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PubMed1978

Lung function in asthmatic children after year or more without symptoms or treatment.

Lung function was examined in 24 children who for a year or more had not received treatment for asthma or had any asthmatic symptoms. Although clinical recovery from asthma was apparent, increased bronchial smooth-muscle tone remained present, which probably renders such children susceptible to obstructive lung disease in adult life. These children should be given guidance on treatment of their symptoms and instructed in preventive measures.

Adolescent↗

PubMedDate not supplied

Exposure, lung function, and symptoms in car painters exposed to hexamethylendiisocyanate and biuret modified hexamethylendiisocyanate.

Individuals who paint cars often complain to doctors about respiratory problems. Car painters are exposed to isocyanates, especially hexamethylendiisocyanate (HDI), and biuret modified HDI (HDI-BT). The mean exposure to HDI-BT was 115 micrograms/m3 in the air (range 10-385 micrograms/m3), which exceeds the time-weighted Swedish threshold level of 90 micrograms/m3. Exposure to HDI was about 1.0 microgram/m3 with brief peaks. This study investigated the effect of HDI and HDI-BT on lung function and included two control groups: (1) car platers, exposed to the same solvents and grinding dust as car painters, but not to isocyanates, and (2) car mechanics (controls), not exposed to the mentioned agents. Car painters and car platers were compared to car mechanics on Monday before work. Acute effects of car painting were tested by comparing the lung function values on Monday morning with those on Friday afternoon. Pulmonary function was evaluated by means of spirometry and a single breath nitrogen washout. Spirometry in painters and platers did not differ from that in controls, i.e., car mechanics. Closing volume in relation to vital capacity (CV%) was increased in car painters, suggestive of a "small airways disease" on Monday before work and tended to increase during a work week. Car platers did not differ from controls.

Adult↗

PubMed1987

Severe impairment in lung function induced by high peak airway pressure during mechanical ventilation. An experimental study.

We explored the pulmonary effects of continuous mechanical ventilation (MV) at a peak inspiratory pressure of 50 cm H2O in healthy, paralyzed, and anesthetized adult sheep during a period of 48 h. The 9 control sheep (Group A) were ventilated with 40% oxygen at a tidal volume of about 10 ml/kg and a peak inspiratory pressure of 15 to 20 cm H2O. All these animals remained stable throughout the 48 h of MV with no change in lung function. The 7 sheep in Group B were ventilated with 40% oxygen using a pressure-controlled ventilator at 50 cm H2O peak inspiratory pressure, at a VT of 50 to 70 ml/kg. All sheep in Group B developed severe respiratory failure and died or were killed within 2 to 35 h, and showed parenchymal consolidation at autopsy. The 9 sheep in Group C were ventilated as in Group B, except that 3.8% CO2 was added to the inspired gases: the Group C animals deteriorated more slowly, with little change in PaO2 but with a severely reduced FRC, VT, total static lung compliance, and grossly abnormal lungs at autopsy. We conclude that in this model, mechanical ventilation at peak airway pressure of 50 cm H2O will lead to progressive impairment in pulmonary mechanics, lung function, acute respiratory failure, and alveolar cellular dysfunction, as demonstrated by highly abnormal minimal surface tension values of saline lung lavage fluid in both study groups.

Animals↗

PubMed2000

Serum amino acids in relation to nutritional status, lung function and energy intake in patients with advanced pulmonary disease.

Malnutrition, hypoxia and energy deficit may affect protein metabolism. We wanted to evaluate the cross-sectional association between serum amino acids and fat-free mass in a group of hypoxic patients. We also wanted to explore, in the same group of patients, whether the blood amino-acid pattern could possibly be influenced by differences in lung function and energy intake. Serum amino acids were measured in 71 hypoxic underweight and normal-weight patients with advanced pulmonary disease and related to the fat-free-mass index, arterial oxygen (PaO2) and carbon dioxide tension (PaCO2), forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1) and energy intake. Only one amino acid (aspartic acid) remained significantly correlated to the fat-free-mass index after adjustments for age and sex (beta = -0.30, P=0.011). None of the amino acids were significantly correlated to PaO2 but alanine was significantly negatively correlated to PaCO2 (beta = -0.46, P<0.001), phenylalanine to FVC1 (beta = 0.52, P=0.001) and tyrosine to FVC (beta = 0.36, P=0.008). Citrulline and tryptophan were significantly correlated to energy intake (beta = 0.32, P=0.008; beta=0.37, P=0.009 respectively). In conclusion, there was no convincing association between fat free mass and serum amino acids. The negative effect of hypercapnia and reduced lung function on some serum amino acids was suggested and some amino acids were sensitive to reduced energy intake.

