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PubMed1978

Serial lung function studies in cystic fibrosis in the first 5 years of life.

Lung mechanics were studied in 8 infants with cystic fibrosis at 6 months of life and radiosotopic lung function was measured in 5 of them at 5 years of age. The children who were initially asymptomatic had normal lung mechanics in infancy but the 2 restudied later had abnormal radioisotopic lung function. The symptomatic children showed abnormalities in infancy and more marked changes later. It is concluded that the lungs in cystic fibrosis are probably normal initially and that damage occurs later even in the absence of symptoms.

Child, Preschool↗
PubMed2002

Cardiopulmonary bypass for bilateral sequential lung transplantation in patients with chronic obstructive pulmonary disease without adverse effect on lung function or clinical outcome.

OBJECTIVE: The use of cardiopulmonary bypass in lung transplantation remains controversial. Previous studies have concluded that cardiopulmonary bypass is deleterious, but these studies were confounded by the inclusion of patients with different diagnoses undergoing single- and double-lung transplantation with elective or emergency use of bypass. The goal of this study was to determine whether cardiopulmonary bypass has deleterious effects on lung function or clinical outcome by analyzing the cases of patients with a single disease entity and elective use of bypass for bilateral sequential lung transplantation. METHODS: A retrospective review of 50 patients with chronic obstructive pulmonary disease who underwent bilateral sequential lung transplantation was performed. Fourteen patients who underwent elective cardiopulmonary bypass for 218.3 +/- 75.4 minutes were compared to 36 control patients. RESULTS: After the operation, the bypass and nonbypass groups were not significantly different with respect to median duration of mechanical ventilation (1 day vs 1 day, P =.76), median stay in the intensive care unit (4 days vs 4 days, P =.44), median hospital stay (15.5 days vs 16 days, P =.74), mean increase in serum creatinine level (1.4 +/- 1.9 mg/dL vs 0.9 +/- 1.0 mg/dL, P =.33), and mean ratio of Pao(2) to fraction of inspired oxygen at 1 hour (376.6 +/- 123 vs 357.0 +/- 218, P =.75), at 24 hours (309.9 +/- 92 vs 350.6 +/- 122, P =.26), and at 48 hours (335.0 +/- 144 vs 316.2 +/- 120, P =.64). Late outcome markers compared between the bypass and nonbypass groups were the following: 1-year percentage predicted forced expiratory volume in 1 second (76.1% +/- 17.0% vs 85.3% +/- 21.7%, P =.24), 30-day mortality (7.1% vs 8.3%, P >.999), 1-year survival (85.7% vs 80.1%, P =.66), 3-year survival (64.3% vs 58.3%, P =.70), and the prevalence of bronchiolitis obliterans syndrome (0% vs 36.1%, P =.01). CONCLUSION: Cardiopulmonary bypass appears to have no deleterious effect on early lung function or clinical outcome. We hope that this pilot study removes some of the unwarranted fear of the use of bypass in lung transplantation for chronic obstructive pulmonary disease.

Analysis of Variance↗
PubMedDate not supplied

Reversibility of asthma-like symptoms and lung function growth over two-year follow-up in preadolescent children.

BACKGROUND: The interesting feature of childhood asthma is the great reversibility of symptoms. The main purpose of this study was to assess the effect of persistent and reversed asthma-like symptoms on lung function growth in preadolescent children. MATERIAL AND METHODS: The follow-up respiratory health survey has been conducted in the sample of 1129 children aged 9 yrs over two years follow-up. The basic health end-points was the occurrence of asthma-like symptoms and the slower lung function growth (SLFG). RESULTS: Adjusted OR for SLFG(FVC) was significantly higher only in the children having the continued symptoms(OR = 3.40; 95% CI: 1.32-8.77). There was a consistent trend of adjusted ORs for SLFG(FEV1) with the category of symptoms, where OR was 1.46 (95% CI: 1.02-2.10) in children with recent new symptoms; 2.06; (95% CI: 0.93-4.58) in those with symptoms remitted, while 3.46; (95% CI: 1.43-8.40) in children who had persistent symptoms. The corresponding ORs for SLFG(FEF25-75%) were 2.03; (95% CI: 0.97-4.28), 2.63; (95% CI: 1.38-4.99), and 5.84; (95% CI: 2.53-13.50). CONCLUSIONS: The consistent association between reversibility of asthma-like symptoms and lung function gain in preadolescent children confirmed the clinical significance of the symptoms in question. The observed slower lung function gain in preadolescence may have implications for the development of chronic lung disease later in adulthood.

