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Results for “Forced Expiratory Volume”

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PubMed1976

Respiratory response to tobacco dust exposure.

Results of a study of the respiratory responses of 318 nonsmoking female workers to long-term tobacco dust exposure are reported. The mean total tobacco dust concentrations ranged from 0.9 to 27.5 mg per m3; the respirable fraction, from 0.3 to 3.6 mg per m3. The mean length of exposure to tobacco dust was 14.9 years; 24 per cent of the workers had been exposed to tobacco dust for 20 years or more. Comparatively low prevalences of chronic respiratory symptoms were found, and only the prevalences of chest tightness and wheezing were significantly higher among workers exposed to tobacco dust than those of the control group (P less than 0.01). Calculating the expected 1-sec forced expiratory volume and forced vital capacity values by means of multiple linear regression equations, developed on the basis of data obtained in the 210 control subjects, revealed no significant differences between the measured and expected ventilatory capacity values among any of the groups of the workers observed. In contrast to negative findings with regard to chronic respiratory effects, significant acute decreases in ventilatory capacity during the work shift were recorded. No dose-response relationship was found between the level of exposure and the acute decreases in ventilatory capacity.

Adolescent↗

PubMed2003

Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation.

OBJECTIVES: Bronchiolitis obliterans is the greatest limitation to the long-term applicability of lung transplantation. Although alloimmune events are important, nonimmune events, such as gastroesophageal reflux, might contribute to lung injury and the development of bronchiolitis obliterans syndrome. METHODS: We retrospectively studied the 396 patients who underwent lung transplantation at the Duke Lung Transplant Program from April 1992 to April 2002. Reflux was assessed for using an ambulatory 24-hour esophageal pH probe. RESULTS: Reflux assessment with an esophageal pH probe was obtained in 128 patients after lung transplantation. Abnormal pH study results were present in 93 (73%) patients. Forty-three patients underwent a surgical fundoplication. There was no in-hospital or 30-day mortality in the patients undergoing fundoplication. At the time of fundoplication, 26 patients met the criteria for bronchiolitis obliterans syndrome. After fundoplication, 16 patients had improved bronchiolitis obliterans syndrome scores, with 13 of these patients no longer meeting the criteria for bronchiolitis obliterans syndrome. In patients at least 6 months after lung transplantation and 6 months after fundoplication, the forced expiratory volume in 1 second improved by an average of 24% (mean forced expiratory volume in 1 second before fundoplication, 1.87 L; mean forced expiratory volume in 1 second after fundoplication, 2.19 L/sec; P <.0002). Overall actuarial survival was significantly better in patients who had either normal pH studies or who had fundoplication. CONCLUSIONS: Gastroesophageal reflux disease is very common after lung transplantation and appears to contribute to mortality and development of bronchiolitis obliterans syndrome. Fundoplication in lung transplant recipients with gastroesophageal reflux disease is associated with significant improvements in lung function, particularly if performed before the late stages of bronchiolitis obliterans syndrome.

Actuarial Analysis↗

PubMed2004

Peroxidase activity within circulating neutrophils correlates with pulmonary phenotype in cystic fibrosis.

Excess neutrophils are present in the airways of patients with cystic fibrosis (CF). Myeloperoxidase (MPO) activity of acid extracts of sputum is directly correlated with airflow obstruction in CF patients. We hypothesized that the sputum MPO was derived from the MPO of neutrophils that entered the airways from the circulation. Active MPO without protease activity injures airways. If MPO activity from circulating neutrophils that emigrate into the airways of these patients causes increased airway epithelial permeability and mucus-gland secretion, then (1) those patients with greater MPO activity per circulating neutrophil would be more likely to produce sputum and (2) the MPO activity per circulating neutrophil would positively correlate with airflow obstruction. We determined the MPO activity for both circulating and sputum neutrophils. Spirometry and respiratory cultures were obtained simultaneously with blood and sputum samples. CF patients with more MPO activity within their circulating neutrophils were more likely to produce sputum ( P =.001, chi 2 test), and the MPO activity per circulating neutrophil was positively correlated with airflow obstruction as measured on the basis of the ratio of 1-second forced expiratory volume to forced vital capacity ( P <. 03, Kruskal-Wallace test). These associations were independent of age, sex, the results of respiratory-tract culture, or protease activity in the circulating neutrophils. MPO activity in circulating neutrophils from CF patients homozygotic for the deletion of phenylalanine at position 508 in the CF transmembrane regulator protein is directly related to the severity of these patients' pulmonary disease. Our results are consistent with the hypothesis that circulating neutrophils deliver active MPO to the airway, producing airway injury and airflow obstruction in homozygotic delF508 CF patients.

