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Small airways disease: time for a revisit?

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Figure 1 Graphical representation of a flow-volume loop indicating the traditional parameters (Fev1 and FVC) and the various flow parameters measured at intervals throughout the forced expiratory curve.Abbreviations: Fev1, the forced expiratory volume in one second; FvC, forced vital capacity; MMEF, maximal mid-expiratory flow; MEF25, maximal expiratory flow when 25% of FvC remains; MeF50, maximal expiratory flow when 50% of FVC remains; MeF75, maximal expiratory flow when 75% of FVC remains; PEF, peak expiratory flow.
Figure 2 A typical plot of exhaled volume versus nitrogen concentration (N2 %) obtained during the single breath nitrogen washout test.Note: Stages I–Iv (including the Phase III slope) are indicated, and the volume relationship between Cv, CC, Rv and TLC is also shown.Abbreviations: CC, closing capacity; Cv, closing volume; Rv, residual volume; TLC, total lung capacity.
Figure 4 sRtot percentage predicted in 254 AATD patients with normal spirometry and varying degrees of airflow obstruction: mild (GOLD Stage I), moderate (GOLD Stage II), severe (GOLD Stage III) and very severe (GOLD Stage Iv).Note: *Significantly different from patients with normal spirometry (P,0.001).Abbreviations: AATD, alpha-1 antitrypsin deficiency; GOLD, the Global Initiative for Chronic Obstructive Lung Disease; sRtot, specific total resistance.
Table 1 Methodologies to assess small airways function

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