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PubMed2006

Temporal profile of forced expiratory lung function in allergen-challenged Brown-Norway rats.

The Brown-Norway rat is often used to study the allergic pulmonary response. However, relatively little is known about the delayed phase reactions after allergen challenge in this species. To evaluate the temporal changes in lung function and elucidate the mechanisms involved in the delayed phase response, Brown-Norway rats were sensitized and challenged to aerosolized ovalbumin and lung functions were measured by forced expiratory maneuvers and forced oscillation for up to 10 days after a single antigen challenge. Statistically significant (P < 0.05) reductions in inspiratory capacity, forced vital capacity, functional residual capacity, peak expiratory flow and maximum mid-expiratory flow and increases in respiratory system resistance and elastance were seen by 1 to 3 days after ovalbumin challenge that returned to baseline by 10 days. The reductions in lung function after ovalbumin challenge were blocked by the corticosteroid, betamethasone (1 mg/kg, p.o.). Histological evaluation of lung tissue of sensitized rats demonstrated evidence of interstitial pulmonary edema, an increase in tissue eosinophils and an increase in Periodic Acid Schiff-positive cells in the airway epithelium. Bronchoalveolar lavage fluid samples showed large numbers of eosinophils and increased mucin content up to 6 days after antigen challenge. There was also an increase in wet-to-dry lung weight ratio in the lungs of sensitized rats after antigen. These results demonstrate that prolonged reductions in lung function occur after a single antigen challenge in Brown-Norway rats that is probably due to inflammatory processes producing interstitial pulmonary edema, mucus secretion and cellular influx into the lungs.

Allergens↗

PubMed2004

Lung function in children with diabetes mellitus.

A cross-sectional study design was undertaken to assess pulmonary function in children with insulin-dependent diabetes mellitus (IDDM), and to establish if there is any relationship with diabetic factors and complications. Thirty-eight children (10 +/- 1.8 years) with IDDM and without clinical or radiological evidence of lung involvement, and 41 healthy age-matched reference subjects, underwent a pulmonary function study. Thirteen (34%) of 38 subjects with IDDM were studied at the onset of their disease. Adjusted values expressed as SD score of forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV(1)), and the transfer factor for carbon monoxide (TLCO) were found to be significantly lower than in controls (-0.54 +/- 0.87 vs. 0.40 +/- 1.10, P = 0.0008; -0.11 +/- 0.96 vs. 0.52 +/- 1.07, P = 0.01; -1.60 +/- 1.07 vs. -0.57 +/- 1.28, P = 0.001, respectively). These differences also existed in the group investigated at onset of diabetes. Residual volume (RV) and RV/total lung capacity ratio (RV/TLC) were significantly higher in the whole group of patients with IDDM than in controls (-0.20 +/- 0.83 vs. -0.80 +/- 0.88, P = 0.003; and 26 +/- 6.2 vs. 21 +/- 5.0, P = 0.0002, respectively). Seventeen patients (45%) had abnormal pulmonary function (SD score, less than -1.64): 16 subjects had reduced TLCO, 4 had reduced FVC, and in 3 of the 17, both functional indices were abnormal. There was no significant relationship between pulmonary function indices and diabetic factors or complications. The only significant association was between abnormal TLCO and females (P = 0.03), suggesting that sex may be a predisposing factor for the development of pulmonary complications. This study supports the view that the lung is functionally involved in children with IDDM early on in the course of the disease.

Child↗

PubMed2002

Persistent abnormal lung function after childhood empyema.