Adolescent↗

PubMed2004

Minimally supervised home rehabilitation improves exercise capacity and health status in patients with COPD.

OBJECTIVE: The purpose of this study was to investigate the effects on exercise tolerance and quality of life of an outpatient rehabilitation program implemented at home without a physiotherapist's direct supervision in patients with chronic obstructive lung disease. DESIGN: Patients with moderate chronic obstructive pulmonary disease were studied. The rehabilitation program included lower limb exercise on a stationary bicycle and upper limb exercise and stretching, together with education, and it lasted for 12 wks. Every 2 wks, a physiotherapist contacted patients by phone to evaluate their compliance with the rehabilitation program and any adverse effects. The main measures of outcome were the Health Status Index, cycle ergometer test, forced expiratory volume in 1 sec, and forced vital capacity. Patients were evaluated at the baseline and at 12 wks. RESULTS: A total of 32 patients were recruited and 28 (mean age, 70.4 yrs) completed the trial. After pulmonary rehabilitation, a significant improvement was found in seven of the nine Health Status Index quality-of-life subscales. Exercise tolerance also improved significantly, whereas no variation was observed in pulmonary function tests. There was no correlation between the improvement in quality of life and the improvement in exercise tolerance. The improvements in the Health Status Index physical function and general health subscales correlated negatively with forced expiratory volume in 1 sec (percentage of predicted value) and positively with residual volume/total lung capacity ratio. The improvement in exercise tolerance (expressed in watts or as maximum oxygen uptake), but not in quality-of-life indexes, was associated negatively with age and positively with weight, cognitive function, and forced expiratory volume in 1 sec/forced vital capacity ratio. CONCLUSIONS: We conclude that an inexpensive home rehabilitation program can improve quality of life and exercise tolerance in patients with moderate chronic obstructive pulmonary disease. Furthermore, our results indicate that exercise tolerance evaluated by cycloergometry and quality of life evaluated by the mean of the Health Status Index questionnaire are independent outcome measures of pulmonary rehabilitation.

Aged↗

PubMed1992

Therapeutic equivalence of a fenoterol/ipratropium bromide combination (Berodual) inhaled as a dry powder and by metered dose inhaler in chronic obstructive airway disease.

A randomized double-blind cross-over study was performed to compare the bronchodilator effects of a fenoterol/ipratropium bromide combination (Berodual) when inhaled as a dry powder and by metered dose inhaler (MDI) in an equal doses (fenoterol 100 micrograms + ipratropium bromide 40 micrograms). Thirty-eight patients (29 male, 9 female, mean age 53 years) with reversible chronic obstructive airway disease were studied on 2 separate days by employing the double-dummy technique. The effects of the two modes of administration of the fixed combination were followed by pulmonary function tests [forced expiratory volume (FEV1), forced vital capacity (FVC)] from 15 min up to 6 h after administration. In addition, the pulse rate was recorded just before each pulmonary function test. The FEV1 and FVC time-response curves showed that the dry powder had an overall efficacy profile similar to MDI. Both formulations produced clinically significant improvements in FEV1 in approximately 10 min. Peak effects occurred in 1 h while at 6 h after test drug inhalation there was still an increase in FEV1 of 14%. No safety problems were observed after the use of the test drugs and no clinically significant changes in pulse rate were found. It is concluded that the dry powder of the fenoterol/ipratropium bromide combination provided effective bronchodilation of similar degree and duration to that achieved with the MDI. It would appear, therefore, to be a valuable alternative to MDI.

Administration, Inhalation↗

PubMed1985

Relationship of ventricular ectopy to nocturnal oxygen desaturation in patients with chronic obstructive pulmonary disease.

