A method for measuring the functional residual capacity and dynamic lung compliance during oxygen and halothane inhalation.
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Studies of static lung volumes were performed before and after surgery in 92 scoliotic patients, aged 10 to 25 years. The majority of the patients had idiopathic dorsal curves. Vital capacity, total lung capacity, functional residual capacity and residual volume were measured at least 18 months after surgery. A significant increase was observed in all static volumes, averaging 10 per cent; the pre- and postoperative values were expressed in per cent of predicted normal values according to age and height. Correction of body height was taken into consideration in the prediction of normal values. Patients with the more advanced scoliosis had the greatest improvement in lung volumes. The patients were treated postoperatively with a Milwaukee brace for an average of 15 months. The use of this brace, which allows for chest expansions, might account for the improved lung function compared to previous series where plaster body jackets were used. Thus the correction of idiopathic scoliosis by the standard posterior fusion with Harrinton instrumentation together with our postoperative routine provides a lasting reduction of the spinal deformity, prevents progression of respiratory impairment and, in fact, increases the lung volumes, vital capacity, total lung capacity and functional residual capacity by an average of 10 per cent.
The experiment was a prospective, repeated-measures design intended to determine how the variation of lung volume affects specific measures of swallowing physiology. Swallows were recorded in 28 healthy subjects, who ranged in age from 21 to 40 yr (mean age of 29 yr), by using simultaneous videofluoroscopy, bipolar intramuscular electromyography, and respiratory inductance plethysmography. Each subject swallowed three standardized pudding-like consistency boluses at three randomized lung volumes: total lung capacity, functional residual capacity, and residual volume. The results showed that pharyngeal activity duration of deglutition for swallows produced at residual volume was significantly longer than those occurring at total lung capacity or at functional residual capacity. No significant differences were found for bolus transit time or intramuscular electromyography of the superior constrictor. The results of this experiment lend support to the hypothesis that the respiratory system may have a regulatory function related to swallowing and that positive subglottic air pressure may be important for swallowing integrity. Eventually, new treatment paradigms for oropharyngeal dysphagia that are based on respiratory physiology may be developed.
In 43 women and 3 men suffering from primary Sjögren's syndrome pulmonary function was correlated to various clinical, haematological and serological disease activity parameters. Primary Sjögren's syndrome was defined as the presence of keratoconjunctivitis sicca and xerostomia, in the absence of other well-defined chronic inflammatory connective tissue diseases. Only objective tests were used in the evaluation of the patients [2]. Total lung capacity, residual volume, vital capacity, functional residual capacity and ventilatory capacity were normal. The diffusion capacities measured for CO were significantly reduced compared with the predicted values. This indicates that pulmonary interstitial disease is a common feature of primary Sjögren's syndrome. There was a statistically significant negative correlation between reduced diffusion capacity and previous pneumonia, previous pleurisy, tiredness, dyspnoea, ESR and p-orosomucoid. No correlation was found to certain other clinical disease parameters, the duration of disease or tobacco smoking.
Pulmonary and cardiovascular responses to simulated weightlessness, i. e. 6 degrees head-down tilt bedrest (HDT) were investigated in six healthy male volunteers (mean age 26 yrs). Pulmonary diffusing capacity, functional residual capacity, pulmonary capillary blood flow, and lung tissue volume were measured by inert gas rebreathing. Heart rate and mean arterial blood pressure were obtained from finger blood pressure readings using a plethysmographic technique (Finapres). The short-term (20 min) response to HDT consisted of a 22% increase in pulmonary blood flow, and 13% and 31% falls in blood pressure and heart rate relative to standing. Functional residual capacity fell by 33%, while lung tissue volume increased insignificantly. Subsequent measurements during 10 days of HDT and 5 days of recovery revealed no further changes in lung volume, lung tissue volume, or blood pressure. However, diffusing capacity fell gradually and remained 4%-5% below baseline values after the 7th day of bedrest and during recovery (p less than 0.05). Pulmonary blood flow decreased by 16% during head-down bedrest and recovered partially within the following 5 days (p less than 0.05). We conclude that during and after simulated weightlessness marked alterations in cardiovascular function and marginal affections of gas exchange can be demonstrated already at rest. They may be considered as contributing factors to orthostatic and exercise intolerance observed after space flight.
