Biomedical subjects

Robert O Crapo

Publications and source records attributed to Robert O Crapo.

4 recordsLinked to original sources

PubMed2003

A genome-wide scan of pulmonary function measures in the National Heart, Lung, and Blood Institute Family Heart Study.

Spirometric measures of pulmonary function exhibited high heritability in the National Heart, Lung, and Blood Institute Family Heart Study. A genome scan of FEV1, FVC, and the ratio of FEV1/FVC was performed to identify chromosomal regions influencing these measures. The pulmonary traits were adjusted through multiple linear regression techniques for the effects of age, age2, body mass index, height, smoking status, and pack-years of smoking. The distribution of FEV1/FVC was transformed to account for nonnormality, and standardized residuals were used as the quantitative trait for variance component linkage analysis in GENEHUNTER (Whitehead Institute, Cambridge, MA). The genome scan identified regions on chromosomes 4 and 18 with logarithm of the odds favoring linkage (LOD) scores above 2.5, and these two chromosomes were further evaluated by incorporating additional marker genotyping. The FEV1/FVC ratio was linked to chromosome 4 around 28 centimorgans (cM; D4S1511) with a LOD score of 3.5, and the transformed ratio was linked to the same region with a LOD of 2.0. FEV1 and FVC were suggestively linked to regions on chromosome 18 with multipoint LOD scores of 2.4 for FEV1 and 1.5 for FVC at 31 cM (D18S843) and a LOD of 2.9 for FVC at 79 cM (D18S858).

Chromosomes, Human, Pair 18↗

PubMed2003

Standards and interpretive issues in lung function testing.

Pulmonary function tests are most useful when performed with good technique and with an accurate system. Using standard techniques in performing the tests minimizes diagnostic and therapeutic errors. This report discusses the rationale and limits of standardization and offers practical suggestions for using available standards to increase confidence in test results.

Humans↗

PubMed2003

Diffusing capacity: how to get it right.

The carbon monoxide diffusing capacity test (D(LCO)) is a commonly performed pulmonary function test that requires technical expertise and attention to detail to get acceptable results. With the advent of automated devices and powerful computer programs, D(LCO) measurement has rapidly gained wide clinical acceptance. But there are many subtle aspects to performing the test that can diminish its accuracy and repeatability. The clinician must ensure: that the D(LCO) instrument is correctly calibrated; that inhalation is least 90% of the largest previously measured vital capacity; that the patient executes a quick, smooth inhalation within 2 seconds; that the breath-hold is 9-11 seconds; that the breath-hold is without straining (no Valsalva or Müller maneuvers); that exhalation is quick and smooth; that a representative gas sample is obtained from the correct portion of the exhalation; and that at least 5 minutes elapse between D(LCO) tests. At least 2 but no more than 5 D(LCO) tests should be conducted, and testing is complete when 2 tests are within 10% or 3 D(LCO) units (mL CO/min/mm Hg) of each other. The reported D(LCO) value is the average of the first 2 tests that meet the reproducibility criteria, but if 5 tests are performed and no 2 meet the reproducibility criteria, the reported value is the average of the 2 tests with the highest inspiratory volumes. These quality controls will help laboratories achieve consistent high D(LCO) accuracy.

Humans↗

PubMed2002

Pulmonary function and health-related quality of life in survivors of acute respiratory distress syndrome.

Although survival rates for acute respiratory distress syndrome have increased, there is only limited information regarding the quality of life and the relationship between quality of life and pulmonary function after survival. We prospectively measured pulmonary function, emotional function, and health-related quality of life in a cohort of acute respiratory distress syndrome survivors recruited from patients who were enrolled in a randomized clinical trial of high versus low tidal volume mechanical ventilation at 1 year after their recovery. No significant differences were found between the patients treated with high and low tidal volumes on any pulmonary function measure. Approximately 80% of the patients in both groups demonstrated reduced diffusing capacity; 20% had airflow obstruction, and 20% had chest restriction. Scores on measures of depression and anxiety were within the normal ranges, suggesting that they did not have significant affective symptoms. However, both groups reported decreased health-related quality of life in physical functioning, physical ability to maintain their roles (role-physical), bodily pain, general health, and vitality (energy) on the Medical Outcome Study Short Form Health Survey with similar physical limitations reported on the Sickness Impact Profile questionnaire. The pulmonary function abnormalities correlated with decreased health-related quality of life for domains reflecting physical function. Acute respiratory distress syndrome survivors treated with high and low tidal volumes have abnormal pulmonary function that was related to decreased health-related quality of life 1 year after hospital discharge.

APACHE↗