Asthma↗
PubMed2005

Discordance between lung function of chinese university students and 20-year-old established norms.

OBJECTIVE: We examined the validity of the 20-year-old established Asian norms for pulmonary function in a contemporary cohort of Hong Kong Chinese university students. DESIGN AND PARTICIPANTS: Pulmonary function testing was conducted in university students (n = 805). SETTING: A university campus in Hong Kong. MEASUREMENTS AND RESULTS: Parameters recorded included gender, age, height, weight, standard lung function variables (ie, FEV1, FVC, and peak expiratory flow rate [PEFR]), and exhaled carbon monoxide (CO) level. Subjects completed a questionnaire on pulmonary health, smoking history, and their dietary and exercise habits within 3 months of the study. Data were compared with the established norms for lung function for Chinese persons from Hong Kong. On average, subjects were taller than those reported in the original cohort, on whom the established norms are based; however, FEV1, FVC, and PEFR were lower. As predicted, the exhaled CO level was higher in smokers. Those who exercised regularly had a higher FEV1 and FVC, and reported fewer respiratory complaints. CONCLUSIONS: Our findings support the idea that lung function norms not only differ across ethnic groups, but that they may be susceptible to change over a single generation within an ethnic group living in the same geographic region. Assuming the equivalence of our testing methods and those on which established norms are based, our findings shed further insight into the dynamic nature of lung function, and have implications regarding the definition of normal pulmonary function and its variance over the short term.

Adult↗
PubMed1995

Influence of red blood cells on lung function in an ex vivo rat heart-lung model.

Crystalloid perfusates commonly are utilized for lung preservation in extracorporeal small animal lung models. However, the function of these grafts is limited. In a new ex-vivo rat heart-lung model the role of red blood cells added to the crystalloid perfusate was investigated. Heart-lung blocks were rapidly excised (n = 9, each group) and the blocks were connected to the extracorporeal perfusion circuit using Krebs-Henseleit solution (KH) or KH with washed bovine red blood cells (hematocrit 38%) (KHRBC). The lungs were ventilated with room air. The coronary system was perfused via the aortic root with oxygenated perfusate. The lungs were perfused via the right ventricle with deoxygenated perfusate (PO2 15 mm Hg). Venoarterial improvement of oxygenation, pulmonary vascular resistance (PVR), and peak inspiratory pressure (PIP) were continuously monitored for 50 min. At the end of the experiment the wet/dry (W/D) ratio was determined using the mediastinal lung lobe while the remaining lung was used for light microscopic (LM) evaluation. After 30 min of perfusion, lung function was significantly better in the KHRBC group (PVR (KH): 752 +/- 193 dyn*sec*cm-5; (KHRBC): 279 +/- 48 dyn*sec*cm-5; PIP (KH): 31 +/- 3.2 mm Hg; (KHRBC): 25.8 +/- 1.9 mm Hg). In addition, lungs perfused with KHRBC showed significantly less edema than those perfused with KH only (W/D ratio (KH): 7.8 +/- 1.2; (KHRBC) 5.1 +/- 0.6; LM (KH): 3.5 +/- 0.9; (KHRBC): 2.3 +/- 0.8). The use of red blood cells in KH perfusate improved functional and structural integrity.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2006

Long term effects of antenatal betamethasone on lung function: 30 year follow up of a randomised controlled trial.

BACKGROUND: Antenatal betamethasone is routinely used for the prevention of neonatal respiratory distress syndrome in preterm infants. However, little is known of the long term effects of exposure to antenatal betamethasone on lung function in adulthood. METHODS: Five hundred and thirty four 30 year olds whose mothers had participated in the first and largest randomised controlled trial of antenatal betamethasone were followed. Lung function was assessed by portable spirometric testing. The prevalence of asthma symptoms was assessed using the European Community Respiratory Health Survey questionnaire. RESULTS: Fifty (20%) betamethasone exposed and 53 (19%) placebo exposed participants met the criteria for current asthma (relative risk 0.98 (95% CI 0.74 to 1.30), p = 0.89). 181 betamethasone exposed and 202 placebo exposed participants had acceptable spirometric data. There were no differences in lung function between betamethasone and placebo exposed groups (mean (SD) forced vital capacity in the betamethasone and placebo groups 105.9 (12.0) v 106.6 (12.6)% predicted, difference = -0.7 (95% CI -3.2 to 1.8), p = 0.59; mean (SD) forced expiratory volume in 1 second in the betamethasone and placebo groups 98.9 (13.4) v 98.5 (13.6)% predicted, difference = 0.3 (95% CI -2.4 to 3.1, p = 0.80)). CONCLUSIONS: Antenatal exposure to a single course of betamethasone does not alter lung function or the prevalence of wheeze and asthma at age 30.