Adult↗

PubMed2001

Respiratory muscle strength, lung function, and dyspnea in patients with sarcoidosis.

BACKGROUND: Sarcoidosis is a systemic granulomatous disorder that is estimated to involve the skeletal muscles in up to 50% of patients. There is little information on the relationship among respiratory muscle strength, lung volumes, and the degree of dyspnea in patients with sarcoidosis. DESIGN AND PATIENTS: Lung function and maximal respiratory muscle force generation were measured in 36 patients with sarcoidosis (24 patients with pulmonary parenchymal infiltration) and 25 control subjects free of cardiorespiratory disease. Dyspnea in the sarcoidosis patients was quantitated by a score based on an activity tolerance assessment scale (ranging from rest to climbing hills or stairs). SETTING: Outpatient clinics of two teaching hospitals. RESULTS: Mean FVC, maximal voluntary ventilation, total lung capacity (TLC), functional residual capacity, residual volume (RV), and diffusing capacity of the lung for carbon monoxide (DLCO) were all at least 16% less than corresponding control values (in all cases, p < 0.001), while maximal inspiratory mouth pressure (PImax) and maximal expiratory mouth pressure (PEmax) were 37% and 39% less, respectively, than control values (both at p < 0.0001). PImax and PEmax declined with increasing dyspnea in a more graded, steady manner than did spirometric and DLCO values. For all measurements, however, the lowest mean values were found in patients with the most severe level of dyspnea. Strong inverse relationships were observed between PEmax and PImax with dyspnea level (p < 0.0001 and p < 0.01, respectively). Both PImax and PEmax correlated best with absolute values of FVC, while only PEmax correlated with RV (absolute and percent predicted) and percent predicted values of TLC. CONCLUSIONS: Maximal respiratory pressures correlate more closely with dyspnea level than lung volumes and DLCO. Since dyspnea is the most common presentation in early to moderately advanced sarcoidosis, respiratory pressures may be a more reliable index of functional work capacity and reflection of activities of daily living than standard tests of lung function.

Adult↗

PubMed2004

Respiratory symptoms and lung function in relation to atopy in children born preterm.

Respiratory morbidity is a major health problem among children. The aim of this study was to compare the background of respiratory problems of children born preterm with that of children born full-term, with special reference to atopy. The study comprised two cohorts of 10-year-old children: a group of 72 children born preterm with birth weights of less than 1,501 g, and a group of 65 children born full-term with birth weights of over 2,500 g. Histories of respiratory and atopic symptoms, and of risk factors for atopy, were collected with a questionnaire. Predisposition to atopy was verified by skin-prick testing and by measuring serum total and antigen-specific IgEs. Lung function was evaluated by spirometry testing. Children born preterm had significantly more wheezing. In them, the lifetime prevalence of wheezing was 43%, vs. 17% in children born full-term (P = 0.001; odds ratio, 3.71; 95% confidence interval, 1.67-8.25). In the full-term group, wheezing was associated with atopy: 64% of wheezers were atopic; in the preterm group, 23% of wheezers were atopic (difference between groups, P = 0.024). Children born preterm expired significantly lower spirometry values of forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), FEV1/FVC ratio, forced expiratory flow after 50% of vital capacity has been exhaled (FEF50), and forced expiratory flow during middle half of FVC (FEF25-75). In the preterm group, wheezing, asthma, and low gestational age, but not atopy, were significantly associated with lower lung function values. Wheezers of the preterm group who still wheezed at age 10 were significantly more often atopic than those who no longer wheezed (62% vs. 9%, P = 0.006). In conclusion, we demonstrated a significant difference between groups in the association of atopy with respiratory problems. However, although atopy was not associated with a lifetime prevalence of respiratory symptoms in prematurely born children, an atopic predisposition in them was found to associate with persistence of wheezing.

