Vital capacity and forced expiratory volume one second in South Indian men.
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Acids↗
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Anatomical dead space and airway resistance after glycopyrrolate or atropine premedication.
The effects of atropine and glycopyrrolate on anatomical dead space, one and three second forced expiratory volume, maximal expiratory flow rate, and total forced expiratory volume were determined in ten healthy volunteers. Using Fowler's single breath nitrogen analyzing technique, atropine was found to increase dead space by 19.2 per cent at one hour, declining to 11.02 per cent at four hours. Glycopyrrolate increased dead space by 21.57 per cent at one hour, 29.28 per cent at two hours, and 26.65 per cent at four hours. When compared to the effects of saline control injection, the dead space increases are significant. The difference between glycopyrrolate and atropine is significant only at four hours. Increases in maximal expiratory flow rate induced by atropine and glycopyrrolate were significant at one-half hour, while atropine alone induced a significant increase in one second forced expiratory volume. Three second forced expiratory volume and total forced expiratory volume were not significantly altered.
Adult↗
Bronchodilating effect and side effects of beta2- adrenoceptor stimulants by different modes of administration (tablets, metered aerosol, and combinations thereof). A study with salbutamol in asthmatics.
Effects and side effects of an adrenergic beta2-stimulant (salbutamol) given by mouth and by inhalation from a metered aerosol were compared. Cumulative dose-response curves for both routes of administration concerning 1-sec forced expiratory volume, forced vital capacity, heart rate, blood pressure, and tremor were constructed. Tremor was found to be the dose-limiting side effect with both modes of administration. The metered aerosol in doses as large as 0.6 mg was shown to produce a greater increase in the 1-sec forced expiratory volume, with fewer side effects than could be achieved with tolerable doses of salbutamol by mouth. An oral dose of 6 mg is probably the maximal tolerable dose in most cases. Oral treatment seems to have a better effect than inhalation treatment on the forced vital capacity at the same effect on 1-sec forced expiratory volume, possibly due to a better effect on small peripheral airways. The effect of combining different oral doses of salbutamol with inhaled salbutamol was also studied. A very good additional effect of inhalations given after 4 and 6 mg by mouth was shown.
Adult↗
High prevalence of reversible airway obstruction in asbestos-exposed workers.
In this retrospective study of 97 male workers exposed to asbestos for 2-50 yr, data were collected on chest x-ray findings and lung function, including lung volumes, forced expiratory flow rates (i.e., forced expiratory volume in 1 sec [FEV1.0], forced expiratory flow measured between 25% and 75% of forced vital capacity [FEF(25-75%)]), airway resistance (R(aw)), carbon monoxide (CO)-diffusing capacity, and the existence of airway obstruction reversible by a beta-adrenergic agonist (RAO). The authors performed multiple-regression analyses to correlate the variations in lung function data with age, smoking habits, duration of asbestos exposure, and time since last exposure. Occupational activities of subjects that might induce specific lung abnormalities were also considered. No significant decrease was seen in lung volumes or CO-diffusing capacity; however, a decrease in FEV1.0 and an increase in R(aw) were measured in 65% of the subjects, and an isolated decrease in FEF(25-75%) occurred in only 18%. There was no difference in lung-function data between subjects who had chest x-ray signs of abnormalities (n = 59) and those who did not (n = 38). A significant relationship was found between the decrease in FEV1.0 and age; however, no correlation was noted between altered lung function and cigarette smoking, duration of asbestos exposure, or time since last exposure. RAO prevalence was higher (34%) than previously reported (9%) in subjects with chronic obstructive pulmonary disease (COPD) who were not exposed to asbestos or outdoor pollution. The RAO prevalence in asbestos-exposed workers was nearly the same as that measured in COPD subjects who lived downtown and who were exposed to outdoor pollution (36%). The high RAO prevalence in asbestos-exposed workers was found in 43% of subjects who were exposed only to asbestos, and in 33% of subjects who were also exposed to air pollution due to their occupational activities. It is hoped that the observations in this study will encourage practitioners to check for RAO in asbestos workers who use inhaled bronchodilators.
Aged↗
Effects of rapid saline infusion on lung mechanics and airway responsiveness in humans.
