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PubMed1998

Evaluation of catheter-mounted transducers for intra-oesophageal pressure recording in respiratory function tests.

Oesophageal pressure measurements in respiratory function tests are commonly performed using a balloon-catheter system. This study investigates the usefulness of catheter-mounted pressure transducers as an alternative to balloon-catheter systems. Calibration related physical properties of the catheter mounted pressure transducers are evaluated in vitro. The behaviour of these transducers in vivo is evaluated in ten volunteers by relating pressures measured in the oesophagus to airway opening pressures and by comparing these relationships with those sequentially obtained by a balloon-catheter system. The catheter-mounted pressure transducers show no drift after a proper preparation procedure. These catheters, with integrated pressure transducers, are tolerated significantly better by the subjects than are balloon catheters. The catheter-mounted pressure transducers are found to give an equivalent performance compared with the balloon-catheter system, if relative pressures are of interest. However, unpredictable and uncontrollable shifts in offset occur during the in vivo measurements, disturbing absolute pressure readings. Possible explanations for these shifts are the presence of bubbles and adhesion of mucus to the transducers, exerting Van der Waals forces, and contact with the tissue of the oesophageal wall. These shifts are found to be quite stable throughout a period of measurement and therefore of minor disturbance to relative pressure measurements, for instance in assessing the elastic properties of lungs.

Adult↗
PubMedDate not supplied

The effects of L-carnitine on respiratory function tests in children undergoing chronic hemodialysis.

Respiratory functions are affected during hemodialysis. Ultrafiltration rate, acid-base balance and the strength of respiratory muscles have been suggested as important factors in adults undergoing chronic hemodialysis. L-carnitine is crucial for energy producing utilization fatty acid and, possible amino acids. Carnitine treatment has been associated with hypertrophy of type I muscle fibers. Carnitine supplementation in nondialysis patients increases exercise tolerance. Eventually, administration of L-carnitine to adult hemodialysis patients improves exercise capacity, energy metabolism and muscle mass. The study was performed to investigate the chronic effects of L-carnitine treatment on respiratory functions in children receiving chronic hemodialysis therapy. Predialytic and postdialytic respiratory function tests were performed in ten children with end-stage renal disease before and after a three-month L-carnitine treatment period. The mean age was 12 +/- 4 years. L-carnitine was administered at a dose of 20 mg/kg intravenously at the end of each hemodialysis session. Mean predialytic serum carnitine value before and after the carnitine treatment period were 21.8 +/- 3 and 132.0 +/- 48.5 mmol/L, respectively, and the increase was significant (p < 0.05). Respiratory function tests performed just before the carnitine treatment period implied bronchospasm that was clinically vague and could only be detected by a significant decrease in FEV1/FVC, PEF and FEF25-75 values (p < 0.05). Nevertheless, at the end of the three-month carnitine therapy period these respiratory function parameters did not show any significant variation. Hence, it is implied that carnitine therapy might have prevented the subclinic bronchospasm that developed in children during hemodialysis.

Adolescent↗
PubMed2006

Nocturnal hypoxia in motor neuron disease is not predicted by standard respiratory function tests.

BACKGROUND: With increasing awareness of motor neuron disease (MND) in Australia, the approach to respiratory management of patients with this disease will more commonly face the respiratory physician. AIM: The aim of this study was to determine if standard respiratory function tests could determine the presence of nocturnal hypoxia (NH) in patients with MND. METHODS: Respiratory function tests were used to examine daytime respiratory function, and sleep studies were used to detect NH in 16 consecutive patients with MND and in 9 healthy control subjects. Demographic data, clinical parameters, respiratory function tests and sleep studies were obtained. Statistical analyses were carried out using t-tests and anova, where appropriate. RESULTS: NH was detected in 50% of patients with MND, with no hypoxic events detected in the control group. Standard respiratory function tests were not able to predict the presence of NH. CONCLUSION: There was no correlation between respiratory function tests and NH. This study emphasizes the inability of standard respiratory function tests to predict NH that may arise early in the course of MND.

