[Exercise test in respiratory function tests (author's transl)].
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Chest radiographic scores and respiratory function on 80 sets of results from 50 patients with Cystic Fibrosis were analyzed. Chest radiographic scores were assessed independently using the method of Chrispin and Norman. Respiratory function tests were found to correlate well with the chest radiographic score, the best correlation being with the forced expiratory volume in 0.75 sec. to forced vital capacity ratio F.E.V. 0.75/ F.V.C. (r = -0.674 n = 80 p less than 0.001).
The relationship between pulmonary haemodynamics and values of various respiratory function tests was studied in patients with mild chronic obstructive pulmonary disease (COPD) and the following results were obtained. (1) The value of mean pulmonary artery pressure (mPAP) at rest in COPD patients was slightly elevated to 19.4 mmHg on average compared with our control value of less than 18 mmHg. (2) Analysis of the data of 11 routine respiratory function tests in 88 COPD patients extracted two principal components: an index of the expiratory function and an index for overinflation of the lung. (3) In individual patients, mPAP expressed the severity of pulmonary circulatory disorder roughly inverse to the factor score of the first principal component (index of expiratory function) but not to that of the second principal component (overinflation of the lung). (4) Discriminant analysis was performed in all 88 COPD patients according to data from the 11 respiratory function tests. The probability of mPAP being above or below 18 mmHg was 18.2%. (5) The relationship between the predicted EPOI value and the factor score was similar to that between mPAP and the factor score. EPOI (exercise pulmonary artery pressure-oxygen consumption index) was calculated with the following equation: EPOI = (mPAPex#-mPAPrest)/[VO2ex-VO2rest)/BSA##). On the other hand, EPOIpred was calculated with the prediction equation obtained from multiple linear regression (dependent variable; EPOI, independent variable; respiratory function).
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Twenty seven patients on artificial ventilation were studied in terms of gas exchange, respiratory mechanics and haemodynamics. The characteristics of acute respiratory failure (dead space effect, shunt effect, disturbances in respiratory mechanics) may be identified and their severity determined. The effects of adjusting artificial ventilation settings (tidal volume, frequency, inspiration/expiration ratio, inspiratory flow, end expiratory pressure, inspired oxygen fraction) may be studied and better adapted to the individual functional requirements of each patient. An organigram of settings based upon the experience gained in this series is suggested.
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