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 109 records · Page 6Linked to original sources

PubMed2002

A comparison of the effectiveness of an opioid analgesic and a nonpharmacologic intervention to improve incentive spirometry volumes.

The purpose of this study was to compare the effects of opioid analgesics and relaxation as interventions for incentive spirometry in postcardiovascular surgery patients. With the use of incentive spirometry change scores from pre- to posttreatment, 72 patients received either relaxation, opioid analgesia, or no intervention. Pre- to posttreatment differences in achieved spirometry volumes were significantly different for the 3 groups (F[2, 69] = 7.32; p =.002), whereas no difference in spirometry volume was found between the opioid and relaxation groups. Relaxation was as effective as opioid analgesia in permitting postcardiovascular surgical patients to deep breathe.

Adult↗

PubMed1993

Using spirometry in the primary care office. A guide to technique and interpretation of results.

Spirometry is important in evaluating patients with respiratory complaints and helpful in following the course of disease. The American Thoracic Society encourages office use of spirometry and has published guidelines and minimum standards to promote accurate and appropriate testing. Equipment designed to meet these standards is available for office use, and peak flowmeters are available for home use by selected patients. When performed correctly and interpreted in the context of other clinical data, spirometry may identify reductions in flow (obstruction) or volume (restriction). Characteristics of the flow-volume loop may suggest specific types of upper or large airways obstruction. Serial monitoring of forced expiratory volume in 1 second in chronic obstructive pulmonary disease and of peak expiratory flow rate in asthma may help guide medical therapy. When spirometry fails to detect or completely characterize impairment of lung function, more extensive testing in a pulmonary function laboratory is indicated.

Diagnosis, Differential↗

PubMed1999

Detection of chronic obstructive pulmonary disease (COPD) in primary health care: role of spirometry and respiratory symptoms.

OBJECTIVE: To evaluate the role of spirometry and respiratory symptoms in the detection of chronic obstructive pulmonary disease (COPD) in primary health care. DESIGN: A cross-sectional study. SETTING: A primary health centre in Landskrona, southern Sweden. SUBJECTS: 164 subjects who in 1992 had answered a postal questionnaire concerning obstructive pulmonary diseases and respiratory symptoms. They were aged 45-64 years, with a mean of 55 years. MAIN OUTCOME MEASURES: In 1997, the subjects were invited to perform a spirometry and a medical examination and to answer the same questionnaire as in 1992. Subjects with a forced expiratory volume in 1 second (FEV1) < 85% of the predicted normal value performed reversibility tests. RESULTS: 131 subjects participated in the examinations. 15 subjects (11.5%) were diagnosed as having COPD. Only three of them had been previously diagnosed as having a respiratory disease. Many commonly occurring respiratory symptoms were associated with a reduction in FEV1. CONCLUSIONS: Spirometry examinations in primary health care improve the probability of detecting COPD. A spirometry examination should be considered for patients with respiratory symptoms. It should also be considered for middle-aged smokers, even if they are symptom-free.

Analysis of Variance↗

PubMed1997

Spirometry and airway reactivity in elite track and field athletes.

OBJECTIVES: To characterize spirometry and to document the incidence of exercise-induced bronchospasm (EIB) during competition in elite track and field athletes. DESIGN: Spirometry was performed in 120 men and 69 women athletes before competition and peak expiratory flows in 50 men and 23 women athletes before and after competition. SETTING: The 1991 (Randalls Island, NY, U.S.A.) and the 1993 (Eugene, OR, U.S.A.) National Track and Field Championships (World Championship team-qualifying meet). PARTICIPANTS: American track and field athletes who met World Championship qualifying standards. MEASUREMENTS: Spirometry (Cybermedic, Inc., Boulder, CO, U.S.A.) and peak expiratory flows (Personal Best, Healthscan Products, Cedar Grove, NJ, U.S.A.)--the best of three reproducible efforts. RESULTS: Male sprinters had lower vital capacities than other track athletes, whereas both male and female field (throwing) athletes had larger vital capacities than both runners and other field athletes. Decreases of 10% peak expiratory flows were found in 10% of men and 26% of women track athletes within 15 min after competition. The incidence was higher in longer-distance events. Most participants did not have a history of asthma. CONCLUSIONS: A higher-than-expected prevalence of EIB was found in high-level track athletes. The results suggest that spirometry and/or peak flows should be measured in track athletes because small decreases in airflow may impair training or performance, a condition that is easily treated.

Adult↗

PubMed1996

Evaluation of the utility of spirometry in a regional public health screening program for workers exposed to welding fumes.