Adult↗
PubMed2001

[Respiratory function tests--current and future perspective].

The apparatus for the respiratory function test have recently made a great progress and become very easy to handle owing to the development of computer technology and medical ordering system. However, the respiratory function tests depend its result on the cooperation of patients. Thus, it is important for the medical technician to obtain the maximum efforts and cooperation of the patients in the testing. In the sense, the standardization of the testing should be done urgently regarding procedures, softwares, hardwares and maintenance of apparatus. In the future perspectives, we would like to emphasize following 3 points. First, more noninvasive and sophisticated testing methods and instruments should be developed, since the patients' age will become more and more old and vigorous active cooperation may not be possible for the assessment of respiratory function. The testing for the transplantation of lung should also be developed. Second, the development of screening test and its performance for the routine medical check for the local inhabitants have been important for the early detection, treatment, and follow up of respiratory diseases. Finally, the medical technician should be prepared so that the testing is available when it is needed.

Forced Expiratory Flow Rates↗
PubMed1982

[Comparative value of different respiratory function tests for the early diagnosis of the respiratory distress syndrome (author's transl)].

The diagnostic value of different respiratory function tests in the respiratory distress syndrome was compared in 5 groups of subjects: healthy non-smokers, asymptomatic smokers, patients with bronchitis affecting the large bronchi, asthmatic patients between attacks, and patients with emphysema. Indices measured were the forced expiratory volume per second (FEV1), mean expiratory flow between 25 and 75% of vital capacity (MEF 25-75%), maximum instantaneous flow at 25-50-75% of vital capacity, and peak flow (Vmax 25-50-75%, PF), residual volume, expiratory resistance volume, and the curve of the alveolar plateau of expired nitrogen. The Vmax 50% and the MEF 25-75% appear to be sufficiently sensitive indices of bronchial obstruction in current practice, the MEF 25-75% being simple to measure, and presenting the advantage of not requiring complicated equipment. The Vmax 25% and the respiratory resistance volume present wide inter-individual variations, and this, together with their lack of reproducibility, limit their value in exploratory tests in isolated cases.

Adult↗
PubMed2004

Respiratory function testing: the impact of respiratory scientists on the training and support of primary health care providers.

OBJECTIVE: In rural Australia access to doctors is limited, access to respiratory physicians even more so and these are the traditional sources of lung function testing. The aim of this study was to assess the feasibility of training and supporting existing rural primary healthcare providers in lung function testing as a screening and monitoring mechanism due to the shortage of healthcare professionals capable of providing such a service. METHODOLOGY: As pharmacists are readily accessible healthcare professionals, they were trained in spirometry measurement and supported with ongoing quality assurance by respiratory scientists. Spirometers were provided to the pharmacists. People purchasing respiratory medications or responding to advertising about the service were tested after giving informed consent. Spirometic assessments were assessed for accuracy and reproducibility. Participants' spirometry results were reviewed and those with abnormal test results were referred to their doctor. RESULTS: Pharmacists were able to competently develop the skills necessary for providing spirometry measurement as a screening and monitoring technique. The level of competence exceeded that reported in previously published studies. Pharmacists were able to successfully identify spirometry results within the normal range. CONCLUSIONS: Training and supporting accessible healthcare professionals to provide lung function testing increases access in areas of need and has implications for respiratory morbidity and mortality in such settings.

Adolescent↗
PubMedDate not supplied

The effect of childhood obesity on respiratory function tests and airway hyperresponsiveness.

