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PubMed1992

[Energy metabolism, respiratory heat loss, and lung functions in patients with chronic obstructive pulmonary disease and pulmonary fibrosis].

Resting energy expenditure (REE) and respiratory heat loss (RHL) were measured in 17 patients with chronic obstructive pulmonary disease (COPD), 7 patients with pulmonary fibrosis (PF), and 8 normal healthy subjects, three hours after a light breakfast. Correlations between these values, and also predicted basal metabolic rate (PreBMR) and normalized lung functions were assessed. REE, REE/Pre BMR, RHL and RHL/REE in all patients increased significantly compared with those of control subjects. When all the studied subjects were combined, significant negative relationships were found between REE, REE/PreBMR, RHL and RHL/REE and percent predicted values of forced expiratory volume in one second (FEV1.0), between RHL and RHL/REE and percent predicted values of vital capacity (VC), and between REE/PreBMR, RHL and RHL/REE and percent predicted values of carbon monoxide diffusing capacity (DLCO). These results indicate that resting energy expenditure and respiratory heat loss increase in patients with COPD and PF in association with even slight to moderate deterioration of lung function. Therefore, elevated resting energy expenditure and respiratory heat loss need to be taken into account in determining caloric and water requirements of these patients.

Aged↗

PubMed2002

Respiratory symptoms, lung function, and nasal cellularity in Indonesian wood workers: a dose-response analysis.

OBJECTIVES: It was hypothesised that inflammation plays a dominant part in the respiratory effects of exposure to wood dust. The purpose of this study was to relate the nasal inflammatory responses of workers exposed to meranti wood dust to (a) levels of exposure, (b) respiratory symptoms and (c) respiratory function. METHODS: A cross sectional study was carried out in 1997 in a woodworking plant that used mainly meranti, among 982 workers exposed to different concentrations of wood dust. Personal sampling (n=243) of inhalable dust measurements indicated mean exposure in specific jobs, and enabled classification of 930 workers in three exposure classes (<2, 2-5, and >5 mg/m(3)) based on job title. Questionnaires were used to screen respiratory symptoms in the entire population. Lung function was measured with two different techniques, conventional flow-volume curves and the forced oscillation technique. Nasal lavage was done to assess inflammation in the upper respiratory tract. RESULTS: A negative trend between years of employment and most flow-volume variables was found in men, but not in women workers. Current exposure, however, was not related to spirometric outcomes, respiratory symptoms, or nasal cellularity. Some impedance variables were related to current exposure but also with better function at higher exposure. CONCLUSIONS: Exposure to meranti wood dust did not cause an inflammation in the upper respiratory tract nor an increase of respiratory symptoms or decrease of lung function. These data do not corroborate the hypothesis that inflammation plays a part in airway obstruction induced by wood dust.

Adult↗

PubMed1980

[Lung function after thoracic injury--an aid for indication for an early decortication (author's transl)].

In 16 patients with severe chest injuries the pulmonary function was evaluated as early as possible. Special emphasis was laid upon the basic criteria for the indication of an early decortication in cases of organized hematothorax. A follow-up study of ten patients, who were treated conservatively and of six patients, who underwent decortication, showed that the inspiratory and expiratory reserve volume and the compliance of the lung were the most reliable criteria. They showed, if a traumatic disturbance of the lung function was reversible or irreversible. It seems that patients improve faster after decortication. If, however, signs of a quick spontaneous recovery of the lung function is seen, there is no indication for surgery.

Follow-Up Studies↗

PubMed2003

Accelerated decline of lung function in COPD patients with chronic hepatitis C virus infection: a preliminary study based on small numbers of patients.

