Official Journal of the Asian Pacifi c Society of Respirology Respirology Volume 23 Supplement 1 March 2018 Annual Scientific Meeting 23 – 27 March 2018, Adelaide Convention and Exhibition Centre anzsrs Australian and New Zealand Society of Respiratory Science Ltd Volume 23 Supplement 1 March 2018 The Australia & New Zealand Society of Respiratory Science and The Thoracic Society of Australia and New Zealand (ANZSRS/TSANZ) Annual Scientifi c Meeting 23–27 March 2018 Adelaide, Australia Disclaimer This abstract book has been produced using author-supplied copy. Editing has been restricted to some corrections of spelling and style where appropriate. The publisher assumes no responsibility for any claims, instructions, methods or drug dosages contained in the abstracts. It is recommended that these are verifi ed independently. The contents contained herein are correct at the time of printing and may be subject to change. Contents ANZSRS Oral Abstracts New Investigators Awards (AO 001 – AO 005) ANZSRS Oral Abstracts Part (AO 006 – AO 012) ANZSRS Poster Abstracts ANZSRS Poster Abstracts (AP 001 – AP 016) TSANZ Oral Abstracts TSANZ Respiratory Nurses SIG Symposium 1 (TO 001 – TO 002) TSANZ Respiratory Nurses SIG Symposium 2 (TO 003 – TO 005) TSANZ Respiratory Nurses SIG Symposium 3 (TO 006 – TO 007) Asthma and Allergy 1 (TO 008 – TO 013) Paediatric (TO 014 – TO 019) Asthma and Allergy 2 (TO 020 – TO 025) Cystic Fibrosis 1 (TO 026 – TO 031) Occupational & Environmental Lung Disease / Population Health (TO 032 – TO 037) Primary Care/ Palliative Care/ Tobacco (TO 038 – TO 043) Cell Immunology & Molecular Biology of the Lung 1 (TO 044 – TO 049) Chronic Obstructive Pulmonary Disease [COPD] 1 (TO 050 – TO 055) OLIV 1 (TO 056 – TO 061) TSANZ Ann Woolcock Young Investigator Awards (TO 062 – TO 067) Late Breaking Abstracts (TOL 001 – TOL 004) Cystic Fibrosis 2 (TO 068 – TO 073) Interventional Pulmonary / Bronchology 1 (TO 074 – TO 079) Pulmonary Physiology & Sleep 1 (TO 080 – TO 085) Asthma and Allergy 3 (TO 086 – TO 091) Cell, Immunology & Molecular Biology of the Lung 2 (TO 092 – TO 097) Chronic Obstructive Pulmonary Disease [COPD] 2 (TO 098 – TO 103) Pulmonary Physiology & Sleep 2 (TO 104 – TO 109) Respiratory Infectious Diseases (TO 110 – TO 115) Asthma and Allergy 4 (TO 116 – TO 121) Cell, Immunology & Molecular Biology of the Lung 3 (TO 122 – TO 127) Chronic Obstructive Pulmonary Disease [COPD] 3 (TO 128 – TO 133) Interventional Pulmonary / Bronchology 2 (TO 134 – TO 139) Lung Cancer (TO 140 – TO 145) OLIV 2 (TO 146 – TO 151) Evidence-Based Medicine and Practice (TO 152 – TO 155) TSANZ Poster Abstracts Asthma and Allergy 1 (TP 001 – TPL 002) Cell, Immunology & Molecular Biology of the Lung 1 (TP 011 – TPL 003) Chronic Obstructive Pulmonary Disease [COPD] 1 (TP 023 – TPL 006) OLIV (TP 033 – TP 047) Respiratory Infectious Diseases (TP 048 – TPL 007) Cystic Fibrosis (TP 060 – TP 072) Evidence-Based Medicine & Practice (TP 073 – TP 082) Asthma and Allergy 2 (TP 083 – TPL 008) Chronic Obstructive Pulmonary Disease [COPD] 2 (TP 096 – TP 107) Paediatric (TP 108 – TP 120) Primary Care/ Palliative Care/ Tobacco (TP 121 – TPL 009) Asthma and Allergy 3 (TP 131 – TPL 010) Cell, Immunology & Molecular Biology of the Lung 2 (TP 144 – TP 155) Interventional Pulmonary / Bronchology (TP 156 – TP 167) Lung Cancer (TP 168 – TP 181) Occupational & Environmental Lung Disease / Population Health (TP 182 – TP 194) Pulmonary Physiology & Sleep (TP 195 – TPL 011) ANZSRS ORAL PRESENTATIONS AO 001 AO 002 WINDS OF CHANGE: BRONCHODILATOR RESPONSIVENESS ASSESSING THE SUITABILITY OF FRACTIONAL EXHALED FROM MORE THAN ONE DIRECTION NITRIC OXIDE (FENO) CUT-OFF RANGES FOR ABORIGINAL AND/OR PLOEN L1, SOUTHWELL P2, MICALOS P3, SWANNEY M1 TORRES STRAIT ISLANDER CHILDREN AND YOUNG ADULTS 1Canterbury District Health Board, Christchurch, New Zealand, 2Charles BLAKE T1,2,3, CHANG A2,3, CHATFIELD M4, PETSKY H5, MCELREA M1,2,3 Sturt University, Orange, Australia, 3Charles Sturt University, Bathurst, 1Centre For Children's Health Research, South Brisbane, Australia, Australia 2Indigenous Respiratory Outreach Care (IROC) Program, Chermside, Australia, 3Department of Respiratory and Sleep Medicine, LCCH, South Introduction: Positive bronchodilator responsiveness (BR) using cur- Brisbane, Australia, 4QIMR Berghofer Medical Research Institute, rent American Thoracic Society and European Respiratory Society Herston, Australia, 5School of Nursing and Midwifery, GU, Nathan, fi (ATS/ERS) criteria, purportedly ensures spirometric variability is signi - Australia cantly exceeded. The ATS/ERS guidelines acknowledge there is no clear consensus about what constitutes bronchodilator responsiveness in sub- Introduction/Aim: Fractional exhaled nitric oxide (FeNO) is used as jects with