1999 Resident Poster Competition
Samer Al-Kaade M.D.
ST. LOUIS UNIVERSITY
Spirometry at 6 Months After Lung Transplant in Patients Monitored through the Internet With Daily Home Spirometry vs. Transbronchial Biopsy (TBB)
Background: Several reports have demonstrated the usefulness of daily home spirometry for early detection of graft rejection and opportunistic infections after lung transplantation. Direct report of spirometry through the Internet may improve patient care and result in better preservation of lung function.
Methods: We retrospectively reviewed the spirometry of 16 patients for a period of six months after lung transplant. Eight patients were followed by routine clinic visits and bronchoscopy scheduled at regular intervals; the other eight patients were followed by home spirometry and the results were reported daily via modem to a central service (Datalog Inc.) where the data were converted into a spreadsheet format and reported to us via the World Wide Web for daily review.
Results: At 6 months post transplant the control group had a mean FVC%, FEV1% and FEF35-75% of predicted of 60%; 46%; and 27% respectively. The values for the group monitored with daily spirometry were 81%, 80% and 80% respectively. The percentage of change from the baseline at one month after transplant for FVC%, FEV1%, and FEF25-75% was 32%, 19% and -6% for the control group and 31%, 23% and 0% for the study group.
Conclusion: After six months post lung transplant there was no difference in the improvement in the spirometry between patients who were followed by regular pre-scheduled visits Vs those followed with daily home spirometry via the Internet.
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Alan D Forker, MD MACP
Missouri Chapter Governor
Patrick Mills
Missouri Chapter Executive Director