The objective of this study was to determine the usefulness of spirometry in the screening of chronic pulmonary problems related to exposure to welding fumes, in a regional public health-based screening program. Pulmonary questionnaires and spirometric tests were administered twice at 5-year intervals on 229 welders/cutters (mean age, 39.9 years from 31 metal manufacturing plants. The baseline mean value at the first test for the forced expiratory volume in one second (FEV1) was 102% of predicted, the forced vital capacity (FVC) was 107%, and the FEV1/FVC ratio was 79%. The mean annual changes in the three spirometric indicators were -47 mL, -46 mL, and -0.3%, respectively. The usefulness of spirometry was assessed by looking at the relationship between exposure to welding fumes and changes in spirometric indices, in multivariate linear regression analysis, accounting for age, height, and smoking. A high lifetime exposure to welding fumes was associated with better lung functions in the cross-sectional approach (healthy worker effect) but not in the longitudinal approach, where no association was found. We concluded that the public health regional application of this screening program generated too many sources of variation for spirometry to fulfill the objective of early detection of pulmonary function decline related to exposure to welding fumes. Based on these observations, we recommend that maintaining questionnaire screening, with spirometry reserved as a second-line diagnostic intervention.

Adult↗

PubMed2005

Benefits of and barriers to the widespread use of spirometry.

PURPOSE OF REVIEW: To review the basis for spirometry, its benefits in diagnosing and managing both acute and chronic pulmonary disorders with emphasis on chronic obstructive pulmonary disease, and to critically examine the barriers to its widespread use. RECENT FINDINGS: A number of recent articles have established the scientific basis for spirometry in the early identification of chronic obstructive pulmonary disease and in improving smoking cessation in patients with chronic obstructive pulmonary disease. Economic and other considerations are reported. SUMMARY: Spirometry is an important office diagnostic device that should be used by all primary care and most specialist physicians. Spirometry is to dyspnea as the electrocardiogram is to chest pain.

Adult↗

PubMed2006

Monitoring of lung motion in patients with malignant pleural mesothelioma using two-dimensional and three-dimensional dynamic magnetic resonance imaging: comparison with spirometry.

PURPOSE: To monitor lung motion in patients with malignant pleural mesothelioma (MPM) before and after chemotherapy (CHT) using 2-dimensional (2D) and 3-dimensional (3D) dynamic MRI (dMRI) in comparison with spirometry. METHODS AND MATERIALS: Twenty-two patients with MPM were examined before CHT, as well as after 3 and 6 CHT cycles (3 months and 6 months) using 2D dMRI (trueFISP; 3 images/s) and 3D dMRI (FLASH 3D, 1 slab (52 slices)/s) using parallel imaging in combination with view-sharing technique. Maximum craniocaudal lung dimensions (2D) and lung volumes (3D) were monitored, separated into the tumor-bearing and nontumor-bearing hemithorax. Vital capacity (VC) was measured for comparison using spirometry. RESULTS: Using 2D technique, there was a significant difference between the tumor-bearing and the nontumor-bearing hemithorax before CHT (P < 0.01) and after 3 CHT cycles (P < 0.05), whereas difference was not significant in the second control. In the tumor-bearing hemithorax, mobility increased significantly from the status before versus after 3 CHT cycles (4.1 +/- 1.1 cm vs. 4.8 +/- 1.4 cm, P < 0.05). Using 3D technique, at maximum inspiration, the volume of the tumor-bearing hemithorax was 0.6 +/- 0.4 L and of the nontumor-bearing hemithorax 1.25 +/- 0.4 L before CHT. In the follow-up exams, these volumes changed to 1.05 +/- 0.4 L (P < 0.05) and 1.4 +/- 0.5 L, respectively. Using spirometry, there was no significant change in VC (1.9 +/- 0.4 L vs. 2.2 +/- 0.7 L vs. 2.2 +/- 0.9 L). CONCLUSION: dMRI is capable of monitoring changes in lung motion and volumetry in patients with MPM not detected by global spirometry. Thus, dMRI is proposed for use as a further measure of therapy response.

Aged↗

PubMed2004

Exclusion spirometry: an initiative to increase lung function assessment in primary care.

Ongoing spirometry quality standards are difficult to bring into the daily routine of general practice. As a result, spirometry is rarely performed by primary care physicians. A new approach is proposed: exclusion spirometry. Acceptable and reproducible results are sought. However, the goal of the test is to try to reach values within normal limits, even if results do not reach quality standards. Normal results would be sufficient to exclude respiratory impairment, except in asthma. Abnormal results would require further testing in a diagnostic spirometry laboratory. The aim of the initiative is to enhance the compliance of general practitioners in using spirometers for screening.