OBJECTIVE: The purpose of this study was to examine pulmonary function tests in children at various time points in their recovery from empyema. DESIGN: Cross-sectional study. SETTING: Academic Children's Hospital. PATIENTS: Pediatric patients with a diagnosis of empyema between 1992-2000. RESULTS: A total of 45 pulmonary function tests were carried out in 36 study participants. Within 3 months of hospital discharge, 91% of pulmonary function tests demonstrated a restrictive pattern with a mean forced vital capacity (FVC) of 69.2 +/- 4% and a mean total lung capacity (TLC) of 74.9 +/- 4% of predicted. The incidence of restriction in pulmonary function significantly decreased over time and for patients tested > 1 year from hospital discharge the mean FVC was 87.1 +/- 2% and the mean TLC 95.0 +/- 2% of predicted. However, 19% of the patients tested > 1 year from discharge demonstrated a mild restrictive pattern and 16% demonstrated a mild obstructive changes. Patients with abnormal lung function > 1 year from hospital discharge did not demonstrate any signs or symptoms of respiratory insufficiency . CONCLUSION: There is a high incidence of restrictive patterns in lung function for children tested within 3 months from hospital discharge for empyema. The incidence of restrictive patterns decreased significantly over time and most patients tested >1 year from hospital discharge demonstrated normal lung function.

Adolescent↗

PubMed2006

Influence of lung volume, glossopharyngeal inhalation and P(ET) O2 and P(ET) CO2 on apnea performance in trained breath-hold divers.

Breath-hold divers train and compete in maximal apnea performance. Glossopharyngeal inhalation (GI) is commonly used to increase lung volume above vital capacity (VC) prior to apnea. We investigated the hypothesis that this practice would increase apnea performance and relaxed airway pressure. Seven well-trained breath-hold divers performed maximal bouts of apnea at three different lung volumes (85% VC, VC and VC + GI) both at rest (dry static apnea) and during underwater swimming (dynamic apnea). Heart rate, apnea time and end tidal PCO(2) and PO(2) (P (ET) CO(2) and P (ET) O(2)) were recorded. In addition, relaxed airway pressure was measured after GI. Maximal GI increased lung volume by 1.59+/-0.57 l above VC and increased relaxed airway pressure to from 3.5+/-0.5 to 8.7+/-1.7 kPa. Dry static apnea time was higher at VC + GI (346+/-46 s) than at VC (309+/-38 s, P<0.05) and 85% VC (297+/-48 s, P<0.01). Likewise, dynamic apnea time was higher at VC + GI (97+/-27 s) than at VC (78+/-14 s, P<0.05) and 85% VC (71+/-17 s, P<0.05). P (ET) O(2) values reached 3.5+/-0.6 kPa at the end of dry static apnea bouts and this was not different from dynamic apnea when taking hydrostatic pressure at swimming depth into account (3.7+/-0.6 kPa, P=0.48). In conclusion, GI increases lung volume, relaxed airway pressure and apnea performance in well-trained breath-hold divers.

Adult↗

PubMed1976

Bronchoconstriction and pulmonary hypertension during abortion induced by 15-methyl-prostaglandin F2alpha.

Patients have experienced severe breathlessness during second trimester abortion initiated by the intramuscular injection of 15-methyl-prostaglandin F2alpha (15-me-PGF2alpha). In four healthy women given 400 mug of 15-me-PGF2alpha to induce abortion, pulmonary function tests showed reductions in arterial oxygen tension, maximum expired air flow and vital capacity. Residual lung volume and the slope of phase III of the closing volume curves increased.

Abortion, Induced↗

PubMed1993

Can moderate chronic obstructive pulmonary disease be diagnosed by historical and physical findings alone?