STUDY OBJECTIVES: It has been suggested that chronic viral infection may increase the risk for development of COPD. This prospective study was designed to determine that chronic hepatitis C virus (HCV) infection is associated with accelerated decline of lung function in patients with COPD, and that antiviral therapy against HCV is effective for such patients. DESIGN: Prospective 5-year follow-up study. SETTING: University hospital. PATIENTS: Fifty-nine patients with COPD (group A, 15 HCV-negative ex-smokers; group B, 14 HCV-negative current smokers; group C, 14 HCV-positive ex-smokers; group D, 16 HCV-positive current smokers). INTERVENTIONS: After a 5-year follow-up period, 21 HCV-positive patients received interferon (IFN)-alpha therapy. MEASUREMENTS AND RESULTS: The rate of annual decline in FEV(1) and diffusing capacity of the lung for carbon monoxide (DLCO) during the 5-year follow-up period were significantly higher in group B (DeltaFEV(1), 59.7 mL/yr [SD, 17.5], p = 0.0008; DeltaDLCO, 3.50%/yr [SD, 0.44], p < 0.0001) and group C (DeltaFEV(1), 54.0 mL/yr [SD, 15.3], p = 0.0128; DeltaDLCO, 3.36%/yr [SD, 0.28], p < 0.0001) than in group A (DeltaFEV(1), 33.5 mL/yr [SD, 7.7]; DeltaDLCO, 2.66%/yr [SD, 0.34]). Moreover, these parameters in group D (DeltaFEV(1), 79.5 mL/yr [SD, 20.6]; DLCO, 4.5%/yr [SD, 0.40]) were also significantly higher than those in group B and group C. We evaluated the DeltaFEV(1) after IFN therapy during the 3-year follow-up period in the 8 IFN responders and 13 IFN nonresponders. DeltaFEV(1) in the IFN nonresponders did not significantly change during the 3-year follow-up period (before, 65.5 mL/yr [SD, 23.5]; after, 66.1 mL/yr [SD, 24.0]). However, DeltaFEV(1) in the IFN responders significantly decreased (before, 68.4 mL/yr [SD, 26.2]; after, 57.3 mL/yr [SD, 23.6], p = 0.0116). CONCLUSIONS: Our findings suggest that chronic HCV infection might accelerate decline in lung function in patients who already have COPD.

Disease Progression↗

PubMed1997

Does occupational exposure to brown coal dust cause a decline in lung function?

OBJECTIVES: To determine if the rate of change in forced expiratory volume in one second (FEV1) in subjects with high exposure to Latrobe Valley brown coal dust was significantly greater than the rate of change among subjects with low exposure. METHODS: A retrospective dynamic cohort design with variable time windows. This study was conducted over a period of 14 years from 1980 to 1994 and used data collected by the State Electricity Commission (SEC) Lung Function Unit for an asbestos surveillance programme. The subjects were exposed to low, medium, or high levels of coal dust. Basic spirometry with wedge bellows spirometers was used to assess lung function. A general linear model (GLM) was used to assess the effects of smoking and exposure to coal dust upon the change in forced expiratory volume in one second (FEV1) while adjusting for age and height. RESULTS: The mean (95% confidence interval (95% CI) rate of decline in FEV1 was 40 (36 to 44) ml/year. Age was a significant predictor of change. A significant effect was found for smoking (P = 0.02) and for exposure to coal dust (P = 0.008). The only significant difference with exposure to coal dust was between the high and mixed exposure categories. CONCLUSION: There is no convincing evidence of excessive decline in FEV1 with exposure to coal dust > 0.75 mg/m3. The absence of a dose response relation provides some evidence against a causal relation. On the basis of this study, reduction of the exposure standards currently applied to brown coal dust in the Victorian electricity industry is not warranted to prevent respiratory disease.

Age Factors↗

PubMed1991

Assessment of asbestos-induced pleural disease by computed tomography--correlation with chest radiograph and lung function.

We compared computed tomography (CT) scanning with chest radiography in the assessment of asbestos-induced pleural disease (AIPD) in 20 patients (17 men and 3 women, mean age 55 years, range 43-74 years). Involved pleura was scored on plain chest radiographs according to the International Labour Office (ILO) method of evaluating AIPD. A CT score was calculated from the measurement, using a digital length probe, of the circumference of the chest wall involved by pleural disease in each slice. The maximum width of pleural disease was taken into account in a way analogous to the ILO method for the chest radiograph. The CT score correlated with the chest radiograph score (r = +0.82, P less than 0.0006). CT demonstrated discrete plaques in 95% of patients but these were identified only in 59% patients on the radiograph. Diffuse pleural thickening was evident on the CT scan in all patients and in 70% on the radiograph. There was more inter-reader agreement about the type of pleural disease on the CT scans than on the chest radiographs. CT and chest radiograph scores inversely correlated with all lung function measurements except KCO. We conclude that increasingly extensive pleural disease is associated with increasingly severe impairment of lung function. CT scanning demonstrates the type of AIPD better than plain chest radiography.

Adult↗

PubMed1990

Lung function in teenage Bangladeshi boys and girls.

