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PubMed2006

Lung function in infants after repair of congenital diaphragmatic hernia.

BACKGROUND/PURPOSE: Congenital diaphragmatic hernia (CDH) is initially characterized by severe restrictive lung defect and low lung compliance, but survivors have relatively few abnormalities later in life. We studied the changes in lung growth and function in infants after the repair of CDH. METHODS: Retrospective analysis of pulmonary function tests was performed during the first 24 months of life in 56 infants (33 male and 23 female) after repair of CDH. Lung function (functional residual capacity [FRC], respiratory system compliance [C(rs)] and resistance [R(rs)], and maximum expiratory flow rate at FRC [V'(maxFRC)]) were compared among 4 different ages (0-3, 4-6, 7-12, and 13-24 months). RESULTS: All indices of lung function (mean +/- SD of z scores) were abnormal during the first 6 months of life but were almost normalized by 24 months (P < .0001): FRC, from -0.84 +/- 0.5 to 3.26 +/- 2.07; C(rs), from -0.87 +/- 0.4 to 1.84 +/- 1.75; R(rs), from 2.85 +/- 2.71 to -0.23 +/- 2.03, and V'(maxFRC), from -1.63 +/- 0.4 to -0.09 +/- 0.94. There was significant correlation (P < .001) between lung function and increase in age, height, and especially weight. CONCLUSIONS: Lung growth and function gradually normalize between 6 and 24 months of life after repair of CDH.

Airway Resistance↗

PubMed1983

Smoking, lung function, and body weight.

In a cross-sectional study of steelworkers aged 45-55 years, smokers (n = 105; mean weight 76.1 kg) were found to weigh significantly less than non-smokers (n = 54; 81.6 kg) and ex-smokers (n = 51; 82.6 kg). The lower weight of smokers was attributable to a group with airflow obstruction (n = 37; forced expiratory volume in one second/vital capacity (FEV1/VC) less than 66%), who weighed less (4.8 kg; p less than 0.05) than smokers with normal FEV1/VC (n = 68). In smokers, but not in ex-smokers or non-smokers, body mass index and FEV1/VC ratio were closely related (r = 0.34; p less than 0.001). This association was apparently not due to an effect of body weight on lung function. Weight loss in smokers may be the consequence of impaired lung function or reflect the effect of cigarette smoking on both the respiratory tract and metabolism in susceptible subjects.

Body Weight↗

PubMedDate not supplied

Lung function level as a valuable predictor of survival among the elderly. A 5-year community-based mortality study in Cracow.

The objective of the study undertaken among the elderly was to assess the strength and importance of health variable predictors (ventilatory lung function, blood pressure) in comparison with that of sociodemographic variables (age, sex, education), smoking habit, obesity and health self-assessment. The study covered a sample of elderly inhabitants of Cracow (698 males and 1211 females) who attended the mass screening X-ray clinic. The sample examined did not include patients of old people's homes or geriatric wards. Statistical analysis of the relation between mortality over a 5-year period and chosen predictors was carried out with Cox proportional hazards model. It was found that besides age, forced expiratory volume in 1 s (FEV(1)) level is the strongest survival predictor among the elderly. Subjects who had better FEV(1) by 500 ml showed significantly lower death risk, by 18% in males and 27% in females after allowing for age and height. The results obtained confirmed the expectation that ventilatory lung function is one of the strongest predictors of survival in the elderly. In the sample studied, the impact of education, smoking habit, obesity, health self-assessment on mortality was not significant. The effect of hypertension appeared to be relevant only in the female group.

Journal Article↗

PubMed2006

Pulmonary blood volume and transit time in cirrhosis: relation to lung function.

