Clinical Evaluation of Deployed Military Personnel With Chronic Respiratory Symptoms
| Autor: | Brian S. Barber, Robert Walter, Aaron B. Holley, Michael J. Morris, Christina Murillo, John H. Sherner, John Hunninghake, Edward T. McCann |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Spirometry medicine.medical_specialty medicine.diagnostic_test medicine.drug_class business.industry Interstitial lung disease Sleep apnea Critical Care and Intensive Care Medicine medicine.disease respiratory tract diseases Pulmonary function testing Lung Disorder 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Bronchodilator Internal medicine medicine Lung volumes 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Asthma |
| Zdroj: | Chest. 157:1559-1567 |
| ISSN: | 0012-3692 |
| Popis: | Background Chronic respiratory symptoms are frequently reported after Southwest Asia deployment in support of combat operations. The full spectrum of clinical lung diseases related to these deployments is not well characterized. Methods Military personnel with chronic symptoms, primarily exertional dyspnea, underwent a standardized cardiopulmonary evaluation at two tertiary medical centers. Pulmonary function testing consisted of spirometry, lung volume, diffusing capacity, impulse oscillometry, and bronchodilator testing. Further testing included methacholine challenge, exercise laryngoscopy, high-resolution CT scan, ECG, and transthoracic echocardiography. Results A total of 380 participants with a mean age of 38.5 ± 8.4 years completed testing. Asthma was the most common diagnosis in 87 patients (22.9%) based on obstructive spirometry/impulse oscillometry and evidence of airway hyperreactivity, whereas another 57 patients (15.0%) had reactivity with normal spirometry. Airway disorders included 25 (6.6%) with laryngeal disorders and 16 (4.2%) with excessive dynamic airway collapse. Interstitial lung disease was identified in six patients (1.6%), whereas 11 patients (2.9%) had fixed obstructive lung disorders. Forty patients (10.5%) had isolated pulmonary function abnormalities and 16 (4.2%) had miscellaneous disorders. The remaining 122 patients (32.1%) with normal studies were classified as undiagnosed exertional dyspnea. Significant comorbidities identified included elevated BMI > 30 kg/m2 (34.2%), smoking (36.4%), positive allergy testing (43.7%), sleep apnea (38.5%), and esophageal reflux (13.6%). Mental health disorders and posttraumatic stress disorder were likewise common. Conclusions Postdeployment pulmonary evaluation should focus on common diseases, such as asthma and airway hyperreactivity, and include testing for upper airway disorders. Diffuse lung diseases were rarely diagnosed, whereas numerous comorbidities were common. |
| Databáze: | OpenAIRE |
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