Child↗

PubMed2006

Lung function after acute and repeated exposures to extremely cold air (-110 degrees C) during whole-body cryotherapy.

Whole-body cryotherapy (WBC) is one mode of cold therapy, during which rheumatic patients are exposed to very cold air (-110 degrees C) in minimal clothing. It is also proposed to have a bronchodilatory effect. The aim was to examine the effects of WBC on lung function in healthy humans after acute and repeated exposures. Twenty-five healthy, non-smoking subjects participated in the study. They were exposed to WBC for 2 min three times per week for 12 weeks. The peak expiratory flow rate (PEF) and forced expiratory volume in 1 s (FEV1) were measured before and after (at 2 and 30 min) the first WBC, and then similarly at 4, 8 and 12 weeks. At all time points, after 30 min of the WBC the PEF values were slightly lower compared with values before the WBC, and the reductions reached statistical significance at 1 month (5.1 +/- 1.2%), and at 3 months (3.2 +/- 1.7%). After 30 min of the first WBC, the FEV1 was significantly reduced by 2.3 +/- 0.8%, but no other changes were observed during the study. In conclusion, the WBC induced minor bronchoconstriction in healthy humans instead of proposed bronchodilatation. The WBC seems not to be harmful for lung function, but should be used with caution in susceptible individuals.

Bronchoconstriction↗

PubMed1995

The effects of inhaled beclomethasone dipropionate on lung function and histamine responsiveness in recurrently wheezy infants.

Inhaled steroids improve pulmonary function and bronchial responsiveness in older asthmatics. Data from studies using subjective outcome measures to determine the effectiveness of inhaled steroids in infants with recurrent wheezing are equivocal. Therefore, this study tested the hypothesis that beclomethasone dipropionate improves pulmonary function, including bronchial responsiveness to histamine, in recurrently wheezy infants. The study was double blind, placebo controlled lasting nine weeks. After the first baseline week, pulmonary function was measured using the rapid thoracoabdominal compression technique and bronchial responsiveness assessed with a histamine challenge test. Infants were then randomly allocated to receive doses of placebo or beclomethasone dipropionate (100 micrograms/puff) from metered aerosols. Two puffs of test aerosol were administered twice daily for eight weeks via a large volume spacer fitted with a facemask. Symptoms were recorded daily and pulmonary function and bronchial responsiveness assessed at the end of the treatment period; 50 infants, median age 12 months (range 5 to 18 months), were recruited. Twenty three in the beclomethasone dipropionate group and 15 in the placebo group completed the study and had pairs of pulmonary function measurements. Three were probable treatment failures (one beclomethasone dipropionate, two placebo), three were possible treatment failures (placebo), and others were non-compliant with study protocol. Baseline variables were not significantly different between those infants who completed the study and those who did not. Beclomethasone dipropionate and placebo groups were similar in all respects at baseline. Lung function and symptoms improved for both groups of infants during the study. Bronchial responsiveness increased significantly in the placebo group but there were not statistically significant differences between groups for any of the other outcome measures. It is concluded that beclomethasone dipropionate (400 microgram daily) via a large volume spacer does not significantly improve lung function or symptoms in recurrently wheezy infants but might hav a beneficial effect on bronchial responsiveness.

Administration, Inhalation↗

PubMed1978

The Tecumseh study of respiratory illness. X. Relation of acute infections to smoking, lung function and chronic symptoms.