BACKGROUND/AIMS: In cirrhosis a systemic vasodilatation leads to an abnormal distribution of the blood volume with a contracted central blood volume. In addition, the patients have a ventilation/perfusion imbalance with a low diffusing capacity. As the size of the pulmonary blood volume (PBV) has not been determined separately we assessed PBV and pulmonary transit time (PTT) in relation to lung function in patients with cirrhosis and in controls. METHODS: Pulmonary and cardiac haemodynamics and transit times were determined by radionuclide techniques in 22 patients with alcoholic cirrhosis and in 12 controls. The lung function including diffusing capacity for carbon monoxide (DL, CO) was determined by conventional single breath technique. RESULTS: In the patients, PTT was shorter, 3.9+/-1.2 vs 5.7+/-1.0 s in the controls, P<0.001, and the PBV was lower, 362+/-151 vs 587+/-263 ml, in the controls, P<0.005. Both PTT and PBV were lowest in patients with advanced disease. DL, CO was reduced in the patients and correlated significantly with PTT (r=0.58, P=0.007) and PBV (r=0.49, P<0.03). CONCLUSIONS: The results suggest that the reduced PBV contributes to the reduced effective blood volume in cirrhosis. The relation between PBV and PTT and the low diffusing capacity suggests the pulmonary vascular compartment as an important element in the pathophysiology of the lung dysfunction in cirrhosis.

Aged↗

PubMed1975

A comparison between measured and calculated changes in the lung function after operation for pulmonary cancer.

Eighteen patients operated on for pulmonary cancer, the procedure varying from the removal of two segments to pneumonectomy, were subjected to measurement of the spirometric values VC, FEV1, FRC and RV preoperatively and 2-3 months postoperatively. The possibility of predicting the postoperative values from the number of segments removed was studied, partly with standard percentages (5.26%) per segment (method I), and partly with a percentage per segment in the affected area, calculated from the preoperative regional lung function tests using 133xenon. This latter test was carried out with a mobile apparatus using four detectors with tubular colimators and from the anterior surface of the thorax. Both methods of calculation gave, for the material as a whole, good agreement between the postoperative (measured) and the calculated values. However, with regard to certain patients, the regional lung function tests gave important information on preoperative reduced function in the affected area. In these patients, method No. II was by far the best for prediction of the postoperative values.

Aged↗

PubMed2006

Tumour necrosis factor and lymphotoxin A polymorphisms and lung function in smokers.

Genetic variants in the tumour necrosis factor (TNF) gene have been investigated in chronic obstructive pulmonary disease (COPD). However, there are many instances of nonreplication of these associations due to insufficient power or other factors. In this study, a large number of subjects were examined to elucidate whether genetic variations of TNF and/or lymphotoxin A (LTA), which is clustered with TNF, are associated with variations in lung function among smokers. The present authors designed two nested case-control studies in the National Heart, Lung, and Blood Institute Lung Health Study (LHS), which enrolled 5,887 smokers. The first design included continuous smokers who had the fastest (n = 279) and the slowest (n = 304) decline of lung function during the 5-yr follow-up period, and the second included the subjects who had the lowest (n = 533) and the highest (n = 532) post-bronchodilator % predicted forced expiratory volume in one second at the start of the LHS. Within the TNF and LTA region, 10 tagging single-nucleotide polymorphisms were selected and genotyped. Unlike the previous associations between TNF-308 and COPD in Asians, the current study found no association between either of the two phenotypes and the LTA and TNF polymorphisms. In conclusion, these results support the findings of previous studies in late-onset chronic obstructive pulmonary disease in Caucasian populations.

Case-Control Studies↗

PubMed2002

Silicosis and lung function decrements among female ceramic workers in Italy.