Sudden death and oxyhemoglobin desaturation are known to occur during sleep in patients with chronic obstructive pulmonary disease. The present study was undertaken to determine the frequency with which nocturnal oxygen desaturation promotes an increase in ventricular ectopic activity, since such a relationship could represent a potential pathophysiologic mechanism for sudden death during sleep. Forty-two clinically stable subjects with moderately severe obstructive airways disease, mean ratio of one-second forced expiratory volume to forced vital capacity = 51 +/- 12 percent, underwent overnight polygraphic sleep study. Oxyhemoglobin saturation was monitored by ear oximetry, and electrocardiographic leads CC5 and CM5 were employed for arrhythmia detection. Premature ventricular complexes were detected in 27 (64 percent) of the subjects and were complex (multifocal, repetitive, or both) in 17. No significant relationship between premature ventricular complex frequency and arterial oxygen saturation was detected for the group as a whole. In part, this result can be attributed to the relatively mild hypoxemic stress experienced by the 22 subjects in whom arterial oxygen saturation remained greater than 80 percent. In contrast, six (30 percent) of the 20 patients who had desaturation to less than 80 percent showed a greater than 150 percent increase in premature ventricular complex frequency with oxygen desaturation. These results suggest that nocturnal hypoxemia, if of sufficient magnitude, is capable of increasing ventricular ectopy during sleep in a substantial number of patients with chronic obstructive pulmonary disease.

Adult↗

PubMedDate not supplied

Identifying population differences in lung function: results from the Allied Dunbar national fitness survey.

In order to identify valid population differences in lung function (e.g. occupational, ethnic), it is necessary to adjust for known confounding variables (e.g. age, body size). The present paper proposes appropriate methods for analysing forced expiratory volume (FEV1), forced vital capacity (FVC) and maximum oxygen uptake (VO2 max), recorded as part of the Allied Dunbar national fitness survey (ADNFS). The ADNFS randomly selected subjects from 30 regional sites throughout England. Measurements of FEV1, FVC and complete records of other relevant information were available on 2672 subjects. Traditional analyses of co-variance (ANCOVA) were found to be inappropriate to investigate population differences in FEV1 and FVC, due to a significant increase in error variance with age. However, by fitting a multiplicative model with allometric body size components to the FEV1 and FVC measurements using weighted log-linear regression, valid and plausible associations with body size, age, smoking, and physical activity, together with 'gender specific' regional differences in lung function were identified. Further insight was obtained when FEV1 and FVC were included into the multiplicative model to predict VO2 max. The apparent advantage of being taller when predicting VO2 max, was explained more accurately by the subjects' superior FVC. In summary, by fitting the multiplicative 'allometric' model using weighted log-linear regression, valid population differences in lung function were identified. Regions containing a higher proportion of working-class, unemployed or less affluent subjects were found to be associated with below average lung function performances.

Adolescent↗

PubMed1983

How many blows really make an FEV1, FVC, or PEFR?

We have collected peak expiratory flow rates, one-second forced expiratory volumes, and forced vital capacities in sets of 10 or 20 values at one-minute intervals from 30 normal, 49 asthmatic, and 26 bronchitic subjects. Analysis shows that the derivatives are compatible with a normal distribution of the values in the sets, so that the true value is best represented by the arithmetic mean of all valid attempts. One-third of all subjects showed skewness in one or more indices but these were equally divided between positive and negative directions. There is no sign of the dominant negative skewness that would result if the true value was indeed a maximum, which could be approached or equalled but never exceeded. There is no sign that repetition worsens performance. Seventy-two subjects showed no regression in any index and those of the remainder who deteriorated were balanced by equal numbers in all categories who improved. There is a significant tendency for both the highest and the lowest values to occur in the earlier part of any series. Probability theory suggests that this is a statistical phenomenon. The best estimate of the true value of these indices is probably the mean of as many observations as can be conveniently obtained and the data can be treated statistically as if they were a sample from a normally distributed population.

Adolescent↗

PubMed2005

Preoperative preparation of the patient with myasthenia gravis.