Data on forced vital capacity, forced expiratory volume in one second and peak expiratory flow rate were obtained in a group of 588 healthy and well-nourished (but not obese) Bangladeshi teenagers to establish normal values in this population. Bangladeshi girls in their early teens showed higher peak expiratory flow rates than boys of the same age but while this continued to rise in boys after the age of 15 years the peak expiratory flow rate in girls seemed to have attained its maximum values by that age. Correlations between sitting height and the lung function variables were found to be marginally greater than those with standing height. Prediction equations were calculated for each lung function variable with sitting and standing separately. Comparison of the results in our study with those reported from other ethnic groups indicate that Bangladeshi values are lower than those of Europeans, Jordanians or Chinese but not significantly different from those reported for Libyans. Since in practice, genetic, nutritional and environmental factors are not readily disentangled, norms for a given study population need to be derived from healthy subjects of similar background and ethnicity.

Adolescent↗

PubMed2003

Allergic sensitization, symptoms, and lung function among bakery workers as compared with a nonexposed work population.

Only few studies have assessed relative risks on occupational asthma and allergy among bakery workers, and none of them have included respiratory and work-related symptoms as well as sensitization to occupational allergens and pulmonary function. A random sample of 246 workers from traditional and industrial bakeries in two regions of Belgium were compared with a reference population of 251 workers from a petrochemical plant in the same region. Data on skin test positivity, symptoms, and lung function were collected by standardized procedures. Differences between the two subpopulations were analyzed using multiple logistic and linear regression analyses. On average, bakery workers did not more often have skin test positivity than reference workers (39.4% and 42.6%, respectively). However, bakery workers had a strongly increased risk of sensitization to specific bakery allergens (OR 22.0, 95% CI = 6.3-77.1.), whereas their risks of positive skin tests to common allergens, including wheat pollen and storage mite, were significantly decreased (OR 0.6, 95% CI = 0.4-0.9). Bakery workers had significantly more often respiratory and work-related symptoms. Accordingly, they had lower lung function parameters. Atopy and sensitization to bakers' allergens were independent and additional risk factors for work-related symptoms. Bakery workers are at increased risk of respiratory and allergic symptoms and skin test reactivity to specific bakers' allergens wheat flour and alpha-amylase. Wheat pollen and storage mite should not be regarded as baker's allergens. Nevertheless, pulmonary function of bakery workers can be characterized as mild airway obstruction only.

Adult↗

PubMed2006

[Does timing of thoracic spine stabilization influence perioperative lung function after trauma?].

BACKGROUND: Proper timing of stabilization for spine injuries is discussed controversially. Whereas early repair of long bone fractures is known to reduce complications. PATIENTS AND METHODS: We investigated retrospectively 48 patients who were stabilized in a ventrodorsal approach for fractures of the thoracic spine. Patients were divided into three groups. All patients in groups I and II presented radiological or clinical signs of lung contusion. Patients were stabilized in the prone position via single-step dorsal stabilization with internal transpedicular fixation and ventral fusion with titanium cage or autologous bone graft using a minimally invasive video-assisted thoracotomy. RESULTS: The average duration of the procedures in group I was 213+/-40 min, in group II 250+/-75 min, and in group III 255+/-65 min (p: n.s.). Intraoperative blood loss did not differ significantly between the three groups. The PaO(2)/FiO(2) ratio improved in groups I and III, whereas in group II an significant impairment of lung function occurred perioperatively. Postoperative ICU stay was comparable in groups I and II (I: 10+/-5 days; II: 9+/-7 days); overall ICU stay tended to be shorter in group I versus II. The postoperative dependence on ventilator support did not differ significantly among the three groups. The mortality rate was 0% in this series. CONCLUSION: Our data provide further evidence that early stabilization of combined thoracic and thoracic spine injuries is safe, does not alter perioperative lung function, and results in a reduced overall ICU stay.

Adolescent↗

PubMed1982

[Bronchogenic cysts. A clinical and regional lung function study before and after surgery (author's transl)].

Studies of regional lung function were performed on two children with bronchogenic cysts before and after surgery. The first patients, aged two, presented with a severe and continuous airflow obstruction leading to significant disturbance of perfusion per unit of alveolar volume; the abnormalities of perfusion were partly reversible when the ventilation was restored after surgery. Patient no 2, aged 10 years, had a voluminous peripheral cyst, which was shown to be ventilated by pulmonary function studies and further confirmed by bronchography. After lobectomy, studies revealed a reduction in the functional pulmonary parenchyma in the right hemithorax. The abnormal distribution of perfusion was still seen two years after the operation.

Adult↗

PubMed2004

Lung cancer pulse oximetry and capnography in lung function laboratories.