Lung mechanics and airway responsiveness to methacholine (MCh) were studied in seven volunteers before and after a 20-min intravenous infusion of saline. Data were compared with those of a time point-matched control study. The following parameters were measured: 1-s forced expiratory volume, forced vital capacity, flows at 40% of control forced vital capacity on maximal (Vm(40)) and partial (Vp(40)) forced expiratory maneuvers, lung volumes, lung elastic recoil, lung resistance (Rl), dynamic elastance (Edyn), and within-breath resistance of respiratory system (Rrs). Rl and Edyn were measured during tidal breathing before and for 2 min after a deep inhalation and also at different lung volumes above and below functional residual capacity. Rrs was measured at functional residual capacity and at total lung capacity. Before MCh, saline infusion caused significant decrements of forced expiratory volume in 1 s, Vm(40), and Vp(40), but insignificantly affected lung volumes, elastic recoil, Rl, Edyn, and Rrs at any lung volume. Furthermore, saline infusion was associated with an increased response to MCh, which was not associated with significant changes in the ratio of Vm(40) to Vp(40). In conclusion, mild airflow obstruction and enhanced airway responsiveness were observed after saline, but this was not apparently due to altered elastic properties of the lung or inability of the airways to dilate with deep inhalation. It is speculated that it was likely the result of airway wall edema encroaching on the bronchial lumen.
Administration, Inhalation↗
Terbutaline aerosol from a metered dose inhaler with a 750-ml spacer or as a nebulized solution. Comparison of two delivery systems for bronchodilator aerosol.
The clinical effect of 1.0 mg terbutaline given as a pressurized aerosol with a 750-ml spacer was compared with that of 4.0 mg terbutaline given as a nebulized solution (Pari Inhalier Boy). No differences were found in the parameters measured--forced vital capacity, 1 s forced expiratory volume, forced mid-expiratory flow, and oscillatory resistance. The results indicate that the same clinical response to a given dose of a pressurized aerosol supplied with a 750-ml spacer has the same effect as a fourfold dose via a nebulizer. It is concluded that the more practical 750-ml spacer should be tried when contemplating nebulization therapy.
Adult↗
Five- to seven-year course of pulmonary function in cystic fibrosis.
The pulmonary function records of 132 patients with cystic fibrosis followed for 5 to 7 years were reviewed. Changes in forced vital capacity, 1-sec forced expiratory volume, mean forced expiratory flow during the middle half of the forced vital capacity, and 1-sec forced expiratory volume as a percentage of forced vital capacity were examined. There was considerable variation in the rates of change, but the general pattern was consistent with a theory of exponential decline, mean forced expiratory flow during the middle half of the forced vital capacity showing the earliest and most dramatic changes. The pulmonary function of 33 patients (25 per cent) remained stable or improved throughout follow-up, possibly reflecting mild forms of lung disease or the efficacy of therapy. Twenty of these patients (15 per cent) maintained completely normal pulmonary function. The rate of decline in pulmonary function values, with progress of the disease, was steeper in the female patients.
Adolescent↗
Lung function and treadmill performance of smoking and nonsmoking males receiving ascorbic acid supplements.
Twelve cigarette smoking and 10 nonsmoking healthy human volunteers, 25 to 38 yr of age, performed lung function and treadmill performance tests over two periods of 3 wk duration while taking either ascorbic acid (300 mg daily) or placebo tablets in a cross-over design. The two exercise periods were separated by a one-month inactive phase. Tablets were administered in a random, double-blind manner. Plasma vitamin C levels were significantly increased after 3 wk of ascorbic acid supplementation in both smokers and nonsmokers as compared to initial levels in the same subjects. No differences between ascorbic acid and placebo treatments of smokers and nonsmokers were observed for 1-s forced expiratory volume, forced vital capacity, 1-s forced expiratory percent, resting heart rate, resting and postexercise systolic and diastolic blood pressures, treadmill workload, postexercise blood lactic acid, and ventilation measurements. The postexercise systolic blood pressure values of the nonsmokers were lower, although not quite significantly, after the ascorbic acid treatment than after the placebo. The 300-mg ascorbic acid supplement appeared to have little effect on the lung function and physical performance of healthy smoking and nonsmoking males.