Asthma↗
PubMedDate not supplied

Respiratory symptoms and lung function in jute processing workers: a primary investigation.

This paper presents the results of an investigation of respiratory symptoms and lung function of 404 workers who had been exposed to jute dust in a jute mill. Measurement of total dust concentration and analysis of dust composition were also conducted. Most workers in the jute mill were exposed to jute dusts containing less than 5% silica, whereas a few workers were exposed to dusts containing approximately 10-15% silica. Male smokers and nonsmokers in the dust-exposed group had a higher prevalence of cough and chest tightness compared with those in the control group. Among dust-exposed workers, female nonsmokers had a significantly higher prevalence of cough, chronic bronchitis, chest tightness, and dyspnea than those in the control group. Lung function tests showed that dust-exposed workers had a greater incidence of abnormal lung function than did control workers, as measured by percentage of predicted forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), and FEV1.0/FVC. Dust exposure was the main cause of respiratory symptoms and abnormal values of FEV1.0, but both cigarette smoking and dust exposure contributed to the abnormal values reported for FEV1.0.

Dust↗
PubMed1993

Lung function in insulation workers.

To evaluate the effects of working with modern insulation materials (rock and glass wool), the members of the Copenhagen Union of Insulation Workers were invited to participate in a study based on a health examination that included lung function tests. Three hundred and forty men (74%) agreed to participate, and 166 bus drivers served as the control group. Age distribution, height, and smoking habits were similar in the two groups. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were used as tests for lung function. There were no differences in FVC between the study and control groups, but the insulation workers had significantly lower values of FEV1 (mean 2.51) compared with the controls (mean 3.4 1), independent of smoking habits. Six years before the present study, 114 of the insulation workers participated in a similar study, and eight years after the initial study, the lung function of 59 of the bus drivers was tested. The decline in FVC in insulation workers who smoked was significantly higher (7.7 cl/year) than in bus drivers who smoked (3.1 cl/year); the decline in FEV1 was significantly higher in insulation workers independent of smoking habits (17.0 cl/year v 2.9 cl/year). Self assessed former exposure to asbestos was not associated with lung function in insulation workers. The study concludes that working with modern insulation materials is associated with increased risk of developing obstructive lung disease.

Adult↗
PubMed1997

Upper abdominal surgery: does a lung function test exist to predict early severe postoperative respiratory complications?

We evaluated the capacity to predict severe respiratory complications (SRCs) following upper abdominal surgery (UAS) by using the results of a respiratory questionnaire and preoperative pulmonary function tests. Lung volumes, flows and transfer factor of the lung for carbon monoxide (TL,CO,sb) were assessed in 361 consecutive adult patients (248 males and 113 females). SRCs were diagnosed 24 h after UAS by clinical examination and chest radiography. Univariate and stepwise multiple logistic regression analyses were performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of each single input variable, and to determine which indices best predicted outcome. These patients had a 1% mortality rate and 14% incidence of SRCs, with a male:female ratio of 0.86. The best predictors for SRCs by multiple analysis were: preoperative current hypersecretion of mucus (OR=133; p<0.0001); an increase in residual volume (RV) (OR=3.11; p=0.01); and, to a lesser extent, low percentage of predicted values both of forced expiratory volume in one second (FEV1 % pred) and TL,CO,sb. The algorithm thus obtained (logit theta) was extremely sensitive (84%), specific (99%), and accurate (95%) for preoperative prediction of SRCs. We have found that preoperative current hypersecretion of mucus and pulmonary hyperinflation, and to a lesser extent percentage predicted values both of forced expiratory volume in one second and transfer factor of the lung for carbon monoxide, have a significant predictive capacity for severe respiratory complications following upper abdominal surgery.

Abdomen↗
PubMed1990

[Acute effects of the natural atmospheric ozone exposure on lung function of clinically normal smokers and non-smokers].