STUDY DESIGN: This is a prospective study. OBJECTIVE: The authors investigated the effects of continuous bracing for idiopathic scoliosis on lung function variables at three consecutive time points over a 2-year period. SUMMARY OF BACKGROUND DATA: Only short-term results regarding lung function impairment caused by bracing exist. METHODS: Thirty adolescents (aged 13.6 +/- 1.8 years) with primary idiopathic thoracic scoliosis of 28.7 degrees +/- 4.1 degrees and primary lumbar scoliosis of 26.5 degrees +/- 10.4 degrees were treated with a Boston brace. All patients underwent pulmonary function studies at the beginning of brace treatment and 12 and 24 months after treatment initiation. The examinations were always performed while the patients were sitting, in and out of the brace. Patients removed the brace for 1 hour before the measurements for non-brace-wearing were performed. Vital capacity, forced expiratory volume in 1.0 second, and minute ventilation were determined with a low inertia, low resistance bell spirometer. Lung volume, including total lung capacity and functional residual capacity, was recorded. RESULTS: The primary thoracic scoliosis was corrected to 14.5 degrees +/- 4.0 degrees and the primary lumbar scoliosis to 13.0 degrees +/- 6.0 degrees. The values of the following parameters taken while the brace was worn were significantly lower than those taken without the brace at all time points (one-way analysis of variance); vital capacity (P < 0.02), forced vital capacity (P < 0.03), functional residual capacity (P < 0.02), and residual volume (P < 0.05). Furthermore, the predicted negative residual volume and negative functional residual capacity values differed significantly in all time points from negative residual volume and negative functional residual capacity values of patients while wearing the Boston brace (P < 0.01 and P < 0.02, respectively). CONCLUSIONS: The results suggest that brace wearing for mild idiopathic scoliosis does not harm adolescent lung function over a 2-year period and is recommended for treatment of idiopathic scoliosis in early adolescence when the generally accepted criteria for bracing are fulfilled.
The mouse is the most extensively studied animal species in respiratory research, yet the technologies available to assess airway function in conscious mice are not universally accepted. We hypothesized that whole body plethysmography employing noninvasive restraint (RWBP) could be used to quantify specific airway resistance (sRaw-RWBP) and airway responsiveness in conscious mice. Methacholine responses were compared using sRaw-RWBP vs. airway resistance by the forced oscillation technique (Raw-FOT) in groups of C57, A/J, and BALB/c mice. sRaw-RWBP was also compared with sRaw derived from double chamber plethysmography (sRaw-DCP) in BALB/c. Finally, airway responsiveness following allergen challenge in BALB/c was measured using RWBP. sRaw-RWBP in C57, A/J, and BALB/c mice was 0.51 +/- 0.03, 0.68 +/- 0.03, and 0.63 +/- 0.05 cm/s, respectively. sRaw derived from Raw-FOT and functional residual capacity (Raw*functional residual capacity) was 0.095 cm/s, approximately one-fifth of sRaw-RWBP in C57 mice. The intra- and interanimal coefficients of variations were similar between sRaw-RWBP (6.8 and 20.1%) and Raw-FOT (3.4 and 20.1%, respectively). The order of airway responsiveness employing sRaw-RWBP was AJ > BALBc > C57 and for Raw-FOT was AJ > BALB/c = C57. There was no difference between the airway responsiveness assessed by RWBP vs. DCP; however, baseline sRaw-RWBP was significantly lower than sRaw-DCP. Allergen challenge caused a progressive decrease in the provocative concentration of methacholine that increased sRaw to 175% postsaline values based on sRaw-RWBP. In conclusion, the technique of RWBP was rapid, reproducible, and easy to perform. Airway responsiveness measured using RWBP, DCP, and FOT was equivalent. Allergen responses could be followed longitudinally, which may provide greater insight into the pathogenesis of chronic airway disease.
Functional residual capacity of the lungs (FRC) was measured by a plethysmographic method in anaesthetized, intubated rats breathing air or a hypoxic mixture (10% O2 in N2), before and after bilateral cervical vagotomy. Inhalation of the with intact vagi, the drop in Pao2 was accompanied by a significant rise of FRC; after hypoxic mixture led to the same decrease in Pao2 before and after vagotomy. In rats vagotomy, hypoxia did not affect the FRC. The vagal nerves are thus apparently necessary for the increase of FRC during hypoxia in the rat.
Pulmonary function tests were performed in 22 patients undergoing laparoscopic cholecystectomy. Measurements were made before, 24 h after, and 6 weeks after operation (12 patients). At 24 h postoperatively there were significant decreases in forced expiratory volume in 1 s, vital capacity, functional residual capacity and total lung capacity to 75% (p < 0.001), 73% (p < 0.001), 92% (p = 0.002) and 83% (p < 0.001) of pre-operative values respectively. Inspiratory and expiratory mouth pressures decreased to 66% (p < 0.001) and 63% (p < 0.001) of the pre-operative pressures respectively. There was a reduction in PaO2 (p < 0.01) and an increase in alveolar-arterial gradient (p < 0.001) but no change in PaCO2 at 24 h. The pulmonary function tests measured in the patients who returned after 6 weeks had returned to pre-operative values.