PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Spirometry”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed1996

Spirometry and dyspnea in patients with COPD. When small differences mean little.

OBJECTIVE: To determine when a difference in FEV1 is sufficiently large to be associated with a noticeable difference in dyspnea symptoms for patients with chronic lung disease. DESIGN: Cross-sectional analysis of 15 groups (n = 112 patients, 832 contrasts). SETTING: Respiratory rehabilitation program. PATIENTS: Patients with COPD (mean FEV1 = 35% predicted). MEASURES: Patients' perspectives assessed through subjective comparison ratings of dyspnea and of overall health. Relation between the FEV1 and patients' perspectives determined the smallest difference in spirometry that was associated with a noticeable difference in patients' symptoms. RESULTS: The FEV1 was moderately correlated with patients' ratings of dyspnea (r = 0.29; 95% confidence interval (CI), 0.22 to 0.35). In contrast, the FEV1 was minimally correlated with patients' ratings of overall health (r = 0.10; 95% CI, 0.03 to 0.17). The FEV1 needed to differ by 4% predicted for the average patient to stop rating his or her dyspnea as "about the same" and start rating his or her dyspnea as either "a little bit better" or "a little bit worse" relative to other patients (95% CI, 1.5 to 6.5). This was equivalent to the average patient's FEV1 increasing by 112 mL (starting from 975 mL and ending at 1,087 mL). CONCLUSIONS: Some statistically significant differences in the FEV1 are so small that they may not represent important differences in symptoms for the average patient with severe COPD; an awareness of the smallest difference in FEV1 that is noticeable to patients can help clinicians interpret the effectiveness of symptomatic treatments.

Aged↗
PubMed1997

Preoperative spirometry and laparotomy: blowing away dollars.

STUDY OBJECTIVE: Increasing evidence indicates that routine preoperative diagnostic spirometry (pulmonary function tests [PFTs]) before elective abdominal surgery does not predict individual risk of postoperative pulmonary complications and is overutilized. This economic evaluation estimates potential savings from reduced use of preoperative PFTs. DESIGN: Analyses of (1) real costs (resource consumption to perform tests) and (2) reimbursements (expenditures for charges) by third-party payers. SETTING: University-affiliated public and Veterans Affairs hospitals. PATIENTS: Adults undergoing elective abdominal operations. MEASUREMENTS AND RESULTS: Average real cost of PFTs was $19.07 (95% confidence interval [CI], $18.53 to $19.61), based on a time and motion study. Average reimbursement expenditure by third-party payers for PFTs was $85 (range, $33 to $150; 95% CI, $68 to $103), based on Medicare payment of $52 and a survey of nine urban US hospitals with a spectrum of bed sizes and teaching status. Estimates from published literature included the following: (1) annual number of major abdominal operations, 3.5 million; and (2) proportion of PFTs not meeting current guidelines, 39% (95% CI, 0.31 to 0.47). Local data were used when estimates were not available in the literature: (1) proportion of laparotomies that are elective, 76% (95% CI, 0.73 to 0.79); and (2) frequency of PFTs before laparotomy, 69% (95% CI, 0.54 to 0.84). Estimated annual national real costs for preoperative PFTs are $25 million to $45 million. If use of PFTs were reduced by our estimate for the proportion of PFTs not meeting current guidelines, potential annual national cost savings would be $7,925,411 to $21,406,707. National reimbursement expenditures by third-party payers range from more than $90 million to more than $235 million. If use were reduced, potential annual savings in reimbursements would be $29,084,076 to $111,345,440. Potential savings to Medicare approach $8 million to $20 million annually. CONCLUSION: Reduced use of PFTs before elective abdominal surgery could generate substantial savings. Current evidence indicates reduced use would not compromise patients' outcomes.

Abdomen↗
PubMed2000

The importance of spirometry in COPD and asthma: effect on approach to management.

COPD is characterized by airflow limitation. The diagnosis is suggested by history and physical examination and is confirmed by spirometry (ie, a low FEV(1) level that is unresponsive to bronchodilators). Once diagnosed, there is no widely accepted staging or severity scoring system. COPD presently is graded using a single measurement such as FEV(1), which, unlike the case with asthma, has a limited role in disease management. A more comprehensive staging system is required incorporating, for example, age, arterial blood gases, dyspnea, body mass index, and distance walked, in addition to FEV(1). These criteria should allow for more evidence-based recommendations for management of this condition. Asthma is an inflammatory disease also characterized by airflow limitation. But in contrast with COPD, the airflow limitation is highly reversible either spontaneously or with therapy. Repeated lung function measurements using portable peak flowmeters have resulted in improved outcomes. Therefore, frequent flow determination is recommended in the routine management of asthma. Treatment with anti-inflammatory agents and close monitoring of lung function should help decrease the morbidity and mortality associated with asthma.