Ascorbic Acid↗
Role of right ventricular and pulmonary functional abnormalities in limiting exercise capacity in adults with congenital heart disease.
This study evaluates right ventricular (RV) and pulmonary function during exercise in adults with congenital heart disease (CHD). Thirty-one patients with CHD involving the right side of the heart underwent symptom-limited bicycle exercise testing with simultaneous expired gas analysis and measurement of RV ejection fraction (EF). Twenty-one age-matched normal controls underwent the identical exercise protocol. Maximal oxygen consumption was lower in the CHD than in normal controls (19.5 +/- 6.4 vs 30.5 +/- 0.8 ml/kg/min, p = 0.0001 patients vs controls). Both heart rate (156 +/- 25 vs 171 +/- 13 beats/min, p = 0.01) and oxygen pulse (9.3 +/- 3.7 vs 12.3 +/- 3.7 ml/beat, p = 0.01), an indirect measure of stroke volume, were found to be lower in the CHD group at peak exercise. Pulmonary dysfunction was evidenced in the CHD group by decreased forced expiratory volume, forced vital capacity and maximum voluntary ventilation, and by a higher ventilation/expired carbon dioxide ratio at peak exercise (37.2 +/- 6.9 vs 33.0 +/- 5.4, p = 0.02), suggesting an increase in dead space ventilation. Maximal oxygen consumption was lower in patients whose RVEF decreased with exercise (17.6 +/- 5.4 vs 22.8 +/- 6.4 ml/kg/min, p = 0.03 "decrease RVEF" group vs "increase RVEF" group). Maximal oxygen consumption correlated with the change in RVEF only in the group whose RVEF decreased with exercise (r = 0.5, p = 0.03). In the group that had increased RVEF with exercise, maximal oxygen consumption correlated with forced expiratory volume (r = 0.7, p = 0.02). Thus, adults with CHD have a reduced functional capacity compared with normal controls. This phenomenon appears to be associated with both RV and pulmonary abnormalities.
Adult↗
Selection effects on an estimation of long-term changes in pulmonary function.
To reveal the association of initial pulmonary function level with subsequent mortality and participation in a follow-up reexamination, a prospective cohort study was performed. Female residents in a volcanic area of southern Kyushu, Japan, were followed up for their vital status and the pulmonary function 15 years after they received the first pulmonary function test. A cohort of 512 Japanese female residents who were examined for pulmonary function as indicated by forced expiratory volume and forced expiratory volume in one second was measured in a baseline examination in 1980. After 15 years, 35 females were lost to follow-up. Of the remaining 477 females, 340 and 137 females provided good and poor levels of pulmonary function tests (PFT) at baseline, respectively. Mortality by 1995 in the poor PFT group was significantly higher than that in the good PFT group (33.6% vs 9.4%). The mortality differences were still highly significant when the 35 lost cases were included as all alive. Among the 399 survivors, the nonparticipation rate in the reexamination in 1995 was significantly higher in the poor PFT group than that in the good PFT group (80.2% vs 69.5%). The results of the present study, a longitudinal study of pulmonary function, provide evidence of selection effects due to death or failure to participate in a subsequent reexamination.
Adult↗
Respiratory and glottal efficiency measures in normal classically trained singers.
Respiratory and glottal efficiency measures were collected from a pool of 40 classically trained singers with normal larynges. All singers had > or = 3 years of formal classical voice training and were active professional solo classical singers. Mean flow rates were obtained from all subjects to assess glottal efficiency. Additionally, maximum phonation times and phonation quotients were obtained from a subset of the singers. Pulmonary function test data on forced expiratory volume, forced vital capacity, and forced expiratory flow were obtained for all subjects. Results were compared with published normal values, not specifically derived from trained singers, used commonly in voice laboratories. Differences were found, suggesting the need for separate normative data to be used for evaluation of the vocal athlete.
Adult↗
Effect of yoga training on handgrip, respiratory pressures and pulmonary function.