OBJECTIVE: To compare values reflecting oxyhemoglobin saturation obtained by pulse oximetry (SpO2) and values for end-tidal carbon dioxide pressure (PETCO2) obtained by capnography with direct measures of gas saturation values and pressures (PaO2 and PaCO2) in arterial blood gas samples. PATIENTS AND METHODS: We studied 57 consecutive patients ranging in age from 34 to 83 years--16 of whom were smokers--who presented for lung function testing. RESULTS: The mean (SD) SpO2 was 95% (2.4%), and oxygen saturation measured directly in arterial blood samples was 95.1% (2.3%) (P=NS). The mean PETCO2 was 37.9 (5.3) mm Hg and PaCO2 by arterial blood gas analysis was 40.6 (5.4) mm Hg (P<.0001). The correlation between the 2 measurements of oxygen saturation (SpO2 and direct assessment) was 0.806 (P<.0001), and the correlation between PETCO2 and PaCO2 was 0.845 (P<.0001). The mean difference between the 2 expressions of oxygen saturation was 0.08% (1.46%) and between PETCO2 and PaCO2 was 2.7 (2.9) mm Hg. CONCLUSION: Both measurement devices (pulse oximeter and capnograph) are appropriate for use in a lung function laboratory. The difference between PETCO2 and the PaCO2 should be kept in mind.

Adult↗

PubMed1989

Endocrine maturation and lung function in premature neonates of women with diabetes.

Because respiratory distress syndrome may result, in part, from a hormonal deficiency in the developing fetus, we investigated the endocrine millieu of 28 infants of women with diabetes who were delivered prematurely (34 to 37 weeks of gestation). The umbilical serum concentrations of estrone, estradiol, estriol, cortisol, and prolactin in infants of women with diabetes who developed respiratory distress syndrome (n = 6) were lower than those in infants of women with diabetes who had normal lung function. Serum hormone levels in age-matched newborns of normal women were higher than those in the infants of women with diabetes with respiratory distress syndrome but were not different than those in the infants of women with diabetes with normal lung function. Plasma glucose levels were highest in women whose neonates developed respiratory distress syndrome. An inverse correlation existed between maternal glucose levels and lecithin-sphingomyelin ratios in amniotic fluid. Thus diabetes occasionally results in significantly delayed maturation of the fetal endocrine milieu. In these instances, delayed fetal lung maturation is a frequent occurrence. Moreover, both phenomena may be related to the extent of diabetic control during pregnancy.

Endocrine Glands↗

PubMed2002

Leukotriene-B4 concentrations in exhaled breath condensate and lung function after thirty minutes of breathing technically dried compressed air.

In previous studies it had been shown that leukotriene-B4 [LTB4] concentrations in the exhaled breath mirror the inflammatory activity of the airways if the respiratory tract has been exposed to occupational hazards. In diving the respiratory tract is exposed to cold and dry air and the nasopharynx, as the site of breathing-gas warming and humidification, is bypassed. The aim of the present study was to obtain LTB4-concentrations in the exhaled breath and spirometric data of 17 healthy subjects before and after thirty minutes of technically dried air breathing at normobar ambient pressure. The exhaled breath was collected non-invasively, via a permanently cooled expiration tube. The condensate was measured by a standard enzyme immunoassay for LTB4. Lung function values (FVC, FEV1, MEF 25, MEF 50) were simultaneously obtained by spirometry. The measured pre- and post-exposure LTB4- concentrations as well as the lung function values were in the normal range. The present data gave no evidence for any inflammatory activity in the subjects' airways after thirty minutes breathing technically dried air.

Air↗

PubMedDate not supplied

Calculation of reference values for lung function tests.

The powerful computers that are now available enable calculation of reference values by endless permutations of regression models that are not always biologically meaningful. The aim of this study was to test the ability of simple regression models to describe data that has been collected for calculation of reference values. Healthy non-smoking females (n = 74) and males (n = 51) were studied with 22 commonly used lung function tests. If the data were logarithmically transformed, there was a satisfactory reduction of residual variation and the assumption of normality was fulfilled. Furthermore, the difference between males and females could be described by a binary sex-variable that is independent of interactions with other variables such as age, height and weight. Logarithmic transformation of lung function measurements followed by linear regression is recommended as a simple standard method for calculation of reference values.

Adult↗

PubMed2005

Associations between submicrometer particles exposures and blood pressure and heart rate in patients with lung function impairments.