All patients who are to undergo a thymectomy should be evaluated thoroughly by a neurologist--ideally one with special training and interest in the diagnosis and management of MG. Confirmatory tests to diagnose MG and other potential diseases should be reviewed. The antibody test seems to be most specific, but there are rare cases of other diseases that are ACh-R antibody positive. In 10% of MG patients, serology is negative, and other tests are necessary to confirm the diagnosis. All patients should undergo a contrast-enhanced high-resolution CT scan with 5- to 8-mm slices because thymoma or thymic carcinoma may be present. Pulmonary function tests, including vital capacity, forced expiratory volume, maximal expiratory force, arterial blood gas, and a flow-volume loop, should be performed. Exercise testing to evaluate for hypoxia and hypotension with exercise and ambulation also may be appropriate. A thorough assessment for cardiac dysfunction, including echocardiography, nuclear medicine studies, or a formal cardiology evaluation, may be beneficial. Because MG is a complex autoimmune disease, preoperative blood tests should include thyroid function testing, antinuclear antibody, and rheumatoid factor in addition to routine preoperative studies. Plasmapheresis or intravenous immunoglobulin should be considered for patients with advanced disease, bulbar symptoms, or poor pulmonary function. Given these guidelines, careful selection of candidates for surgery should optimize the long-term results for patients with MG.

Female↗

PubMed1993

Pre-employment lung function at age 16 years as a guide to lung function in adult life.

BACKGROUND: A study was conducted to find out if pre-employment lung function at age 16 improved the estimation of that between ages 25 to 27 compared with the use of reference values based on smoking history, stature, body mass index, and other concurrent anthropometric variables. METHODS: Apprentices attending a shipyard training school were assessed on six occasions from entry during their 17th year to age 25 to 27; results for 114 such men were analysed. The measurements were of stature, body mass, fat free mass and body fat, thoracic dimensions, forced expiratory volume and indices of forced expiratory flow, total lung capacity, and its subdivisions, transfer factor and KCO. RESULTS: At best about half the variance in the final lung function could be accounted for with the concurrent reference variables. For each lung function index the proportion of explained variance was substantially increased by also including in the prediction equation the pre-employment lung function expressed in standard deviation units. CONCLUSION: Estimation of the longitudinal decline in lung function during adult life should be based on initial and final measurements of which the first should ideally be at age 25 but those at age 16 can be used instead: such measurements have long term value and should be preserved.

Adolescent↗

PubMed1986

Comparison of bronchodilator effects of Duovent and Reproterol in patients with chronic reversible airway obstruction.

The bronchodilator effect of Duovent (a combination of a beta-2-agonist, fenoterol, and an anticholinergic, ipratropium bromide) was compared with that of Reproterol (a pharmacological hybrid which presents both resorcinol and theophylline portions) in 16 patients suffering from chronic reversible airway obstruction. Each of the 16 patients (14 males and 2 females, mean age 65.8 years) had a baseline FEV1 ranging from 30 to 70% of their predicted values (CECA values) (mean value +/- SE of the group: 1,238 +/- 78 ml), which increased at least 15% after the inhalation of two puffs of 400 micrograms fenoterol (percent increase of the group: 26.5 +/- 2%, mean +/- SE). This single-blind study was carried out on 3 different days, between 8:30 a.m. and 4:30 p.m. After measurement of the baseline functional parameters [FVC (forced vital capacity), FEV1 (1-second forced expiratory volume), and FEF25-75 (forced expiratory flow between 25 and 75% of vital capacity)], each patient was given two puffs of placebo the 2nd day, and either of Duovent (200 micrograms of fenoterol and 80 micrograms of ipratropium bromide) or of Reproterol (1 mg) the 1st or the 3rd day, at random. The measurements of functional parameters were repeated after 30, 120, 240, 360 and 480 min. Blood pressure, heart rate and possible side effects were recorded at the same time. Both Duovent and Reproterol, at all times, produced a statistically significant increase in FEV1 and FEF25-75.(ABSTRACT TRUNCATED AT 250 WORDS)

Atropine Derivatives↗

PubMed1978

Lung function and respiratory symptoms in silicotic and nonsilicotic gold miners.