BACKGROUND: The value of the history and physical examination in diagnosing chronic obstructive pulmonary disease (COPD) is uncertain. This study was undertaken to determine the best clinical predictors of COPD and to define the incremental changes in the ability to diagnose COPD that occur when the physical examination findings and then the peak flowmeter results are added to the pulmonary history. SUBJECTS AND METHODS: Ninety-two outpatients with a self-reported history of cigarette smoking or COPD completed a pulmonary history questionnaire and received peak flow and spirometric testing. The subjects were independently examined for 12 physical signs by 4 internists blinded to all other results. Multivariate analyses identified independent predictors of clinically significant, moderate COPD, defined as a forced expiratory volume in 1 second (FEV1) less than 60% of the predicted value or a FEV1/FVC (forced vital capacity) less than 60%. RESULTS: Fifteen subjects (16%) had moderate COPD. Two historical variables from the questionnaire--previous diagnosis of COPD and smoking (70 or more pack-years)--significantly entered a logistic regression model that diagnosed COPD with a sensitivity of 40% and a specificity of 100%. Only the physical sign of diminished breath sounds significantly added to the historical model to yield a mean sensitivity of 67% and a mean specificity of 98%. The peak flow result (best cutoff value was less than 200 L/min) significantly added to the models of only one of the four physicians for a mean final sensitivity of 77% and a specificity of 95%. Subjects with none of the three historical and physical variables had a 3% prevalence of COPD; this prevalence was unchanged by adding the peak flow results. CONCLUSIONS: Diminished breath sounds were the best predictor of moderate COPD. A sequential increase in sensitivity and a minimal decrease in specificity occurred when the quality of breath sounds was added first to the medical history, followed by the peak flow result. The chance of COPD was very unlikely with a normal history and physical examination.

Adult↗

PubMed1993

An algorithm for measurement of expiratory flow rate parameters on the partial expiratory flow-volume curve.

Partial expiratory flow-volume (PEFV) curves are a useful tool in airway challenge studies, but unlike the maximal expiratory flow-volume (MEFV) curve, lung function parameters require manual calculation from the flow-volume tracing. We describe an algorithm written in QuickBASIC that analyzes a PEFV curve superimposed on a MEFV curve by (1) identifying the PEFV curve, (2) locating the maximal expiratory flow at the point on the PEFV curve that corresponds to 60% of the baseline forced vital capacity (FVC) below total lung capacity (TLC), termed MEF40%(P), and (3) identifying the size of the PEFV curve along the TLC axis. A report of these parameters is also provided. This algorithm was validated using flow-volume curves from a clinical study in which eight subjects performed two sets of MEFV and PEFV curves separated by approximately 1 hr. Paired comparison of MEF40%(P) determined by the algorithm and two independent manual calculations correlated strongly and yielded no statistically significant differences between the two methods. We conclude that this algorithm provides rapid and accurate determinations of PEFV parameters.

Algorithms↗

PubMed2006

Medical and psychologic outcome of living lobar lung transplant donors.

BACKGROUND: Living donor lobar lung transplantation is a viable therapy for carefully selected patients with end-stage pulmonary disease. Its success is largely dependent upon donor outcome, including both physical and emotional factors. To date, there has been little focus on psychosocial outcomes of lobar lung donors. METHODS: Retrospective evaluation of 15 of 20 living lobar lung transplant donors was performed. Donors underwent evaluation of pulmonary function after recovery from donor lobectomy. Participants completed two self-report questionnaires, the SF-36 Health Survey (SF-36) and the Beck Depression Inventory (BDI), as well as an open-ended psychiatric interview. RESULTS: After lobar donation, mean forced expiratory volume in 1 second (FEV(1)) decreased by 21 +/- 2%, forced vital capacity (FVC) decreased by 16 +/- 3%, total lung capacity (TLC) decreased by 15 +/- 3%, and single-breath diffusing capacity (DLCO) decreased by 14 +/- 4%. All subjects scored higher than the national average on both the physical and mental health components of the SF-36. The BDI scores showed no evidence of clinical depression. However, the subjective interviews elicited two common complaints: (1) a decline in exercise performance, not accounted for by resting lung function measurements; and (2) a dissatisfaction with the degree of acknowledgment of their donation. CONCLUSIONS: Living lobar lung transplant donors enjoy generally satisfactory physical and emotional health. Donors report positive feelings about donation, but wish to be recognized and valued by the transplant team and by the recipient. Despite preservation of lung function within the normal range, some donors also experience a subjective decline in exercise tolerance. Long-term medical and psychologic follow-up appears warranted to monitor symptoms of exercise impairment and to enhance the donor experience.

