1-3.4 s); deep breathing excursion, 5.86 mm (normal range: 3.3-7.5 mm); deep breathing inspiratory time, 2.3 s (normal range: 0.4-2.4 s); deep breathing inspiratory velocity, 2.5 cm/s (normal range: 1.5-7.3 cm/s); thickness at end-expiration (FRC), 1.1 mm (normal range: 1.1-2.7 mm); thickness at end-inspiration, 1.6 mm (normal range: 1.3-3.7 mm); tidal volume thickening fraction (TF), 45% (normal range: 30-36%), and thickness at deep breathing, 2.8 mm (normal range: 2.4-5.4 mm).