The relationship of acute respiratory illness and infection to chronic bronchitis was investigated in the community of Tecumseh, Michigan. Families were randomly selected for study from among all those in the community and they were followed for periods of one year. Occurrence of acute respiratory illnesses was identified on a weekly basis. Frequency of chronic symptoms of cough and sputum production was separately ascertained. Lung function studies were performed three times during the course of the surveillance year and blood specimens were collected at those times. The blood specimens were tested for rise in antibody titer with antigens of type A and B influenza, respiratory syncytial virus and Mycoplasma pneumoniae. Adults with mild or intermittent chronic symptoms of cough and sputum production experienced more acute respiratory illness than those without these symptoms. This finding was present at different levels of smoking frequency. A similar relationship was present when serologic infection rates were used in the analysis instead of acute illness incidence. When the population was dichotomized on the basis of lung function data, the segment of the population with more depressed values was found to have experienced higher infection rates. The results suggest that acute infection may play an independent role in the pathogenesis of chronic respiratory disease.

Acute Disease↗

PubMed2004

Prediction equations for normal and low lung function from the Health Survey for England.

The aim of this study was to derive new spirometric reference equations for the English population, using the 1995/1996 Health Survey for England, a large nationally representative cross-sectional study. The measurements used were the forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) of a sample of 6,053 "healthy" (nonsmokers with no reported diagnosis of asthma or respiratory symptoms) White people aged > or = 16 yrs. Multiple regression analysis, with age and height as predictors, was carried out to estimate prediction equations for mean FEV1, FVC and FEV1/FVC, separately for males and females. A method based on smoothing multiple estimates of the fifth percentiles of residuals was used to derive prediction equations for the lower limit of normal lung function. The new equations fit the current English adult population considerably better than the European Coal and Steel Community equations, and the proportions of people with "low" (below the fifth percentile) lung function are closer to those expected throughout the whole adult age range (16 to > 75 yrs). For the age ranges the studies share in common, the new equations give estimates close to those derived from other nonlinear equations in recent studies. It is, therefore, suggested that these newly developed prediction equations be used for the White English population in both epidemiological studies and clinical practice.

Adolescent↗

PubMedDate not supplied

[Association of lung function decline with the microsatellite polymorphism in the heme oxygenase-1 gene promoter, in a general population sample. Results from the Longitudinal European Community Respiratory Health Survey (ECRHS-France)].

Heme oxygenase (HO1) acts against oxidants which are thought to play a major role in the pathogenesis of chronic obstructive pulmonary disease (COPD). A (GT)n repeat polymorphism in the HO1 gene promoter can modulate the transcription of this gene in response to oxidative stress. We postulated that this polymorphism might be associated with the degree and decline of lung function in subjects exposed to oxidative stress (smokers). We genotyped 749 French subjects (20-44 years, 50% men, 40% never-smokers) who were examined in both 1992 and 2000 as part of the ECRHS. Lung function was assessed by measuring FEV1 (Forced Expiratory Volume in 1 second) and the FEV1/FVC (Forced Ventilatory Capacity) ratio. We compared long (L)-allele carriers ((GT)n > or = 33 repeats for one or two alleles) to non-carriers. During the 8-year study period, the mean annual FEV1 and FEV1/FVC declines were -30.9 +/- 31.1 ml/year and -1.8 +/- 6.1 units/year, respectively. The FEV1/FVC decline was steeper in L-allele carriers than in non-carriers (-2.6 +/- 5.5 vs -1.5 +/- 6.4, p = 0.07). There was a strong interaction between allele L and smoking. In 2000, allele L was associated with lower FEV1 and FEV1/FVC values in heavy smokers (J20 cig/day) only (p for the interactions, 0.07 and 0.002 respectively). Baseline heavy smokers carrying allele L showed the steepest FEV1 decline (-62.0 +/- 29.5 ml/year) and the steepest FEV1/FVC decline (-8.8 +/- 5.4 units/year) (p for the interactions, 0.009 and 0.0006). These results suggest that a long (L) HO1 gene promoter increases the risk of airway obstruction in heavy smokers.

Adult↗

PubMed1979

Regional lung function and central hemodynamics following normovolemic hemodilution in the dog.

Regional lung function, using xenon 133-radiospirometry, and central hemodynamics were studied following normovolemic hemodilution with dextran 70. Normovolemic hemodilution to hermatocrit values of 25% increased cardiac output and pulmonary blood volume significantly. The systemic oxygen transport and mixed venous oxygen tension were unchanged. The acute hemodilution did not significantly change the distribution of ventilation or prefusion within the lungs. It is hypothesised that a tendency to an increase in arterial oxygenation is due to a reduced interstitial pressure in the basal region of the lungs, resulting from water absorption by the hyperoncotic dextran used for hemodilution.