Forced Expiratory Volume↗

PubMed1998

A prospective algorithm for the management of air leaks after pulmonary resection.

BACKGROUND: Air leaks (ALs) are a common complication after pulmonary resection, yet there is no consensus on their management. METHODS: An algorithm for the management of chest tubes (CT) and ALs was applied prospectively to 101 consecutive patients who underwent elective pulmonary resection. Air leaks were graded daily as forced expiratory only, expiratory only, inspiratory only, or continuous. All CTs were kept on 20 cm of suction until postoperative day 2 and were then converted to water seal. On postoperative day 3, if both a pneumothorax and AL were present, the CT was placed to 10 cm H2O of suction. If a pneumothorax was present without an AL, the CT was returned to 20 cm H2O of suction. Air leaks that persisted after postoperative day 7 were treated with talc slurry. RESULTS: There were 101 patients (67 men); on postoperative day 1, 26 had ALs and all were expiratory only. Univariable analysis showed a low ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) (p = 0.005), increased age (p = 0.007), increased ratio of residual volume to total lung capacity (RV/TLC) (p = 0.04), increased RV (p = 0.02), and an increased functional residual capacity (FRC) (p = 0.02) to predict the presence of an AL on postoperative day 1. By postoperative day 2, 22 patients had expiratory ALs. After 12 hours of water seal, 13 of the 22 patients' ALs had stopped, and 3 more sealed by the morning of postoperative day 3. However, 2 of the 6 patients whose ALs continued experienced a pneumothorax. Five of the 6 patients with ALs on postoperative day 4 still had ALs on postoperative day 7, and all were treated by talc slurry through the CT. All ALs resolved within 24 hours after talc slurry. CONCLUSIONS: Most ALs after pulmonary resection are expiratory only. A low FEV1/FVC ratio, increased age, increased RV/TLC ratio, increased RV, and an increased FRC were predictors of having an ALs on postoperative day 1. Conversion from suction to water seal is an effective way of sealing expiratory AL, and pneumothorax is rare. If an expiratory AL does not stop by postoperative day 4 it will probably persist until postoperative day 7, and talc slurry may be an effective treatment.

Adult↗

PubMed1987

Pulmonary function in thalassemia major.

Pulmonary function tests were evaluated in 28 Chinese patients with beta-thalassemia major receiving regular transfusions and desferoxamine, and in 34 height-matched normal Chinese children. Comparison of lung function using analysis of covariance with reference to standing height showed that patients with thalassemia had a proportional decrease in forced vital capacity and forced expiratory flow volume in 1 second, whereas their expiratory flow rates, residual volume, and total lung capacity were comparable to those in normal children. The single-breath carbon monoxide diffusion capacity was normal. Our findings suggest that children with thalassemia major have mild restrictive lung disease. The previous controversy regarding the presence of restrictive or obstructive lung disease in patients with thalassemia may be related to the use of inappropriate control values.

Adolescent↗

PubMed1990

Pleural and parenchymal fibrosis mainly affecting the upper lung lobes in persons exposed to asbestos.

From the County of Uppsala, Sweden, more than 1600 persons with pleural plaques and/or asbestos-related pleural thickening have been seen at the Uppsala University Hospital during a period of about 15 years. During the observation time, 40 patients developed lesions mainly affecting the upper lobes of the lung. They were all men, 41 to 78-years-old, and all had been occupationally exposed to asbestos. The mean latency time from the first exposure was 34 years. The mean width of the apical pleural thickening was 21 mm. In 21 patients the lesions were on the right side, in 15 they were bilateral, and in only four patients was the left side alone affected. Biopsies from the pleura were available in twelve patients and from the lung parenchyma in eight. The biopsies of the lungs all showed varying degrees of asbestosis and of the pleura nonspecific pleuritis. The lesions tended to progress and in all cases except one they were part of a diffuse pleural and parenchymal fibrosis involving the rest of the lung. Consequently, the pulmonary function was impaired, with the vital capacity reduced to an average of 62% and total lung capacity to 68% of the predicted value. In many patients there was contraction of the upper lobe and deviation of the trachea towards the same side. Upper lobe changes are a relatively rare complication of exposure to asbestos but are important to recognise. Other possible causes of upper lobe changes such as tuberculosis must always be excluded before the diagnosis is made.