It is well known that male ceramic workers have elevated risks of chronic silicosis. The objective of this study was to assess whether female ceramic workers also have an increased risk of silicosis and whether these women have decreased lung function related to silica exposure. Ceramic workers from Civitacastellana, Italy, were enrolled in health surveillance during the 1970s. A total of 642 women were under surveillance; a respiratory monitoring program was conducted from 1974 to 1987, with follow-up through 1991 that included annual chest radiography and measurement of lung function. Radiography findings were defined as silicosis if the chest films were > or =1/0 with small, rounded opacities. Multiple linear regression models for repeated measures (generalized estimating equations) were run to evaluate associations of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV(1)) with years of exposure and radiograph opacities. Nine cases of silicosis were identified on the basis of radiographic evidence. Silicosis risk was not associated with smoking but was related to employment before 1970 and demonstrated a dose-response gradient for years of exposure. FVC and FEV(1) both showed significant (p < 0.05) associations with duration of exposure and with positive radiography findings. The results for female ceramic workers are consistent with those for male employees regarding exposure to fibrogenic dusts.

Adult↗

PubMed1989

Lung function in allogeneic bone marrow transplantation recipients.

In order to investigate the incidence of pulmonary function complications following bone marrow transplantation (BMT), 17 patients with leukaemia and 8 with aplastic anaemia were sequentially assessed over a one year period. Before BMT, all the patients were free of respiratory symptoms and had both normal chest X-ray and routine lung function tests. However, 5 patients disclosed airway hyperreactivity. Aplastic anaemia patients had significantly lower haemoglobin-adjusted diffusing capacity for carbon monoxide (DLCO) than those with leukaemia, a finding significantly related to the lower haemoglobin values shown in the former individuals. Following BMT there were transient mild to moderate reductions in DLCO and static lung volumes; moreover, patients with leukaemia had lower DLCO than those with aplastic anaemia. Fourteen of the 25 patients had ventilatory defects, including 10 individuals with bronchial hyperresponsiveness. Post-BMT lung function changes were transiently accompanied by mild to moderate symptoms of respiratory disease in most of the patients.

Adult↗

PubMed2003

Effects of radiotherapy and chemotherapy on lung function in patients with non-small-cell lung cancer.

PURPOSE: To evaluate the effects of chemoradiation on objective tests of pulmonary function. MATERIALS AND METHODS: One hundred lung cancer patients treated in five protocols between 1992 and 2000 with combinations of thoracic radiotherapy (RT) and chemotherapy were evaluated with pre- and post-RT pulmonary function tests. The pulmonary function tests were analyzed for changes in measures of obstruction (forced expiratory volume in 1 s per unit of vital capacity [FEV(1)/VC]), restriction (total lung capacity [TLC]), and diffusing capacity (diffusing capacity for carbon monoxide [DLCO]). The use and timing of chemotherapy and RT, as well as patient, tumor, and treatment factors, were evaluated using univariate and multivariate analyses. RESULTS: No treatment or patient factors were significantly associated with changes in FEV(1)/VC. Chemotherapy with RT, compared with RT alone, was associated with a lower post-RT TLC (92% vs. 107%, p = 0.002). Nodal status (N2-N3 vs. N1), tumor location (central vs. peripheral), use of >/=6 treatment fields, and tumor volume >/=100 cm(3) were also associated with a significantly lower post-RT TLC. On univariate analysis, the use of any chemotherapy (p = 0.029) and the use of concurrent vs. sequential chemotherapy (p = 0.028) were predictive of a lower post-RT DLCO. Patient age >/=60 years, nodal status (N2-N3 vs. N0-N1), tumor volume >/=100 cm(3), tumor location (central vs. peripheral), and use of >/=6 treatment fields were also associated with a significantly lower post-RT DLCO. The fractional volume of irradiated normal lung correlated with the decrease in DLCO (p <0.001), with a 1.3% DLCO decline for each 1% of total lung volume that received >20 Gy. CONCLUSIONS: The addition of chemotherapy to RT significantly exacerbates the post-RT decrease in TLC and DLCO. The greatest decrease in DLCO occurs in patients treated with concurrent chemoradiation.

Adult↗

PubMed1989

Effects of inhaled budesonide on the relationships between symptoms, lung function indices and airway hyperresponsiveness in patients with allergic asthma.