Asthma↗
PubMed2002

Exhaled H(2)O(2) in steady-state bronchiectasis: relationship with cellular composition in induced sputum, spirometry, and extent and severity of disease.

STUDY OBJECTIVES: To determine the concentration of exhaled H(2)O(2) in patients with bronchiectasis, and to study the relationship between levels of exhaled H(2)O(2), extent of disease, symptoms score, spirometry, and cellular composition obtained from induced sputum; furthermore, to account for possible confounding effects of inhaled corticosteroids (ICS) usage, long-term oral antibiotic treatment, and chronic colonization with Pseudomonas aeruginosa. DESIGN: Cross-sectional study. PATIENTS: Thirty patients with steady-state bronchiectasis. RESULTS: Mean (95% confidence interval [CI]) exhaled H(2)O(2) levels were significantly elevated in patients with bronchiectasis compared to normal subjects: 1.1 (0.87 to 1.29) microM vs 0.3 (0.19 to 0.36) microM, respectively (p < 0.0001). Patients treated with ICS had similar values as steroid-naïve patients. The group of patients with P aeruginosa colonization showed a significantly increased concentration of H(2)O(2) compared to the group without P aeruginosa colonization. Patients receiving long-term oral antibiotic treatment had significantly higher values of H(2)O(2) compared to those not receiving antibiotics. There was a significant positive correlation between H(2)O(2) and either the percentage of neutrophils in induced sputum or the extent of the disease as defined by high-resolution CT. A significant negative correlation was found between H(2)O(2) and FEV(1) percent predicted. Finally, there was a significant positive correlation between H(2)O(2) and the symptoms score. CONCLUSIONS: Patients with bronchiectasis in stable condition showed increased levels of exhaled H(2)O(2). The above-mentioned levels were not decreased either by ICS or long-term oral antibiotic treatment, but were significantly affected by chronic colonization with P aeruginosa. H(2)O(2) levels could be an indirect index of neutrophilic inflammation, impairment of lung function, and extension and severity of the disease.

Administration, Inhalation↗
PubMed2005

Effects of partial isothermic immersion on the spirometry parameters of tetraplegic patients.

STUDY OBJECTIVES: Our objective was to compare under controlled conditions the effect of immersion on spirometry parameters of patients with tetraplegia vs those of normal individuals. DESIGN AND PATIENTS: Twenty-three otherwise well tetraplegic subjects were compared to a control group of 11 similar healthy subjects before and during 5 to 15 min of isothermal immersion in water to shoulder level. RESULTS: Measured at baseline, tetraplegic subjects exhibited significant pulmonary restriction, characterized by a mean FVC of 54.9 +/- 14.6% of the predicted value (range, 23.2 to 80.4%), whereas all controls subjects had > 80% of predicted values. Immersion increased the FVC of tetraplegic patients an average of 18.4 +/- 18.7% above basal measurements, while that of the control group worsened (DeltaFVC, - 8.8 +/- 4.4%). Among the tetraplegic patients, the lower the preimmersion vital capacity, the greater the percentage of improvement following immersion (r = 0.79; 95% confidence interval, - 0.91 to - 0.56; p < 0.0001). No relationship was found between the time elapsed since cervical cord injury or its level and the degree of improvement. CONCLUSIONS: Water activities play an important role in the rehabilitation of patients with spinal cord injury. Immersion in isothermal water at shoulder level, under strictly controlled experimental conditions, reduces the vital capacity of normal individuals, while it improves in a group of patients with tetraplegia. The observed phenomenon seems to be mediated by an improvement in breathing mechanics, impaired by cervical cord injury.

Adult↗
PubMed1984

Host factors affecting longitudinal decline in lung spirometry among grain elevator workers.

The host factors affecting the longitudinal decline in lung function among 267 white male grain elevator workers who were still working in the industry and did not change their smoking habits over a period of six years were studied. Spirometric measures declined more rapidly in older grain handlers as compared with younger workers. Smokers had slightly greater decline in spirometry compared to nonsmokers, but the differences failed to reach the level of statistical significance. Acute changes in lung function over the course of one work week during the initial study were also positively correlated with subsequent decline in lung function, as was bronchial hyperreactivity determined during the follow-up study. Positive immediate skin reactivity to common allergens, presence and absence of respiratory symptoms, and initial lung function did not appear to influence the subsequent decline in lung function in this group.