Humans↗

PubMed1994

Impact of using stated instead of measured height upon screening spirometry.

This study examined the impact of using stated height instead of measured height on predicted normal values and clinical interpretation of screening spirometry in an outpatient referral population. In a prospective fashion, we evaluated 210 patients, 20 to 89 yr of age, referred for spirometry to our pulmonary function laboratory by obtaining both stated height (HTs) and measured height (HTm). The mean difference between stated and measured height progressively increased with age, from 0.80 cm (20 to 29 yr; p = 0.01) to 5.70 cm (80 to 89 yr; p < 0.001). For men and women, use of HTs instead of HTm produced a mean difference for all ages in computing predicted FEV1 and FVC values of 3.9 and 4.3%, respectively. This effect was more prominent in the older age groups (80 to 89 yr, n = 30); mean differences were 11.0% (211 ml) and 11.7% (303 ml), respectively. Use of HTs instead of HTm altered the detection of restriction by reduced FVC in 17 patients and the detection of obstruction by reduced FEV1/FVC ratio in four patients. Use of HTs altered the clinical assessment of severity by FEV1 in 15 of 108 (13.9%) obstructed patients and altered the assessment of severity by FVC in 11 of 32 (34.4%) restricted patients, with older patients more frequently affected than younger patients. We conclude that the use of stated height instead of measured height in the performance of screening spirometry can have significant impact on the calculation of predicted normal values. These discrepancies can potentially influence the clinical interpretation of screening spirometry, affecting the detection of abnormality and the assessment of severity of disease, particularly among older patients.

Adult↗

PubMed1998

Expired nitric oxide after bronchoprovocation and repeated spirometry in patients with asthma.

Compared with normal individuals, subjects with asthma have elevated levels of expired nitric oxide (NO). These levels are hypothesized to reflect the degree of airway inflammation. Expired NO levels rise during the late phase of allergen challenge and decrease in asthmatics after steroid treatment. Isocapnic cold air hyperventilation (ISH) is believed to cause airway narrowing through noninflammatory mechanisms. We measured mixed expired NO in 10 individuals with atopic asthma who underwent both ISH challenge and allergen challenge, and compared these measurements with the change in expired NO that occurred after serial spirometry alone. We found that ambient NO levels affected mixed expired NO. Controlling for inspired NO, we found that repeated spirometry alone produced a significant fall in mixed expired NO (p < 0.01) that was maximal after 30 min (36.6 +/- 8.5% fall). After allergen and ISH challenges, expired NO was elevated relative to levels after repeated spirometry (p < 0.01 and p = 0.065, respectively). In addition, we found that prechallenge expired NO levels were significantly correlated with the magnitude of the late fall in FEV1 following allergen challenge (r = 0.80, p < 0.01). These data demonstrate that repeated spirometry results in reduced mixed expired NO and suggest that both ISH and allergen-induced bronchoconstriction share pathobiologic mechanisms that produce increases in mixed expired NO.

Adult↗

PubMed1993

Spirometry reference values for women and men 65 to 85 years of age. Cardiovascular health study.

Pulmonary function was assessed by spirometry in 5,201 ambulatory elderly participants of the Cardiovascular Health Study, sampled from four communities. A stringent quality assurance program exceeded American Thoracic Society (ATS) recommendations for spirometry. Less than 6% of the participants were unable to perform three acceptable spirometry maneuvers. A "healthy" subgroup of 777 women and men 65 to 85 yr of age was identified by excluding smokers and those with lung disease and other factors determined to independently, significantly, and negatively influence the FEV1. Results from black participants were examined separately. Reference equations and normal ranges for FEV1, FVC, and the FEV1/FVC ratio were determined from the healthy group. The results demonstrate differences in predicted values as great as 20% (0.5 to 1 L) for elderly patients when compared with the spirometry reference equations that are most commonly used in the United States.

Aged↗

PubMed2006

Effect of primary-care spirometry on the diagnosis and management of COPD.