Adult↗

PubMed1999

The effect of thoracentesis on lung function and transthoracic electrical bioimpedance.

This study aimed to determine the relationship between improvement in lung function and changes in transthoracic electrical bioimpedance (TEB) after thoracentesis in patients with pleural effusions. Fifteen patients with pleural effusions due to either malignant (n = 8) or cardiac (n = 7) diseases were included. Pulmonary function was assessed before and after thoracentesis. During thoracentesis the patients were monitored with TEB. Using linear correlation analysis, the increases for each litre of aspirated thoracic fluid were: forced expiratory volume in 1 s (FEV1) 0.261; forced vital capacity (FVC) 0.331; total lung capacity (TLC) 0.58; and the lung diffusing capacity (DLCO); 2.4 ml min-1 mmHg-1. Baseline impedance increased by 2.3 Ohm l-1 aspirated thoracic fluid. The relative increase in baseline impedance was twice as high for patients with cancer as for patients with heart failure (P < 0.05). We found only minor changes in systolic blood pressure and mean arterial pressure. The improvements in diffusing capacity, airflow, and lung volumes after thoracentesis are correlated to an increase in baseline impedance, but changes are dependent on the primary disease.

Aged↗

PubMed2001

Pulmonary function testing after operative stabilisation of the chest wall for flail chest.

OBJECTIVE: This is a prospective evaluation of chest wall integrity and pulmonary function in patients with operative stabilisation for flail chest injuries. METHODS: From 1990 to 1999, 66 patients (56 men, 10 women; mean age 52.6 years) with antero-lateral flail chest (> or =4 ribs fractured at > or =2 sites) underwent surgical stabilisation using reconstruction plates. Clinical assessment and pulmonary function testing were performed at 6 months following surgery. RESULTS: Fifty-five (83%) patients had various combinations of injuries of the thorax, head, abdomen and extremities. Sixty-three (95.5%) patients underwent unilateral and 3 (4.5%) patients bilateral stabilisation with a median delay of 2.8 days (range 0-21 days) from admission. The 30-day mortality was 11% (seven of 66 patients). Immediate postoperative extubation was feasible in 31 of 66 patients (47%) and extubation within 7 days following stabilisation in 56 of 66 patients (85%). No plate dislocation was observed during the follow-up. The shoulder girdle function was intact in 51 of 57 patients (90%). Chest wall complaints were noted in 6 of 57 (11%) patients, requiring removal of implants in three cases. All patients returned to work within a mean period of 8 (range 3-16) weeks following discharge. Pulmonary function testing (n=50) at 6 months after the operation revealed a significant difference of predicted vs. recorded vital capacity (VC) and forced expiratory volume in 1s (FEV1) (P=0.04 and P=0.0001, respectively; Wilcoxon signed-rank test). The median ratio of the recorded and predicted total lung capacity (TLC) was shown to be significantly higher than 0.85 (P=0.0002; Wilcoxon signed-rank test), indicating prevention of pulmonary restriction. CONCLUSION: Antero-lateral flail chest injuries accompanied by respiratory insufficiency can be effectively stabilised using reconstruction plates. Early restoration of the chest wall integrity and respiratory pump function may be cost effective through the prevention of prolonged mechanical ventilation and restriction-related working incapacity.

Adult↗

PubMed1999

Pulmonary air trapping during two-lung and one-lung ventilation.