Adult↗
PubMed1985

The effects of oral slow-release terbutaline on the circadian variation in spirometry and arterial blood gas levels in patients with chronic airflow obstruction.

The circadian variation of spirometry and blood gases was studied in eight male, normoxemic, patients with chronic air flow obstruction and complaints of early morning dyspnea. The patients were selected for a high amplitude in circadian variation of PEFR. They were treated for eight days with placebo and slow-release terbutaline tablets (5 mg at 8 am and 10 mg at 8 pm). Thereafter, arterial blood gas levels were measured at four-hour intervals over 24 hours. Just after blood sampling, FEV1 measurements were performed. The results on placebo therapy were compared with results in eight healthy volunteers matched for age, sex, and smoking habits. The circadian rhythms of FEV1, PaO2, and SaO2 in these patients showed a higher amplitude than in normal subjects. The decrease of FEV1 in the patient group at 8 am coincided with the decrease in PaO2 and SaO2. In normal subjects no significant nocturnal fall in FEV1, PaO2, or SaO2 occurred. Administration of slow-release terbutaline tablets for eight days, providing comparable diurnal and nocturnal serum levels, prevented the nocturnal decrease of FEV1, PaO2, and SaO2. The increase of the FEV1 at all hours of observation showed a significant correlation with the increase of the PaO2.

Administration, Oral↗
PubMed1991

Comparison of incentive spirometry and intermittent positive pressure breathing after coronary artery bypass graft.

Fifty-two patients were randomized to receive either incentive spirometry (IS) or intermittent positive pressure breathing (IPPB) in addition to conventional chest physical therapy following coronary artery bypass grafting. Slow vital capacity and peak expiratory flow readings decreased rapidly and to an equal extent in both groups after surgery, and partly recovered by the sixth postoperative day (POP). Arterial PO2 values were similar for the groups on the first three POPs. On the POPs 2, 3, and 6, the number of chest films showing atelectases as well as the number of individual patients having atelectases revealed no statistically significant differences between the two groups. Based on the three variables studied, we consider both devices equal in efficiency after coronary surgery.

Blood Gas Analysis↗
PubMed1988

Standardization of spirometry: a summary of recommendations from the American Thoracic Society. The 1987 update.

The spirometer is used to measure forced vital capacity in pulmonary, occupational, and general medicine. Results of spirometry affect decisions regarding patient treatment and disability compensation. Accurate spirometers are also required for epidemiologic studies. The recommendations of the American Thoracic Society cover equipment selection, validation, and quality control; maneuver performance recommendations; measurement procedures; and reference values and interpretation standardization.

Forced Expiratory Flow Rates↗
PubMedDate not supplied

Spirometry for patients prescribed topical beta-blockers.

AIM: To evaluate the effects of four glaucoma medications on the cardio-respiratory system. METHOD: All newly diagnosed glaucoma (primary open-angle glaucoma--POAG--or normal tension glaucoma) patients were recruited into a 12-month prospective audit. RESULTS: The study has resulted in glaucoma patients having a spirometry lung function test before being prescribed beta-blocker eye drops. The results of this study demonstrate a high level of both systemic and ocular side-effects caused by these topical glaucoma medications. CONCLUSION: This study confirms the findings of previous studies, which have shown topical beta-blockers to be harmful to older people with glaucoma and 'hidden' reversible airways disease. It also shows the consequences of using topical beta-blockers on patients who have previously undiagnosed respiratory and cardiac disease.

Administration, Topical↗
PubMedDate not supplied

Best practice in the use of spirometry.

This article examines spirometry as a method of detecting lung disease, particularly chronic obstructive pulmonary disease (COPD). Methods of producing an accurate assessment and identifying acceptable traces are outlined, and contraindications are discussed.

Humans↗
PubMed1982

Computer-assisted spirometry.

The largest change in spirometric pulmonary function testing in the last 10 years has been the introduction of the digital computer for data acquisition and reduction. Computer-assisted spirometry can enhance the effectiveness of spirometric testing by increasing test accuracy, increasing patient acceptance, and decreasing the time necessary to complete the test and its interpretation. Any computer-assisted spirometer should be easy to use and should clearly display and properly report test results. I recommend that the American Thoracic Society Standards for spirometric testing be used by pulmonary function laboratories and that test interpretation made by a computer be verified.