Primary-care spirometry has been promoted as a method of facilitating accurate diagnosis of chronic obstructive pulmonary disease (COPD). The present study examined whether improving rates of diagnosis lead to improvements in pharmacological and nonpharmacological management. From 1999 to 2003, the current authors provided an open-access spirometry and reversibility service to a local primary-care area, to which 1,508 subjects were referred. A total of 797 (53%) had pre-bronchodilator airflow obstruction (AFO). Of the subjects who underwent reversibility testing, 19.3% were no longer obstructed post-bronchodilator. The results and records of a subgroup of 235 subjects with post-bronchodilator AFO were examined. Of the 235 subjects, 130 received a new diagnosis, most commonly COPD. The patients with COPD were significantly undertreated before spirometry and testing led to a significant increase in the use of anticholinergics (37 versus 18%), long-acting beta-agonists (25 versus 8%) and inhaled steroids (71 versus 52%). More than three quarters of smokers received smoking cessation advice but very few were referred for pulmonary rehabilitation. In conclusion, primary-care spirometry not only increases rates of chronic obstructive pulmonary disease diagnosis, but it also leads to improvements in chronic obstructive pulmonary disease treatment. The use of bronchodilator reversibility testing in this setting may be important to avoid misdiagnosis.

Adult↗

PubMed1996

Spirometry reference values for healthy elderly blacks. The Cardiovascular Health Study Research Group.

Pulmonary function was assessed by spirometry in 497 black and 2,980 white ambulatory elderly male and female participants of the Cardiovascular Health Study. The quality assurance program prompted technicians to exceed American Thoracic Society recommendations for spirometry. A "healthy" subgroup of 235 black and 1,227 white participants age 65 years and older was identified by excluding current and former smoker, and those with self-reported asthma or emphysema, congestive heart failure, and poor-quality results of spirometry tests, since those factors were associated with a lower FEV1. Reference equations and normal ranges for elderly blacks for measurements of FEV1, FVC, and the FEV1/FVC ratio were then determined from the healthy group. These elderly blacks had an FVC about 6% lower than elderly whites, even after correcting for standing height, sitting height (trunk length), and age. The popular use of spirometry reference values from studies of middle-aged white subjects by applying a 12% race correction factor for black patients appears to overestimate predicted values.

Aged↗

PubMed2000

Quality of spirometry test performance in children and adolescents : experience in a large field study.

STUDY OBJECTIVE: To determine the ability of children and adolescents to meet the American Thoracic Society (ATS) goals for spirometry quality that were based on results from adults. DESIGN: Observational. PARTICIPANTS: More than 4,000 public school students, ages 9 to 18 years. MEASUREMENTS: Spirometry was performed annually for 3 years, with the recording of maneuver quality measures of forced expiratory time, end-of-test volume, back-extrapolated volume, and time to peak expiratory flow (PEFT), and the recording of differences between best and second-best FVC, FEV(1), and peak expiratory flow (PEF) values. RESULTS: Regression analyses showed significant influences of participant age, gender, ethnicity, size, clinical status, and previous testing experience, as well as differences among individual test technicians. In general, these influences were small and explained little of the variance in performance. On average, children with a history of asthma or wheeze performed better quality spirometry than did others. Only PEFT improved significantly from year to year. Overall, only 15% of girls' tests and 32% of boys' tests met the PEFT criterion derived from adults in the Lung Health Study. CONCLUSION: Most of the children met adult-based ATS goals for spirometry test performance. Age group-specific criteria are needed to ensure adequately fast PEFT and reproducible PEF values.

Adolescent↗

PubMed2001

Spirometry reference values for American Indian adults: results from the Strong Heart Study.

STUDY OBJECTIVE: To derive spirometry normative values from a large population of American Indian adults and compare them to reference values for white adults. DESIGN: Pulmonary function was assessed using spirometry in participants of the Strong Heart Study, a multicenter, community-based, prospective study of cardiovascular risk factors and disease in American Indians, utilizing American Thoracic Society guidelines and a vigorous quality assurance program. SETTING: Central Arizona, southwestern Oklahoma, central South Dakota, and northeastern North Dakota. PARTICIPANTS: Acceptable spirometry results were obtained from 1,619 women and 1,005 men aged 45 to 74 years. RESULTS: Internal reference values and normal ranges for FEV(1), FVC, and the FEV(1)/FVC ratio were derived from a healthy subgroup of 253 women and 190 men, identified by excluding participants with factors associated with a lower FEV(1). Ten percent of the entire cohort (269 of 2,624 subjects) had airways obstruction, as defined by an FEV(1)/FVC below the lower limit of the normal (LLN) using the internal reference equations. After allowing for measurement "noise," 31 participants were below the LLN using reference equations for white adults from the large National Health and Nutrition Examination Study (NHANES) III study but were normal using the internal reference equations (1.3% false-positive), while 27 participants were classified as normal using NHANES III equations but had airways obstruction using the internal reference equations (1.2% false-negative). Similarly low misclassification rates were seen for a low FVC (prevalence, 17.6%). CONCLUSION: For clinical purposes, NHANES III spirometry reference equations for white adults may be used when testing American Indian women and men aged 45 to 74 years.