airflow obstruction. a non-invasive measure of eosinophilic airway inflammation. It is unknown Aim: This study investigated the individual variability in multiple spiro- how appropriate the recommended FeNO cut-off ranges are for Aboriginal metric parameters in patients having reversibility tests. We address how and/or Torres Strait Islander patients. Our aim was to assess the distribu- spirometric variability can inform current guidelines for identifying a clini- tion of healthy Aboriginal and/or Torres Strait Islander FeNO results cally significant bronchodilator response. according to current American Thoracic Society cut-off guidelines. Method: 102 consenting participants performed slow vital capacity Methods: We measured FeNO (using Aerocrine NioxMINO) in (SVC) and flow volume loops (FVL) before and after Salbutamol adminis- 991 Indigenous children and young adults (aged 3 to 25 years) from seven tration. Measurement of symptom control used the clinical chronic Queensland communities. Questionnaires and medical charts were reviewed obstructive pulmonary disease questionnaire and dyspnoea and wheeze to identify healthy participants (no respiratory and/or atopic illness ever). used the visual analogue scale. Two determinants of BR: ATS/ERS cri- Results: Acceptable FeNO measurements were achieved by 553 chil- teria and a t-score calculation were compared by correlation with the sub- dren (≤12 years) and 288 adults (>12 years). Participants with a history of jective measurements of respiratory impairment. respiratory and/or atopy conditions were excluded resulting in a healthy Results: 63 participants had positive bronchodilator responses by t- cohort of children (n=401, 72.5%) and adults (n=193, 67%). The geomet- score calculation compared with 16 by current ATS/ERS guidelines. T- ric mean FeNO results for children and adults were 11.1ppb and 12.5ppb scores showed a weaker correlation with subjective measures of respira- tory impairment than per cent and absolute change. Inspiratory vital respectively. Table 1 summarises the distribution of healthy FeNO results capacity (IVC), SVC, and inspiratory capacity (IC) correlated more for each ethnic group according to current cut-off ranges. strongly with symptom control, wheeze and dyspnoea than FEV1 or FVC. The mean individual variability and standard deviation (SD) for each Child ≤12 Adult >12 parameter is shown in the table. years (ppb) years (ppb) Normal Inter Inflam Normal Inter Inflam Pre-bronchodilator Post bronchodilator ≤20 21-34 ≥35 ≤25 26-49 ≥50 Mean, *CV, Mean, *CV, Aboriginal 88% 7% 5% (n=51) 90% 6% 4% n SD (L) SD (%) SD (L) SD (%) (n=112) Torres 83% 6% 11% (n=87) 83% 10% 7% FEV1 101 2.58 (0.98) 1.89 (1.46) 2.74 (1.00) 1.67 (1.45) FVC 101 3.60 (1.09) 1.64 (1.27) 3.71 (1.06) 1.35 (1.45) Strait Is FIVC 97 3.57 (1.06) 2.29 (2.06) 3.63 (1.07) 1.89 (1.61) (n=134) SVC 100 3.56 (1.08) 1.91 (1.22) 3.74 (1.03) 1.45 (1.04) Both 85% 8% 7% (n=55) 87% 9% 4% IC 100 2.83 (0.80) 2.95 (2.56) 3.03 (0.82) 2.33 (1.50) (n=155) *CV = Coefficient of Variation; Is=Islander, Both=Aboriginal and Torres Strait Islander fl fl Conclusion: The low individual variability may explain the poorer dis- Int=Intermediate, In am=In ammation criminatory ability of BR by t-score because a smaller change is required Conclusion: Although the majority of participants had FeNO results to be considered significant. T-scores may overestimate bronchodilator within the age-respective normal ranges, we found a proportion of healthy responsiveness, particularly in patients with normal spirometry at base- participants with elevated FeNO results in all groups. The greatest propor- line. Spirometry values that are less influenced by dynamic compression tion of elevated results was seen in Torres Strait Islander children and have potential utility in bronchodilator response testing. Ongoing recruit- adults, and Aboriginal/Torres Strait Islander children. This suggests that ment will allow further investigation into the utility of t-scores and alterna- the recommended cut-off ranges may not be appropriate for these groups. tive spirometry values for participants with airway obstruction. Further investigation is still needed. Key Words: Spirometry, variability, bronchodilator response Key Words: FeNO, Aboriginal and/or Torres Strait Islander, cut-off ranges Nomination for New Investigator Award Nomination for New Investigator Award: Yes Grant Support: Nil Grant Support: IROC Program (Qld Health), CRE for Indigenous Lung Health in Children and TPCH Foundation. NHRMC PhD Scholarship (TB), NHMRC Practitioner Fellowship (AC). Editorial material and organization © 2018 Asian Pacific Society of Respirology. Respirology (2018) 23 (Suppl. 1), 4–9 Copyright of individual abstracts remains with the authors. doi: 10.1111/resp.13265