Fourteen patients with allergic asthma and exercise-induced bronchoconstriction (EIB) completed this study. Effects of a 6-week treatment with inhaled budesonide, daily dose 4 x 0.1 mg, were compared to the effects of treatment with placebo on patient symptom score, clinical assessment score, additional beta 2-agonist use, lung function indices, PC20 histamine and degree of EIB. Furthermore, relationships between these parameters during treatment with placebo and budesonide were analysed. Treatment with budesonide significantly improved symptom scores, FEV1 and morning peak expiratory flow rate (PEFR). A clear decrease in additional beta 2-agonist use was observed. PC20 histamine increased significantly, whereas EIB decreased significantly. Patient symptom scores and clinical assessment scores showed a significant correlation before and after treatment. No relationship was observed between these scores and other parameters, except for nocturnal dyspnoea/wheeze correlating significantly with beta 2-agonist use before treatment with budesonide. There was a significant correlation between beta 2-agonist use before treatment with budesonide and FEV1, morning PEFR, diurnal variation in PEFR, PC20 histamine and EIB. During treatment with budesonide only a significant correlation of beta 2-agonist use with PC20 histamine remained. FEV1 before treatment correlated with PEFR, diurnal variation in PEFR and EIB significantly. During treatment with budesonide the relationship of FEV1 with EIB was no longer observed. Diurnal variation in PEFR correlated with EIB significantly only before treatment. It is concluded that symptom scores are of little value in contrast to the measurement of beta 2-agonist use, lung function indices and airway hyperresponsiveness in the assessment of asthma patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗

PubMed2001

Decreased lung function associated with perinatal exposure to Dutch background levels of dioxins.

UNLABELLED: Perinatal exposure to Dutch background dioxin levels is rather high. Studies of calamities have shown that dioxins negatively influence the respiratory system. It was hypothesized that perinatal exposure to background dioxin levels leads to lung suboptimality, probably through developmental interference. This study aimed to assess lung function in relation to perinatal dioxin exposure. Spirometry was performed in 41 healthy children (aged 7-12 y. mean 8.2 y) with known perinatal dioxin exposure. The ratio of forced expiratory volume in I s to forced vital capacity (FEV1/FVC ratio) was determined. A complete medical history was taken. The prenatal exposure ranged from 8.74 to 88.8 (mean 34.6) ng TEQ dioxin kg fat(-1), measured in breast milk. The postnatal exposure ranged from 4.34 to 384.51 (mean 75.4) ng TEQ dioxin. Twelve children had to be excluded. A significant decrease in lung function in relation to both prenatal (p = 0.045) and postnatal (p = 0.0002) dioxin exposure was seen in the 29 non-excluded children. A clinical association between chest congestion and perinatal dioxin exposure was seen. CONCLUSION: Perinatal background dioxin exposure may be inversely associated with the FEV1/ FVC ratio.

Adult↗

PubMed2004

Childhood asthma: exhaled markers of airway inflammation, asthma control score, and lung function tests.

Exhaled markers of airway inflammation become increasingly important in the management of childhood asthma. The aims of the present study are: 1) to compare exhaled markers of inflammation (nitric oxide, carbon monoxide, and acidity of breath condensate) with conventional asthma measures (lung function tests and asthma control score) in childhood asthma; and 2) to investigate the detectability of albumin, CRP, IL-6, IL-8, TNF-alpha, sICAM-1, and sTNF-R75 in the exhaled breath condensate (EBC) of asthmatic children. Thirty-two children with mild to moderate persistent asthma and healthy controls aged 6-12 years were studied. We measured exhaled NO and CO, and subsequently EBC was collected. Inflammatory mediators in EBC were measured using an enzyme-linked immunosorbent assay. Respiratory symptoms and asthma control were assessed using the asthma control questionnaire (ACQ) of Juniper et al. (Eur Respir J 1999;14:902-907). Exhaled NO showed a significant correlation with exhaled CO (r = 0.59, P < 0.05) and FEV1 (r = -0.59, P < 0.05), but not with ACQ score (r = 0.48, P = 0.06). Exhaled CO was correlated with prebronchodilator FEV1 (r = -0.45, P < 0.05), but not with asthma control (r = 0.18, P = 0.35). Acidity of EBC was significantly lower in asthmatic children than in healthy controls (P < 0.05), but did not correlate with any of the conventional asthma measures. We were not able to demonstrate the presence of CRP, IL-6, IL-8, TNF-alpha, sICAM-1, and sTNF-R75 in EBC. Albumin was found in two EBC samples of asthmatic children. We conclude that exhaled NO had a better correlation with lung function parameters and asthma control than exhaled CO and acidity of EBC, in mild to moderate persistent childhood asthma. However, exhaled NO, CO, and deaerated pH of EBC did not differ between asthmatic children and controls, possibly because of a too homogeneous and well-controlled study population. To further evaluate the clinical utility of exhaled markers in monitoring childhood asthma, more studies are required on a wider range of asthma severity, and preferably with repeated measurements of markers and of asthma control.