In a cross-sectional sample of 1,973 white gold miners 45 to 54 years of age, symptoms of chronic bronchitis were equally common in men with radiologically diagnosed silicosis and those without silicosis; however, more silicotic miners complained of missing work during the previous 3 years because of chest illness. Whereas mean forced vital capacity did not differ between the 2 groups, both the 1-sec forced expiratory volume and the mean forced expiratory flow during the middle half of the forced vital capacity were significantly lower in those with silicosis. This difference was almost entirely accounted for by their higher exposure to dust in the mines. Men with silicosis, therefore, have the same or only slightly more airway obstruction than men without silicosis who have had similar total exposure to dust.

Dust↗

PubMed2006

[Effects of acupuncture on clinical symptoms and pulmonary function in the patient of bronchial asthma].

OBJECTIVE: To explore the clinical therapeutic effect of acupuncture on bronchial asthma. Methods One hundred and four cases of asthma at persistent period and remission stage were divided into a treatment group and a control group with stratified random method of illness degrees. The treatment group were treated with antiasthma agents plus acupuncture at Quchi (LI 11), Lieque (LU 7), Yuji (LU 10), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6), Taixi (KI 3), once each day, 10 sessions constituting one course, and the control group with anti-asthma agents at the same dose. Changes of clinical symptoms and pulmonary function after treatment were investigated. Results Clinical symptoms significantly improved, the score for asthma symptoms decreased and the wheeze in the lung reduced, severity and grading of the disease significantly improved in the treatment group with significant differences as compared with those in the control group (all P< 0.05). And the first second forced expiratory volume (FEV1), peak of forced expiratory flow rate (PEF), FEF(25%-75%) (% PRED), FEF(75%-85%) (% PRED), FEF50% (%PRED), FEF75% (% PRED) more significantly improved in the treatment group than in the control group (P < 0.05 or P < 0.01 or P < 0.001). Six months later, the incidence rate of asthma acute attack in the treatment group was lower than that in the control group (P < 0.05), and the dose of anti-asthma agents in the 50% of patients in the treatment group was reduced by 1/3-1/4. CONCLUSION: Acupuncture can improve clinical symptoms and pulmonary function and reduce the dose of anti-asthma agents, and has a certain long-term therapeutic effect.

Acupuncture Therapy↗

PubMed1977

Acute and chronic theophylline therapy in exercise-induced bronchospasm.

This study examined the effectiveness of theophylline therapy in modifying exercise-induced bronchospasm (EIB) in children with perennial asthma and evaluated whether tolerance to theophylline developed with prolonged use. Twenty-one children between 7 and 16 years of age were studied by a standardized treadmill exercise test carried out before administration of theophylline, 90 minutes after administration of theophylline, and again after three weeks of round-the-clock theophylline treatment. Changes in forced expiratory volume at one second, forced expiratory flow between 25% and 75% of vital capacity, and peak expiratory flow rate were measured before and after each exercise test. Theophylline inhibited EIB in 20 of 21 subjects. There was considerable intersubject variation in the response to theophylline, however, ranging from complete inhibition in five subjects to no inhibition at all in one subject, even though theophylline controlled perennial asthma in all subjects, and all but one had theophylline levels between 10 and 22 microgram/ml when tested. On repeated testing after three weeks of therapy, no tolerance developed to theophylline. These findings suggest that EIB and perennial asthma may result from different causes and tha theophylline's ability to control asthma will not predict its effect on EIB. Subjects who have severe EIB should be retested after theophylline pretreatment of evaluate the effectiveness of therapy.

Acute Disease↗

PubMed1978

[The oral application of berotec in the therapy of obstructive airway diseases].

The intensity and duration of action of Berotec (fenoterol) syrup in doses of 2.5 mg and 5.0 mg were investigated in an acute cross-over study in comparison with placebo, using the double blind technique. By measurement of the forced expiratory volume (FEV1) and the forced expiratory flow rate (FEF200-1200) significant improvement in pulmonary function could be detected from 1 to 4 hours after administration of 2.5 mg and from 1 to 8 hours after administration fo 5.0 mg Berotec syrup. The intensity of action exhibited a statistically significant dose dependence and was greater after the 5.0 mg dose (p=0.05) than after 2 puffs from Berotec metered aerosol taken by the patients in a pre-test. Minor side effects were observed in 2 cases: in one patient on the 5.0 mg dose they were clearly sympathomimetic and accompanied by a stronger bronchodilating effect.