Diagnosis, Computer-Assisted↗
PubMed1999

[The fiftieth anniversary of Miodonski's electro-rhino-spirometry].

On the 50th anniversary of the introduction of the electro-rhino-spirometry by Miodoński the author recalls its theoretical foundations and diagnostic possibilities. Moreover, it has been stressed that Miodoński's method was the first one which does not disturb the nasal function, and the development of electronics supported and widened its diagnostic possibilities leaving the theoretical basis for examination unchanged.

Electrodiagnosis↗
PubMed1999

[The effect of sputum induction on spirometry parameters in patients with bronchial asthma].

Evaluation of differential cell count and biochemical parameters in sputum seems to be a valuable method in asthma studies. The purpose of the paper was to evaluate the effects of sputum induction alone and after fenoterol and salmeterol premedication, on spirometry in asthma patients. The another aim of the study was to observe the correlation between bronchial hyperreactivity and decreases in FEV1 and MEF50 in asthmatics during sputum induction. The studies were carried out on 20 mild to moderate asthma patients (FEV1 baseline 79 +/- 16% of the predicted values) who inhaled an increasing concentration of hypertonic saline (3%, 4% and 5%), using an ultrasonic nebuliser. The forced expiratory volume in one second and MEF50, as the good indicators of bronchial obturation, were evaluated. During the sputum induction significant decreases in FEV1 and MEF50 were observed, which were proportional to the concentration of NaCl. After inhalation of 3% of NaCl the mean of FEV1 was 87.2 +/- 12.7% of the baseline, after 4%--84.3 +/- 16.9% and 5%--77.4 +/- 19.8%. No significant correlation between bronchial hyperreactivity and the induced decreases in FEV1 and MEF50 were found. Fenoterol and salmeterol fully prevented bronchial obturation during sputum induction.

Administration, Inhalation↗
PubMed2000

Spirometry and tests of bronchial hyperresponsiveness in population studies.

The use of spirometry in epidemiological studies has provided objective evidence of the acute and chronic effects of occupational and environmental exposure to many agents as well as data on exposure-response relationships necessary for establishing control levels. Methacholine or histamine challenge testing for the measurement of non-specific bronchial hyperresponsiveness (NSBH) in epidemiological settings is safe when carried out according to a standardised protocol. Measurement of NSBH, a useful tool in the clinical assessment of occupational asthma, has also been used in screening workers in surveys of workforces at risk for occupational asthma. Standardisation and quality control are the key to the success of using lung function testing in the field.

Asthma↗
PubMed1975

[Respiratory function in liver cirrhosis. Spirometry, blood gas analysis and radioisotope study with Xenon 133].

The literature data concerning respiratory function in cirrhosis of the liver are cited and reference is made to the results of a spirometric, gas analysis and 133-Xenon investigation of this parameter in 38 patients. Spirometry pointed to slight ventilatory incapacity of the restrictive type. Arterial gas analaysis showed respiratory alkalosis, usually accompanied by metabolic acidosis and slight hypoxyaemia. Examination with 133-Xe indicated that hypoxyaemia was not due to a shunt effect, since there was no excess of perfusion with respect to district ventilation. It was clear, on the other hand, that the pulmonary capillary reserve was almost exhausted. Such complete perfusion of the capillary bed may be due to increased cardiac output and, in part, to reduction of the respiratory surface caused by raising of the diaphragm and hypoventilation of the lung bases.

Acid-Base Equilibrium↗
PubMedDate not supplied

[Comparative study on diagnostic probes: spirometry vs plethysmography in asymptomatic adult asthmatics].

MATERIAL AND METHOD: The study to aim to do the comparison the sensibility between spirometry and pletismography in 20 asthmatic adult free of acute symptoms in basals conditions and to use subsequent of salbutamol spray. RESULTS: Were found to equal value for vital capacity (CV) with p = 0.02 for the both methods. For the total capacity pulmonary (CPT) with p = 0.05, p = 0.02 and increment in residual volume (VA) with p = 0.001 in the pletismography in both conditions (basal and post-salbutamol). The specific conductance (CE) to show p = < 0.001. The flows velocities (VF50, VF25-75) and (VF75, VF75-85) to show similar obstructions for aerial track smaller and smallest with p = < 0.20. CONCLUSION: Than both methods to have the same specificity, but no sensibility. The pletismography apparently to be more sensitive to diagnostic obstruction in airway tract of caliber medium.

Adolescent↗