Aged↗

PubMed2003

A spirometry-based algorithm to direct lung function testing in the pulmonary function laboratory.

OBJECTIVE: To design a spirometry-based algorithm to predict pulmonary restrictive impairment and reduce the number of patients undergoing unnecessary lung volume testing. DESIGN: Two prospective studies of 259 consecutive patients and 265 consecutive patients used to derive and validate the algorithm, respectively. SETTING: A pulmonary function laboratory of a tertiary care hospital. PATIENTS: Consecutive adults referred to the laboratory for lung volume measurements and spirometry. MEASUREMENTS: The sensitivity of the algorithm for predicting pulmonary restriction and the cost savings associated with its use. RESULTS: Total lung capacity correlated strongly with FVC (r = 0.66) and showed an inverse correlation with the FEV(1)/FVC ratio (r = - 0.41). According to the algorithm, only patients with an FVC < 85% of predicted and an FEV(1)/FVC ratio >or= 55% required lung volume measurements following spirometry. The algorithm had a high sensitivity for predicting restriction and a high negative predictive value (NPV) for excluding restriction (sensitivity, 96%; NPV, 98%). The diagnostic properties of the algorithm were reproducible in the validation study. Application of the algorithm would eliminate the need for lung volume testing in 48 to 49% of patients referred to the pulmonary function test (PFT) laboratory, reducing costs by 33%. CONCLUSIONS: A spirometry-based algorithm accurately excludes pulmonary restriction and reduces unnecessary lung volume testing in the PFT laboratory almost in half.

Algorithms↗

PubMed2005

Office spirometry in primary care pediatrics: a pilot study.

OBJECTIVE: The aim of this study was to investigate the validity of office spirometry in primary care pediatric practices. METHODS: Ten primary care pediatricians undertook a spirometry training program that was led by 2 pediatric pulmonologists from the Pediatric Department of the University of Padova. After the pediatricians' training, children with asthma or persistent cough underwent a spirometric test in the pediatrician's office and at a pulmonary function (PF) laboratory, in the same day in random order. Both spirometric tests were performed with a portable turbine flow sensor spirometer. We assessed the quality of the spirometric tests and compared a range of PF parameters obtained in the pediatricians' offices and in the PF laboratory according to the Bland and Altman method. RESULTS: A total of 109 children (mean age: 10.4 years; range: 6-15) were included in the study. Eighty-five (78%) of the spirometric tests that were performed in the pediatricians' offices met all of the acceptability and reproducibility criteria. The 24 unacceptable test results were attributable largely to a slow start and failure to satisfy end-of-test criteria. Only the 85 acceptable spirometric tests were considered for analysis. The agreement between the spirometric tests that were performed in the pediatrician's office and in the PF laboratory was good for the key parameters (forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow between 25% and 75%). The repeatability coefficient was 0.26 L for forced expiratory volume in 1 second (83 of 85 values fall within this range), 0.30 L for forced vital capacity (81 values fall within this range), and 0.58 L/s for forced expiratory flow between 25% and 75% (82 values fall within this range). In 79% of cases, the primary care pediatricians interpreted the spirometric tests correctly. CONCLUSIONS: It seems justifiable to perform spirometry in pediatric primary care, but an integrated approach involving both the primary care pediatrician and certified pediatric respiratory medicine centers is recommended because effective training and quality assurance are vital prerequisites for successful spirometry.

Adolescent↗

PubMed1992

Relationships among gas exchange, spirometry and symptoms in asthma.

OBJECTIVES: The severity of asthma is usually evaluated by clinical examination and spirometry. In a small study of asthmatics considerable ventilation/perfusion (VA/Q) inequality was found, however, despite essentially normal flow rates. These findings prompted the current study. METHODS: We prospectively examined symptoms, spirometry and VA/Q inequality in 26 patients with chronic, symptomatic asthma once a week for 9 consecutive weeks. VA/Q measurements were made using a less invasive approach of the multiple inert gas elimination technique and symptoms were scored. RESULTS: Correlation coefficients between indices for VA/Q inequality (log SDQ), spirometry (FEV1.0/VC, MEF25) and symptom scores were only in the range 0.24-0.29. CONCLUSION: We conclude that even at the individual level, symptoms, spirometry and VA/Q inequality are so poorly correlated that one cannot evaluate any of these aspects of asthma without measuring each. The data support the notion that spirometric and gas exchange abnormalities in asthma are caused by different pathophysiologic events.

Asthma↗