Animals↗

PubMed2005

Irreversible lung function deficits in young adults with a history of childhood asthma.

BACKGROUND: Asthma, traditionally characterized as reversible airway obstruction, might lead to structural changes and permanent impairment. OBJECTIVE: We sought to study the frequency, severity, and reversibility of pulmonary deficits in adults with a history of moderate-to-severe childhood allergic asthma. METHODS: Subjects (n = 121) previously enrolled in a randomized trial of immunotherapy for childhood asthma were recalled. Eighty-four young adults (age, 17-30 years; 78% male) were reevaluated by means of spirometry. Subjects with a postbronchodilator FEV1, forced vital capacity, or FEV1/forced vital capacity ratio less than or equal to the 5th percentile or 2 or more indices less than or equal to the 10th percentile (National Health and Nutrition Examination Survey III normative data) were invited to undergo complete pulmonary function testing, physical examination, and chest radiography after 1 week of 1 mg/kg daily prednisone. RESULTS: Of 84 subjects reevaluated, 40 (48%) had one or more spirometric indices less than or equal to the 5th and 10th percentiles (P < .0001). Twenty-eight of the 40 subjects were reassessed after prednisone treatment, of whom 21 (75%) did not improve. Adult and childhood (age 5-12 years) spirometric results were positively correlated (r = 0.49-0.72, P < .001). Abnormal adult spirometric results were associated with a longer duration of asthma at enrollment in the original trial (4.6 vs 6 years, P=.02), increased childhood methacholine sensitivity (PC20, 0.11 vs 0.18 mg/mL; P = .01), and birth prematurity (adjusted odds ratio, 10.7; 95% CI, 1.4-84.5). Immunotherapy status was unrelated to adult lung function. CONCLUSIONS: Many adults with a history of moderate-to-severe allergic asthma in childhood have irreversible lung function deficits. Childhood spirometry, duration of asthma, methacholine sensitivity, and birth prematurity might identify such individuals at a young age.

Adolescent↗

PubMed1991

Grain dust and lung function. Dose-response relationships.

Grain dust exposure has been associated with both acute and chronic respiratory abnormalities. We sought to answer two questions with regard to this exposure: (1) is there a dose-response relationship between grain dust and respiratory abnormalities, and (2) is there evidence to suggest that the allowable exposure (currently 10 mg/m3 in Canada) be lowered? We compared respiratory symptoms and lung function among 454 grain elevator workers and 55 civic workers to estimates of lifetime average grain dust exposure. A total of 781 personal air samples representing 20 different job titles over a 15-yr period were used to construct a job title-time period matrix for average dust exposure levels. The matrix was applied to each worker's detailed job history to obtain a value for estimated cumulative and average dust exposure. Significant dose-response relationships were seen for chronic phlegm production, breathlessness on exertion, FEV1, and FVC; and dose-response trends were evident for the longitudinal change in both FEV1 and FVC. Workers with estimated average exposure between 4 and 9 mg/m3 were found to have significantly lower values for FEV1 and FVC compared to both grain workers exposed to less than 4 mg/m3 on average and civic workers, despite no difference in duration of employment among these groups. The results indicate a strong dose-response relationship between grain dust exposure and both respiratory symptoms and lung function and also suggest that the current Canadian allowable exposure level of 10 mg/m3 is too high.

British Columbia↗

PubMed2000

Lung function changes in relation to menstrual cycle in females with cystic fibrosis.