The aims of this study were to investigate the effect of exogenous obesity on respiratory function tests, to define the relationship between the severity of obesity and respiratory function test parameters, and to detect the incidence of airway hyperresponsiveness and exercise-induced bronchospasm in an obese study group. This cross-sectional controlled study was done with 38 exogenous obese patients, aged 9 to 15 years, and 30 healthy children. Basal respiratory function test parameters were measured with spirometry. To display airway hyperresponsiveness, 4.5% hypertonic saline provocation test was used; exercise-induced bronchospasm incidence was defined with bicycle ergometry. Basal respiratory function test parameters were lower in the study group as compared with the control group. Exercise test was positive in 31.6% of the obese group and in 3.3% of the control group (P = 0.003). The provocation test with hypertonic saline test was positive in 18.4% of the obese group. There were strong negative correlations between body mass index (BMI), relative weight, skin fold thickness, waist/hip circumference ratio and basal forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF) values. The diagnosis and management of exercise-induced bronchospasm may improve exercise performance and physical activity, assist with weight loss, and break the vicious circle.

Asthma, Exercise-Induced↗
PubMed2000

[Several aspects of respiratory function testing in children].

Some practical aspects of respiratory function testing (RFT) are reviewed with special interest on applications in preschool children. RFT may be used for diagnostic, management and follow up purposes. Children may benefit from RFT in a variety of pathological situations. Asthma and other obstructive airways diseases certainly represent the most frequent conditions. Vital Capacity and Forced Expiratory Volume in one second (FEV1) may usually be obtained from age 7 on. In smaller children, the forced expiratory manoeuvre is much less successful. Non invasive measurements such as respiratory resistance (Rrs) or specific airway resistance (sRaw) may be used. Rrs is usually measured by the interrupter technique or the forced oscillation technique and sRaw by body plethysmography, not requiring the estimation of thoracic gas volume. Because much variability is introduced by the upper airways, these parameters are less suited than FEV1 to establish the degree of baseline airway obstruction. On the other hand, Rrs and sRaw may quantify reversibility of airway obstruction and/or bronchial hyperresponsiveness. Lung hyperinflation may be identified by the assessment of Functional Residual Capacity (FRC) with a dilution method. More generally lung growth may be followed up in longitudinal studies of FRC even in small children. More work is needed to standardize RFT techniques and indications in the preschool child.

Age Factors↗
PubMed1981

Reference values for respiratory function tests in males: prediction formulas with tobacco smoking parameters.

Prediction equations for respiratory function tests were obtained by multiple regression of data from 263 healthy males. The material was evenly distributed in the ages 20-70 years, about one third each of non-smokers, smokers and ex-smokers. Measurements were done of lung volumes (with body plethysmograph), airways resistance, ventilatory capacity including flow-volume registration, gas distribution and closing volume, transfer factor and static elastic recoil pressures of the lung with calculation of static compliance. The parameters age, height, weight, years of tobacco smoking and grams of tobacco smoked each day showed significant correlation with the outcome of the test in most of the respiratory function tests. Therefore a set of basic regression equations including these parameters were calculated. In addition an 'extended' set of equations was calculated for prediction of some tests with inclusion of nonlinear terms and the parameter 'years of abstinence from smoking.' The reduction in variance which followed inclusion of tested parameters was moderate (20-69%). There were significant differences between results of the present study and several previously published regression formulas.

Adolescent↗
PubMed2006

[Predicted vales of respiratory function tests in young Japanese aged from 10 to 20 years].

To find predicted values of respiratory function tests in young persons in Japan, we measured slow vital capacity and forced vital capacity in 1,141 subjects aged from 10 to 20 years. The values obtained from 636 persons (363 males and 273 females) who were not smokers or had no suspected rhinitis or asthma were analyzed. Although FEV1% by the Gaensler and Tiffeneau methods were almost constant regardless of age, all other values of respiratory function tests increased with age and then reached a plateau level in late teens. Excluding the Gaensler and Tiffeneau FEV1%, in a single regression analysis using gender, age, and height, both the contribution ratio and regression coefficient were the highest using height, followed by age. In addition, the result was similar with multiple regression analysis. Therefore, for a young person aged from 10 to 20 years, body height is the most important predictor variable of respiratory function tests, compared to gender and age. For each respiratory function test, we showed the prediction relation according to gender obtained from multiple linear regression analysis using 2 variables of height and age.

Adolescent↗