Adult↗

PubMed2003

Peak inspiratory flows in children with cystic fibrosis.

OBJECTIVE: To show that in children with moderately severe cystic fibrosis lung disease: (i). inspiratory flow may be reduced; and (ii). peak inspiratory flow may be predicted from height, expiratory flow analysis or body mass index. METHODS: All children attending the Royal Children's Hospital, Melbourne, between May and July, 2001 who had cystic fibrosis, were aged > 5 years, were able to perform spirometry reproducibly and who had a forced expiratory volume in 1 s < 60% predicted were prospectively enrolled. Height, weight, peak inspiratory flow, forced expiratory volume in 1 s and forced vital capacity were recorded. Linear regression analysis was performed. RESULTS: The age range was 9.4-19.9 years. Sixteen boys and 11 girls were studied. All children had a peak inspiratory flow > 0.5 L/s. There was a significant relationship between peak inspiratory flow and forced vital capacity (R2 = 0.50) especially in boys (R2 = 0.65). In boys, peak inspiratory flow was significantly related to forced expiratory volume in 1 s (R2 = 0.47). There was no relationship between peak inspiratory flow and predicted values of expiratory flow, age, height, weight or body mass index. Logistic regression was used to predict the probability that peak inspiratory flow was < 2.0 L/s for a given forced vital capacity. If the forced vital capacity is > 2.5 L, peak inspiratory flow is likely to be > 2.0 L/s. CONCLUSIONS: In children with significant cystic fibrosis lung disease, peak inspiratory flow is likely to be > 0.5 L/s, which is required to activate dry powder inhalers. If the forced vital capacity is < 2.5 L, the peak inspiratory flow may be < 2.0 L/s, and a metered dose inhaler and spacer should be considered. Further studies that investigate the relationship between expiratory flow and peak inspiratory flow against an internal resistance are needed.

Child↗

PubMed1993

Effects of maxillomandibular fixation on respiration.

The effects of maxillomandibular fixation (MMF) on respiration were studied by measuring pulmonary function in 27 healthy volunteer subjects and in six post-operative patients who underwent MMF after sagittal split ramus osteotomies. In addition, airflow resistance of the mouth was measured in seven healthy subjects under MMF. In the healthy subjects, the ratio of forced expiratory volume in one second to forced vital capacity and peak expiratory flow rate were reduced by 22.9% and 52.1%, respectively, after application of MMF, indicating the presence of respiratory obstruction, whereas the ratio of forced vital capacity to predicted forced vital capacity, an indicator of restrictive respiratory defects, was not significantly affected. The obstructive type of respiratory defect was found to be the result of increased airflow resistance with MMF. The decrease of forced expiratory volume was greater in all postoperative patients than in the healthy subjects. The results indicate that careful preoperative and postoperative airway management is essential for the safety of patients undergoing MMF for the treatment of oral and maxillofacial conditions.

Adult↗

PubMed1965

VENTILATORY TESTS AND PULMONARY CONDUCTANCE IN HOSPITALIZED PATIENTS.

In a series of 49 patients, including individuals with varying lung pathology and some older patients with no lung disease, the usual excellent correlation between first-second forced expiratory volume and maximum breathing capacity was found (coefficient of correlation=0.88). The first-second forced expiratory volume and maximum mid-expiratory flow rate were also seen to be closely related (coefficient of correlation=0.87). The relationship between these ventilatory tests and direct mechanical measurements of pulmonary resistance, however, was not as striking. Reduction in pulmonary compliance not due to loss or removal of pulmonary tissue did not affect the interrelationships between these tests. First-second forced expiratory volume, expressed as a percentage of the predicted vital capacity, was more closely related to the expression "% of predicted maximum breathing capacity" than the first-second forced expiratory volume, expressed as a percentage of the actual vital capacity (p<.05).

Asthma↗