Adolescent↗

PubMed1994

Intraperitoneal local anaesthetics after laparoscopic cholecystectomy: effects on postoperative pain, metabolic responses and lung function.

We have compared the efficacy of 0.9% NaCl 20 ml (n = 15), 0.25% bupivacaine 20 ml (n = 15) and 0.5% lignocaine 20 ml (n = 15), administered i.p., in reducing postoperative pain and opioid requirements, and modifying the metabolic response to surgery and postoperative lung function after laparoscopic cholecystectomy. There were no differences in postoperative pain scores (visual analogue scale and verbal rating scale) between the three groups in the first 4 h after operation and in analgesic requirements during the first 24 h. In all groups, forced vital capacity, peak expiratory flow and forced expiratory volume in 1 s decreased 2 h after surgery (P < 0.001). Ventilatory values recovered only partially in the first 2 days after operation (P < 0.05), with no significant differences between groups. Plasma concentrations of glucose and cortisol increased after surgery (P < 0.05). Cortisol concentrations returned to baseline 48 h after operation. There were no significant differences between the groups in any measured variable. These data suggest that the administration of 20 ml of local anaesthetics i.p. is not effective in reducing postoperative pain, improving lung function, or attenuating the metabolic endocrine response after laparoscopic cholecystectomy.

Adult↗

PubMed1995

Scoliosis and lung function in spinal muscular atrophy.

The notes and radiographs of 43 patients with a confirmed diagnosis of spinal muscular atrophy were reviewed. A significant inverse linear relationship between the severity of scoliosis and the percentage of predicted vital capacity and peak flow was found. The patients who stood had a significantly better lung function than patients who were confined to a wheelchair, and their scoliosis deteriorated significantly more slowly. Sixteen patients underwent surgical spinal stabilisation, 4 with Harrington instrumentation and 12 with segmental spinal instrumentation, at an average age of 12 years and 11 months. The average curve correction achieved was 40%. The decline in lung function seen pre-operatively was not only reversed, but a significant improvement was found at final follow-up.

Adolescent↗

PubMed1993

Restrictive lung function and asbestos-induced pleural fibrosis. A quantitative approach.

To assess further the clinical significance of asbestos-induced pleural fibrosis, we used a computer algorithm to reconstruct images three dimensionally from the high-resolution computerized tomography (HRCT) scan of the chest in 60 asbestos-exposed subjects. Pulmonary function tests, chest radiographs, and HRCT scans were performed on all study subjects. The volume of asbestos-induced pleural fibrosis was computed from the three-dimensional reconstruction of the HRCT scan. Among those with pleural fibrosis identified on the HRCT scan (n = 29), the volume of the pleural lesion varied from 0.01% (0.5 ml) and 7.11% (260.4 ml) of the total chest cavity. To investigate the relationship between asbestos-induced pleural fibrosis and restrictive lung function, we compared the computer-derived estimate of pleural fibrosis to the total lung capacity and found that these measures were inversely related (r = -0.40; P = 0.002). After controlling for age, height, pack-years of cigarette smoking, and the presence of interstitial fibrosis on the chest radiograph, the volume of pleural fibrosis identified on the three-dimensional reconstructed image from the HRCT scan was inversely associated with the total lung capacity (P = 0.03) and independently accounted for 9.5% of the variance of this measure of lung volume. These findings further extend the scientific data supporting an independent association between pleural fibrosis and restrictive lung function.