The influence of moderate ambient ozone exposure on spirometric lung function and bronchial responsiveness was analyzed in 13 healthy adult nonsmokers and 11 asymptomatic smokers. The study was divided into an initial investigation at low atmospheric ozone concentrations of about 80 (range 68-102) micrograms/m3 and a subsequent similar testing at moderately elevated ozone concentrations above 140 (range 145-205) micrograms/m3. Overall there was a slight but significant impairment in forced expiratory volumes (p less than 0.002) at elevated compared with low ozone concentrations. Furthermore, a significant increase in bronchial responsiveness was shown, with a decrease in threshold dose for inhaled metacholine to produce a 50% fall in specific airway conductance (p less than 0.02). In both smokers and nonsmokers there was a similar change in lung function at ambient ozone concentrations, with more pronounced bronchial irritation in the smokers group. It is concluded that even moderately elevated ambient ozone concentrations can induce slight but significant ventilatory obstruction and an obvious increase in bronchial responsiveness in healthy adults. Although the minor impairment of lung function did not cause manifest acute respiratory problems, it still reduced maximal physical ventilation capacity. The results further support the assumption that air pollution may act as a primary trigger in the development of obstructive airway disease.

Airway Obstruction↗
PubMed1993

[Postoperative lung function in patients with funnel chest].

We evaluated the postoperative lung function determined by spirometry in 54 patients with funnel chest (48 males and 6 females: age range, 4-18 years). Thirty-one patients had sternal turnover as corrective surgery, while 23 had sternal elevation with absorbable PLA (polylactic acid) strut. The mean value of vital capacity as a percentage of predicted (%VC) was 97.3% before operation. %VC was decreased at 3 months (80.5%), 6 months (87.4%), 12 months (82.8%), 24 months (85.9%), and 36 months (77.7%) after the operation (p < 0.01). In patients who had sternal elevation, %VC was decreased at 3 months but not at 6 months, 12 months, 24 months, or 36 months after the operation, while %VC was decreased at any point after the operation in patients who had sternal turnover. No significant changes were seen in forced expiratory volume in one second as a percentage of predicted (FEV1.0%), nor in the ratio of residual volume to total lung capacity (RV/TLC). In conclusion, sternal elevation with PLA strut is a better corrective surgery for funnel chest than sternal turnover, because of its less lung function loss after the operation.

Adolescent↗
PubMed2002

Physical exercise, sports, and lung function in smoking versus nonsmoking adolescents.

Associations between adolescent smoking habits and exercise, particularly participation in sports and lung function were studied. All students aged 13-19 yrs in Nord-Trøndelag County, Norway, 1995-1997, were invited to join a cross-sectional study. Information on smoking habits and exercise was obtained by self-administered questionnaire. Spirometry was performed in accordance with American Thoracic Society standards. Of the 6,811 students (aged 13-18 yrs, without asthma), 2,993 (44%) reported never-smoking, and 1,342 (20%) reported current smoking (90% daily). Frequency of physical exercise was inversely associated with smoking, but participants in individual sports with lesser endurance, especially body-building and fighting sports, were more likely to be daily smokers than nonparticipants. Both daily (53%) and occasional smokers (43%) were more likely to have quit sports than never-smokers (26%)). Never-smokers showed a positive dose-response between physical exercise and lung function (forced vital capacity and forced expiratory volume in one second, adjusted for age and height). No similar significant association was observed in daily smokers. These data suggest that smoking habits in different sports should be considered when promoting physical activity as smoking prevention, and sports organizations should include smoking prevention programmes. Adolescents with better lung function may self-select into sports; this possibility needs to be studied in a longitudinal design.

Adolescent↗
PubMed1995

Decreased lung function in one year survivors of allogeneic bone marrow transplantation conditioned with high-dose busulphan and cyclophosphamide.

Conditioning with busulphan (BU) and cyclophosphamide (CY) prior to allogeneic bone marrow transplantation (BMT) is an alternative to regimens that include total body irradiation (TBI). The aim of the study was to assess the occurrence and degree of lung function impairment after this treatment. Prospectively, 43 consecutive patients, aged 17-51 (median 31) yrs, were examined by lung function measurements and clinical and radiographic evaluation, prior to BMT and at 3 month intervals up to 1 yr after BMT. All patients had normal chest radiographs before BMT and at the 12 month follow-up. Mean baseline values were above 100% of predicted normal for lung volumes and above 90% for gas transfer. Excluded from the lung function follow-up analyses were nine patients who had suffered infectious pneumonia and/or developed obliterative bronchiolitis. For the remaining patients (n = 34), mean alveolar volume (VA), forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) had dropped by nearly 10% compared with baseline 3 months after BMT, but were restored within 1 yr. FEV1/FVC x 100 (FEV1%) was increased, reflecting the restrictive pattern. Hb-adjusted transfer factor of the lungs for carbon monoxide (TL,CO) had dropped by 20% after 3 months, and remained reduced by 15% after 1 year. Prior to BMT the smokers had significantly lower TL,CO than the nonsmokers, and after BMT the difference was accentuated. Reductions in lung function were independent of sex, age and type of haematological disorder. We conclude that BMT with BU/CY is associated with transient declines in lung volumes and a persistent reduction in gas transfer 1 yr after therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Radiographic appearance and lung function after non-malignant pleural effusion.