OBJECTIVE: The objective of this study was to evaluate whether submicrometer particle is associated with elevated blood pressure (BP) and heart rate (HR). METHODS: We measured ambulatory systolic BP (SBP), diastolic BP (DBP), and HR using a portable BP monitoring system and number concentrations of submicrometer particle with a size range of 0.02 to 1 microm (NC0.02-1) by a P-TRAK Ultrafine Particle Counter for 10 patients with lung function impairments. RESULTS: We found NC0.02-1 exposures at 1- to 3-hour moving averages were associated with the elevation of SBP, DBP, and HR. There were 1.4 to 3.4-mm-Hg increases in SBP, 1.4 to 2.2-mm-Hg increases in DBP, and 0.3 to 3.5-beats/min increases in HR for 10,000 particles/cm increases in NC0.02-1 at 1- to 3-hour moving averages. CONCLUSIONS: Exposures to submicrometer particles were associated with short-term increases in BP and HR in patients with lung function impairments.

Adult↗

PubMed1993

Bronchial reactivity, lung function, and serum immunoglobulin E in smoking-discordant monozygotic twins.

Smokers with chronic bronchitis and/or chronic obstructive pulmonary disease (COPD) have been reported to have an increased bronchial reactivity (BR). It has been discussed whether increased BR is a risk factor for the development of COPD in smokers. We studied 10 monozygotic twin pairs who were discordant for tobacco smoking by means of histamine provocation tests, lung function tests, and serum samples for total IgE. The smokers had a mild obstructive ventilatory impairment, with FEV1 significantly lower than that of the partner both when it was determined from the flow-volume loops (3.2 +/- 1.0 L for smokers and 3.4 +/- 0.8 L for nonsmokers) and by the Vitalograph spirometer (3.5 +/- 1.0 L for smokers and 3.8 +/- 0.8 L for nonsmokers). Forced midexpiratory flow (FEF25-75%) and forced expiratory flow at 75 to 85% of vital capacity (FEF75-85%) were both significantly lower in the smokers (p < 0.05). The alveolar plateau phase N2-delta test and lung clearing index in the multibreath nitrogen washout test were both significantly affected in the smokers (p < 0.05 and p < 0.01, respectively). We found no significant difference in histamine reactivity between smokers and nonsmokers and no correlation between differences in reactivity and differences in lung function within pairs. Total serum IgE was significantly higher in the smokers than in their nonsmoking siblings. These data suggest that obstructive ventilatory impairment and raised serum IgE are earlier and more constant manifestations of tobacco smoking than increased bronchial reactivity. Thus, bronchial hyperreactivity does not seem to be a major risk factor for the development of early airways obstruction in smokers.

Adult↗

PubMedDate not supplied

Characteristics of coalminers who have suffered excessive loss of lung function over 10 years.

From a longitudinal study of respiratory health of coalminers, we have selected 29 smokers and 12 non-smokers with the greatest decline in FEV1 over a ten year period and have compared them with 29 smokers and 14 non-smokers with the least decline. In order to identify syndromes associated with rapid decline in FEV1, we made a clinical and physiological examination of these men five years after the end of the ten year period of measured FEV1 decline. There was no substantial difference in mean lung function between rapid and slow decliners at the time of examination. However, the rapid decliners as a group had an excess of respiratory symptoms, a significantly lower mid-expiratory flow rate and an excess of early and mid-inspiratory crackles on auscultation. Lung function was only abnormal by conventional standards in one third of the smoking rapid decliners. These men had either airflow obstruction (accompanied in three cases by evidence of emphysema) or a concentric reduction of both FEV1 and FVC. There was no excess of atopy nor of history of childhood respiratory illness in rapid decliners. We conclude that it is likely to be difficult to detect the rapid decliners among working men on the basis of a single examination and that at present detection must depend on serial measurements of FEV1.

Adult↗

PubMed1984

Leukocyte count, smoking, and lung function.

The interrelation between leukocyte count, cigarette smoking, and pulmonary function results was examined in two work populations: 1,826 white male workers in a pulp and paper mill and 1,620 white male workers in an aluminum smelter in British Columbia. These workers took part in epidemiologic health studies that consisted of a medical-occupational questionnaire, spirometric measurements, and leukocyte count. Measurements of the air contaminants in the work environment were also carried out simultaneously by personal and area sampling. No significant increase in the prevalence of respiratory symptoms and lung function abnormalities was found between the exposed and nonexposed workers in each work population. Similarly, no difference in leukocyte count was found between exposed and nonexposed workers. Leukocyte count was found to be significantly higher among current smokers than nonsmokers and former smokers in each population. In both populations, there was an inverse correlation between leukocyte count and one-second forced expiratory volume and forced vital capacity of the workers irrespective of the smoking habit. This finding suggests that the leukocyte response to external stimuli may be another determinant of lung function measurements.

Adult↗