OBJECTIVE: Evaluation of the magnitude of pulmonary air trapping during routine thoracic surgery and single-lung transplantation. DESIGN: Prospective study on consecutive patients. SETTING: Single institution, university hospital. PARTICIPANTS: Sixteen patients with no or moderate obstructive lung disease undergoing routine thoracic surgery (group 1), six patients with severe emphysema (group 2), and six patients with severe fibrosis (group 3) undergoing single-lung transplantation. INTERVENTIONS: Occlusion maneuver timed at the end of expiration to measure auto-positive end-expiratory pressure (auto-PEEP) and trapped volume (delta FRC). The maneuver was performed during two-lung ventilation in supine (2LV supine) and lateral decubitus (2LV lateral) positions and during one-lung ventilation (OLV) in lateral decubitus position. At the same time, airway pressures and PaO2 measurements were performed. MEASUREMENTS AND MAIN RESULTS: In group 1, consistent values of auto-PEEP and delta FRC occurred only during OLV: 4.8 +/- 2.5 cm H2O and 109 +/- 61 mL (mean +/- standard deviation). In group 2, auto-PEEP and delta FRC values were 11.7 +/- 6.9 cm H2O and 355 +/- 125 mL during 2LV supine, 8.8 +/- 5.7 cm H2O and 320 +/- 122 mL during 2LV lateral, and 15.9 +/- 3.9 cm H2O and 284 +/- 45 mL during OLV. In group 3, pulmonary air trapping was low. For the three groups together, auto-PEEP and delta FRC (p < 0.0001) related inversely to the ratio of forced expired volume in 1 second (FEV1) to forced vital capacity (FVC) expressed in percent (FEV1/FVC%) during OLV. In contrast, there was no correlation between PaO2 and auto-PEEP or delta FRC. CONCLUSION: Pulmonary air trapping must be suspected in patients with no or moderate obstructive lung disease during OLV and in those with severe obstructive disease as soon as 2LV is initiated.

Adult↗

PubMed1998

Diagnostic role of residual volume in paediatric patients with chronic symptoms of the lower airways.

In bronchial asthma, measurement of absolute lung volumes may reveal lung dysfunction more readily than forced expiratory spirometry. Sixty-one children (aged 4-16 years) with mild to moderate bronchial asthma and 35 children (aged 7-16 years) with other symptoms of the lower airways (OSLA) were studied, and the plethysmographic results were compared with data obtained from 36 healthy volunteers aged 6-16 years. In the first test session, repeatability of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), residual volume (RV), functional residual capacity (FRC) and total lung capacity (TLC) were good. Control subjects were also tested the next day, and intra-subject variability of repeat pulmonary function testing was in the normal range. The FEV1/FVC ratio was significantly higher in control subjects than in patients with asthma or OSLA, but only the decrease in RV after bronchodilator challenge separated patients with asthma from patients with OSLA. Changes in FEV1 and RV after bronchodilator challenge had a significant, although low, inverse correlation. An increase of > or = 5% in FEV1 had a positive predictive value of 44% and a negative predictive value of 68% for the clinical diagnosis of bronchial asthma; for a decrease of > or = 24% in RV, the figures were 86% and 71% respectively. The support of baseline absolute lung volumes on clinical decision-making is not necessarily great. Bronchodilator response, particularly in RV, is more pertinent and may enhance the detection of reversible lung dysfunction.

Adolescent↗

PubMed2000

Airway obstruction and chronic exertional dyspnoea in patients with persistent bronchial asthma.