Oestrogen and progesterone have been shown to have impact on cystic fibrosis transmembrane conductance regulator (CFTR) gene expression, tone of smooth muscle in the airways, immune response, exhaled nitric oxide and cytology in the tracheobronchial epithelium. The aim of this investigation was to study the influence of menstrual cyclicity on airway symptoms among cystic fibrosis (CF) females. Twelve CF women (mean age 30 years, mean Shwachman score 85) kept daily records during three menstrual cycles of lung function, sputum quality and need for intravenous antibiotics. Paired t-test was used as a statistical method to compare the airway symptoms between the time of ovulation (high levels of oestrogen and low levels of progesterone), the luteal phase (high levels of oestrogen and progesterone) and menstruation (low levels of oestrogens and progesterone). Forced expiratory volume in 1 sec (FEV1) was significantly higher during the luteal phase (66% of predicted) compared to during ovulation (63%) and menstruation (61%) (P<0.01). Forced vital capacity (FVC) showed the same pattern, being significantly higher during the luteal phase compared with during menstruation (mean 75% vs. 70%, P<0.01). In conclusion, lung function changes were found during menstrual cycles in women with cystic fibrosis. These changes are probably related to changes in progesterone levels during the menstrual cycles. This result warrants further studies to understand the complexity of CF lung disease in women.

Adolescent↗

PubMed2006

Changes in lung function and respiratory muscle strength after sternotomy vs. laparotomy in patients without ventilatory limitation.

A relevant ventilatory defect occurs after sternotomy, a very common thoracic surgical opening. The mechanism of the ventilatory impairment is unclear. Moreover, until now, the effect of sternotomy on pulmonary gas exchange has scarcely been investigated. We evaluated the time-course up to recovery and changes in spirometry, maximum static inspiratory (PI(max)) and expiratory (PE(max)) mouth pressures and pulmonary gas exchange in 6 patients after sternotomy and in 8 patients after laparotomy. All patients were free of cardiopulmonary diseases and had normal preoperative lung function. Sternotomy and laparotomy decreased forced vital capacity (FVC) by 67 and 49%, respectively. Moreover, the percent decreases in PI(max), PE(max) and PaO(2) after sternotomy vs. laparotomy were respectively 54 vs. 57%, 54 vs. 60%, and 22.6 vs. 7.5% (p < 0.05). Following sternotomy, the percent decreases in FVC correlated with the percent decreases in PI(max) (p < 0.05) and PE(max) (p < 0.01). The return to baseline values occurred after approximately 2 weeks. The present study shows that sternotomy can induce greater respiratory effects than laparotomy and suggests a relevant involvement of respiratory muscle weakness after surgical opening of the thorax. The study also supports the view that the evaluation of patient's lung function before sternotomy can be clinically relevant.

Adolescent↗

PubMed2003

Lung function interpolation by means of neural-network-supported analysis of respiration sounds.

Respiration sounds of individual asthmatic patients were analysed in the scope of the development of a method for computerised recognition of the degree of airways obstruction. Respiration sounds were recorded during laboratory sessions of allergen provoked airways obstruction, during several stages of advancing obstruction. The technique of artificial neural networks was applied for relating sound spectra and simultaneously measured lung function values (spirometry parameter FEV(1)). The ability of feedforward neural networks was tested to interpolate obstruction levels of FEV(1)-classes of which no members were included in the set used for training a network. In this way, a situation was simulated of an existing network recognising a new asthmatic attack under the same physiological conditions. It appeared to be possible to interpolate FEV(1) values, and it is concluded that a deterministic relationship exists between sound spectra and lung function parameter FEV(1). Variance optimisation appeared to be important in optimising the neural network configuration.

Asthma↗

PubMed1988

[Lung function and carboxyhemoglobin during the smog episode of January 1987].

During a phase of elevated ambient air pollution in January 1987 the alert level of the smog alarm recommendation in Northrhine Westfalia (FRG) was reached. The average concentrations during examinations were 0.255 mg/m3 SO2 and 3.2 mg/m3 CO at the closest station. In 111 healthy persons in Cologne and Düsseldorf, resistance measured by oscillatory method was elevated during this period compared to control examinations. In 59 patients with moderate airway-obstruction from different parts of West Germany lung function showed further deterioration during the smog phase: Airway resistance measured by body-plethysmography was higher than during a control period, FVC, FEV1, PEF and MEF75 were decreased. Finally levels of carboxyhemoglobin in blood also were increased in 46 healthy nonsmokers. The investigation shows, that even in moderate smog episodes (compared to earlier years) small, but consistent changes of lung function parameter can be measured.

Adolescent↗