Aged↗

PubMed1980

[Salbutamol in asthmatic children, lung function and plasma levels of free salbutamol after treatment with salbutamol rectally and by pressurized aerosol (author's transl)].

In 10 children with asthma bronchiale aged 4 10/12--14 3/12 years, Salbutamol was given rectally and by pressurized aerosol. After 1 h plasma concentration of free salbutamol and lung function were measured. Plasma concentrations of free salbutamol ranged between 1.2--12.3 ng/ml, when 2 mg of salbutamol were given rectally and between less than 0.5--1.6 ng/ml, when a dose of 0.2 mg salbutamol was inhaled. Airway resistance decreased significantly after both forms of treatment but there was no statistical difference. Plasma concentrations of free salbutamol were rather low following an aerosol dose of 0.2 mg salbutamol, suggesting a topical action of salbutamol. When taken rectally improvement in lung function seemed to be related to plasma levels of free salbutamol.

Adolescent↗

PubMed2004

Lung function and nutritional status of semi-nomadic Fulani children and adolescents in northern Nigeria.

The Fulani are semi-nomadic pastoralists of the western Sahel whose culture and economy are centered on cattle. We have shown previously that Fulani children and adolescents (5-18 years old) are stunted and underweight. Nutritional status and lung function were studied in Fulani children and adolescents (n = 70), aged 6-18, and compared with a non-Fulani, rural Nigerian control group (n = 153) of the same age. Participants were restricted to healthy individuals with no prior history of respiratory disease and no symptoms of an upper respiratory tract infection within the past 6 weeks. Significant deficits in forced vital capacity (FVC; Fulani males, 1.51 l; non-Fulani males, 1.86 l, p = 0.009; Fulani females, 1.36 l; non-Fulani females, 1.79 l, p < 0.001), forced expiratory volume in one second (FEV1; Fulani males, 1.44 l; non-Fulani males, 1.76 l, p = 0.02; Fulani females, 1.24 l; non-Fulani females, 1.69 l, p < 0.001), and peak expiratory flow rate (PEFR; Fulani males, 2.69 l/s; non-Fulani males, 3.48 l/s, p = 0.002; Fulani females, 2.29 l/s; non-Fulani females, 3.35 l/s, p < 0.001) were found in both the Fulani boys and girls compared with the non-Fulani controls. The diminished lung function in the Fulani group could be attributed to respiratory muscle weakness or an overall deficit in energy.

Adolescent↗

PubMed1992

Lung function and the Hering Breuer reflex in the neonatal period.

Lung function and the occurrence of the Hering Breuer reflex during the neonatal period has been investigated. To assess the effect of extrauterine and intrauterine maturation on the strength of the reflex both preterm and term infants were recruited. Ten preterm infants, born at a median gestational age of 29.5 weeks (range 27-34) were studied serially over the first four weeks of life and 10 term infants were studied at a median postnatal age of 1.5 days (1-4). All of the infants were recruited from the neonatal unit and initially had had some form of respiratory distress. Respiratory rate, tidal volume and compliance were measured and end inspiratory occlusion performed in an attempt to provoke the Hering Breuer reflex. The Hering Breuer reflex was provoked in all infants on all occasions. There was no difference in the strength of the reflex between the preterm and term infants or preterm infants studied at different postnatal ages. All infants studied regardless of maturity or postnatal age had non-compliant lungs and a rapid respiratory rate. These data suggest a lack of intrauterine and extrauterine maturation of the Hering Breuer reflex in the neonatal period amongst infants with non-compliant lungs.

Aging↗