In patients with COPD, flow limitation (FL) predicts chronic exertional dyspnoea (CED) better than routine spirometry. Whether, and to what extent, FL and CED are overlapping quantities in chronic asthma has not yet been defined. Forty consecutive clinically stable asthmatic patients without smoking history or cardiopulmonary disorders, were studied. In each subject respiratory function, including static and dynamic pulmonary volumes, was evaluated; maximal (MEFV) and partial (PEFV) expiratory V'-V curves and isovolumic partial to maximal flow ratio (M/P). FL was assessed in a seated patient by comparing tidal and PEFV curves; FL was detected when tidal flows were superimposed or exceeded those obtained during PEFV curves, and was expressed as a percentage of the expired control tidal volume (V(T)) affected by flow limitation (FL% VT). Dyspnoea was assessed by both MRC scale and Baseline Dyspnoea Index (BDI) focal score. Half of the patients were found to have FL. They were older, more dyspnoeic and more obstructed (P<0.03 - P<0.000005) than the non-FL group. FEV1, vital capacity (VC), age, body mass index, FL and M/P ratio were all related to dyspnoea scores. FL was significantly related to FEV1 (r = - 0.59). Multiple regression analysis showed that FEV1 (P=0.003, r2= 15-3% and P = 0.004, r2= 20.3%) and age (P = 0.0006, r2 = 26.8% and P = 0.016, r2 = 11%) independently predicted a part of the variance of MRC (P = 0.0001, r2 = 42.1%) and BDI (P = 0.0008, r2 = 31.3%), respectively. With dyspnoea scale being the gold standard, diagnostic accuracy (sensitivity and specificity) by ROC (receiver operating characteristics) analysis was similar for FEV1 and FL. The results indicate that FL may be present in this subset of asthmatics. CED may not be easily explained by abnormalities of routine spirometry or FL, the largest part of the CED variance remained unexplained. Thus, routine spirometry, FL and CED in patients with bronchial asthma are only partially overlapping quantities which need to be assessed separately.

Adolescent↗

PubMed2001

Lung function in children with Duchenne's muscular dystrophy.

Duchenne's muscular dystrophy (DMD), characterized by gradually developing muscular weakness, leads to respiratory symptoms and reduced lung function. We aimed to assess lung function in 25 patients with DMD in relationship to age and muscular function. The 25 boys, mean age 13 years, comprized patients in southern Norway with DMD, taking part in an epidemiological follow-up study. None had chronic respiratory disease. Lung function was measured by maximum expiratory flow-volume loops and whole body plethysmography, and repeated after 1 year (n= 14). Lung function was reduced compared to predicted values for healthy children. Forced expiratory volume in 1 sec (FEV1)% predicted and forced vital capacity (FVC)% predicted correlated (significantly) inversely to age. FEV1 and FVC decreased annually 5.61 and 4.2% of predicted, respectively. Absolute values of FVC (litres) and FEV1 (1 sec(-1)) increased until mean age 14 years, decreasing thereafter. Values in % predicted decreased steadily throughout the age range (6-19 years). Lung function correlated closely to upper limb muscle function.

Adolescent↗

PubMed2003

Pulmonary function 4 months after coronary artery bypass graft surgery.

The objective of this study was to describe the pulmonary function and pain 4 months after coronary artery bypass graft surgery. Twenty-five male patients performed pulmonary function tests before surgery, on the 4th postoperative day and 4 months after surgery. A severe reduction in pulmonary function was present after surgery. Four months postoperatively, the patients still showed a significant decrease (6-13% of preoperative values) in vital capacity (P<0.001), inspiratory capacity (P<0.001), forced expiratory volume in 1 s (P<0.001) peak expiratory flow rate (P<0.001), functional residual capacity (P=0.05) total lung capacity (P<0.001) and single-breath carbon monoxide diffusing capacity (P<0.01). Residual volume and single-breath carbon monoxide diffusing capacity per litre of alveolar volume had returned to the preoperative level. Four months postoperatively, the median values for sternotomy pain while taking a deep breath was 0.2 and while coughing 0.3 on a 10 cm visual analogue pain scale. In conclusion, a significant restrictive pulmonary impairment persisting up to 4 months into the postoperative period was found after CABG. Measured levels of pain were low and could not explain the impairment.

Aged↗