Although there are a number of reports on the effect of yoga training on pulmonary functions, very few studies have been undertaken on the effect of yoga training on respiratory pressures and handgrip endurance. Hence the present work was planned to study the effect of yoga training on hand grip strength (HGS), hand grip endurance (HGE), maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP), forced expiratory volume (FEV), forced expiratory volume in first second (FEV1) and peak expiratory flow rate (PEFR). 20 school children in the age group of 12 to 15 years were given yoga training (asans and pranayams) for 6 months. 20 age and gender-matched students formed the control group. Yoga training produced statistically significant (P < 0.05) increase in HGS and HGE. MEP, MIP, FEV, FEV1 and PEFR also increased significantly (P < 0.001) after the yoga training. In contrast, the increase in these parameters in the control group was statistically insignificant. Our study shows that yoga training for 6 months improves lung function, strength of inspiratory and expiratory muscles as well as skeletal muscle strength and endurance. It is suggested that yoga be introduced at school level in order to improve physiological functions, overall health and performance of students.
Adolescent↗
Changes in the forced expiratory spirogram in young male smokers.
Forced expiratory spirograms and peak expiratory flow were measured in 102 resident male medical students (60 nonsmokers and 42 smokers). Forced vital capacity; forced expiratory volume in 1 sec; forced expiratory volume in 1 sec expressed as a percentage of forced vital capacity; forced expiratory flows between 80 and 70 per cent, between 55 and 45 per cent, between 30 and 20 per cent, and between 15 and 5 per cent of the forced vital capacity; forced expiratory time for the last 0.5 liter of the forced vital capacity; and maximal mid-expiratory flow were determined from the forced expiratory spirogram. Peak expiratory flow, all forced expiratory flows (except the forced expiratory volume in 1 sec), and the ratio of forced expiratory volume in 1 sec to forced vital capacity were significantly lower, and forced expiratory time for the last 0.5 liter of the forced vital capacity was significantly higher in the heavy smokers (those who had smoked a lifetime total of more than 10,000 cigarettes) than the nonsmokers. The light smokers (those who smoked a lifetime total of fewer than 10,000 cigarettes) had values between those of nonsmokers and the heavy smokers. Thus, a definite dose-related response to smoking was seen. Flows at lower lung volumes showed greater percentage changes than flows at higher lung volumes. The forced expiratory flow between 30 and 20 per cent of the forced vital capacity was the most sensitive test for detecting abnormality in smokers. Among heavy smokers, 58 per cent had abnormally low forced expiratory flow between 30 and 20 per cent of the forced vital capacity, whereas only 47 per cent had abnormally low ratio of forced expiratory volume in 1 sec to forced vital capacity, and 32 percent had abnormally low maximal mid-expiratory flow. The results show that even subjects with short smoking histories may have changes in pulmonary function that probably reflect narrowing of small airways. Moreover, these changes can easily be detected by simple tests, such as evaluation of a forced expiratory spirogram.
Adult↗
HLA-DR4 and pulmonary dysfunction in rheumatoid arthritis.
Rheumatoid arthritis is associated with an increased frequency of the B cell alloantigen HLA-DR4, and preliminary work has suggested an association between HLA-DR4 and obstructive lung disease in subjects with rheumatoid arthritis. To prospectively evaluate the influence of HLA-DR4 on pulmonary involvement in patients with rheumatoid arthritis, pulmonary function was measured in four groups of subjects with rheumatoid arthritis in whom HLA-DR4 and smoking status was known: 16 DR4-positive smokers (six current and 10 exsmokers), 16 DR4-negative smokers (six current and 10 exsmokers), eight DR4-positive nonsmokers, and eight DR4-negative nonsmokers. Significant reductions in one-second forced expiratory volume and forced vital capacity were observed in DR4-positive subjects compared with DR4-negative subjects irrespective of cigarette smoking status. In addition, patients with keratoconjunctivitis sicca (secondary Sjögren's syndrome) demonstrated significant reductions in one-second forced expiratory volume, forced vital capacity, and ratio of one-second forced expiratory volume to forced vital capacity compared with those patients without evidence of secondary Sjögren's syndrome. It is concluded that the presence of the HLA-DR4 antigen and secondary Sjögren's syndrome are associated with abnormal pulmonary function in patients with rheumatoid arthritis.