In order to study factors associated with changes in radiographic appearance and lung function after pleural effusion, we investigated 178 consecutive patients with non-malignant pleural effusion. At the initial examination etiology, smoking habits, asbestos exposure, ESR, blood eosinophils, size of effusion and other X-ray lesions were registered. At a 3-year follow-up, chest radiographs and lung function values were obtained and the association with the initially registered factors was evaluated. At follow-up, 20% of the patients had developed major additional X-ray lesions and/or significantly reduced lung function. Prognostically unfavourable factors were idiopathic etiology as compared to infectious, medium and large-size effusions and initial radiographs showing converging pleural linear structures and/or rounded atelectasis as compared to no or minor radiographic lesions. Converging pleural linear structures and rounded atelectasis were seen almost exclusively in association with idiopathic effusions. The obvious differences noted between patients with idiopathic and infectious effusions suggest that these effusions represent separate clinical entities.

Bacterial Infections↗
PubMed2006

Lung function in type 2 Saudi diabetic patients.

OBJECTIVE: To study the effects of type 2 diabetes mellitus on lung function and to determine its severity in relation to duration of disease. METHODS: We conducted this study in the Department of Physiology, College of Medicine, King Khalid University Hospital and Diabetic Centre, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia during the year 2002 - 2004. A group of 32 apparently healthy volunteer male type 2 diabetic patients were randomly selected with an age range from 24-73 years. We matched the diabetic patients with another group of 40 control healthy male subjects in terms of age, height, weight, and socioeconomic status. Both groups met with exclusion criteria as per standard. Spirometry was performed on an Electronic Spirometer (Schiller AT-2 Plus, Switzerland) and results were compared using the 2-tailed student t-test. RESULTS: Diabetic patients showed a significant reduction in the forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) relative to their matched controls. However, there were no significant difference in the forced expiratory ratio (FEV1/FVC%) and middle half of the FVC (FEF 25-75%) between the groups. CONCLUSION: Lung function in type 2 diabetic patients is impaired by a decrease in FVC, FEV1 and PEF, as compared to their matched controls. Stratification of results by years of disease showed a dose-response effect on lung function.

Adult↗
PubMed1995

Effects of environmental ozone on the lung function of senior citizens.

Measurements with a body plethysmograph of lung function parameters and reports of unusual complaints or irritations were taken from 41 senior citizens in the situations where they usually spend their daytime hours. The subjects belonged to a group commonly assumed to be at risk from ozone. Each subject was examined on 8 days both in the morning and in the afternoon. The object was to obtain for every subject an equal distribution of measuring days between those with elevated ozone concentrations (maximum 0.5 h mean values between 1.00 and 4.00 p.m. of at least 0.050 ppm) and those with low ozone concentrations (maximum 0.5 h mean values between 1.00 and 4.00 p.m. of at most 0.040 ppm). The results showed no relevant ozone related effects on the lung function parameters or the subjective reports of irritations. Thus there was no indication that senior citizens represent a group at particular risk with respect to moderately elevated concentrations of environmental ozone, as occur in central Europe.

Aged↗
PubMed2003

Lung function--clinical importance, problems, and new results.

This review tackles the usefulness of spirometry, a more than century old method of assessing pulmonary lung function. Variables measured with a spirometer, such as forced expiratory volume in 1 s, have long been the mainstays of the diagnosis and treatment of lung disorders. But there are problems with the reliability of spirometric measurements. The method depends on the cooperation of the investigated subject, which introduces a confounding subjective element and all too often results in test failure, and the results are evaluated against the predicted values that are based on a set of fixed factors, some of which, such as body height, are not in a straight proportion to the intrathoracic gas volume. Substantial spread of results arises, which makes a reliable assessment of lung function difficult. New methods, such as the resistance-volume curve, provide better information on airway behavior in different conditions. These new methods, which basically evolved from spirometry, show that the old idea of lung function analysis is still viable and may remain helpful for diagnosis and treatment of respiratory pathological states.

Animals↗