Arthritis, Rheumatoid↗
Dynamic airflow limitation after topical anaesthesia of the upper airway.
This prospective before-and-after observational study investigated the effect of upper airway anaesthesia on dynamic airflow. Six consenting ASA 1 adults, all authors of this study, underwent a series of spirometric measurements before and after topical anaesthesia of the upper airway using lignocaine. Peak inspiratory flow rate, forced inspiratory flow between 25% and 75% of the maximum inhaled volume, forced expiratory volume at 1 second, and forced vital capacity in the supine and sitting positions were measured. The measured inspiratory parameters were significantly reduced after lignocaine topical anaesthesia of the upper airway. Expiratory flow parameters were not affected. We conclude that topical anaesthesia of the upper airway leads to dynamic inspiratory airflow limitation.
Administration, Topical↗
Computerized rapid analysis of pulmonary function test: use of a least mean squares correlation for interpretation of data.
Although systems for automated calculation and interpretation of screening pulmonary function tests (PFT) have been discussed by previous investigators, these systems are often unavailable to other users, require large or hybrid computers, or are difficult to modify. The use of a branching decision tree for PFT interpretation may also limit the number of correlations possible and make revision of the program difficult because changes in the proximal branches of the tree require a rewriting of the entire distal program. We have developed a system based on a minicomputer which uses a least mean squares analysis for rapidly analyzing the patient's PFT data. This program considers the following types of PFT data singly and in combination: percentage predicted total lung capacity and/or alveolar volume, forced expiratory volume in one second to forced vital capacity ratio (before and after bronchodilator or 80% helium challenge), and percentage predicted single breath diffusing capacity for carbon monoxide. The interpretation program (IP) then selects the 'best interpretation' for the patient by computing the variance between the patient's data and data from a menu of over 120 interpretation statements. During the past two years we have used this system for screening over 3000 patients. In about 90% of patients the computer selected interpretation statements which were acceptable to a sub-specialty pulmonary physician. The use of this IP for screening purposes has facilitated the efficient use of laboratory personnel and equipment.
Diagnosis, Computer-Assisted↗
Respiratory functions in thermal burns.
In our present series, respiratory functions were observed in patients with a relatively small extent of burn compared to that commonly represented by the published works, and for a considerable duration of time (three weeks), commencing soon after the burn trauma. Respiratory rate increased in the post burn trauma and the peak expiratory rate was observed on the 8th post burn days and then it gradually fell but still remaining much higher than the control normal value. The minute volume and tidal volume also showed similar rise on the 8th post burn day and then gradually fell to below the mean level of 3rd post burn day before the 3rd post burn week. Forced vital capacity, forced expiratory volume in one second, forced expiratory volume in three seconds, forced expiratory volume in one second as a percentage of forced vital capacity, forced expiratory volume in three seconds, as a percentage of forced vital capacity and peak expiratory flow rates, did not vary much and indicated no significant respiratory abnormality.
Burns↗
Evaluation of pulmonary function and quality of life in women with osteoporosis.
Osteoporotic vertebral fractures generally result in an increased kyphotic angle, which in turn may lead to disturbances in pulmonary function. The objective of the present study was to evaluate pulmonary function and quality of life in a group of osteoporotic patients. Fifteen women with osteoporosis and thoracic vertebral fractures (group 1), 20 women with osteoporosis without vertebral fracture (group 2) and 20 control women (group 3) were submitted to spirometry using a Vitatrace-130 SL spirometer and to an SF-36 quality of life questionnaire. Women with osteoporosis and vertebral fractures showed an increased kyphotic angle (median=60 degrees) and decreased forced vital capacity (group 1 vs. group 2, P =0.020; group 1 vs. group 3, P =0.039) and forced expiratory volume in 1 s (group 1 vs. group 2, P =0.008; group 1 vs. group 3, P =0.014) when compared with women without vertebral fractures or osteoporosis. A negative correlation was observed between thoracic kyphosis and the predicted value of expiratory forced volume in 1 s ( r =-0.713, P =0.003). No differences in the quality of life were detected between the three groups studied. We conclude that women with thoracic vertebral fractures have an increased kyphotic angle and present a decrease in lung volume.
Absorptiometry, Photon↗