Respiratory oscillometry identifies disease progression in interstitial lung disease.

Quantification differences between supine and prone CT in interstitial lung disease.

243 Comparison of Two Studies of the Upper Esophageal Sphincter (UES) Assist Device for the Treatment of Extraesophageal Reflux

241 Increased Reflux Severity on Impedance Predicts One-Year Pulmonary Function Decline in Pre-Lung Transplant Patients With Idiopathic Pulmonary Fibrosis

Study association of urinary Club Cell Protein with air pollution-related pulmonary function compromised among children

Purpose: Survivors of preterm birth are at high risk of chronic pulmonary disease. We examined lung function in the school-age children born preterm and investigated the relationship between lung function and clinical parameters. Methods: Thirty children born preterm were enrolled and divided into 2 groups: 14 very preterm (<32-week gestational age [GA]) and 16 moderate-to-late preterm (32- to 36-week GA). Pulmonary function tests (PFTs) were performed repeatedly during school-age and PFT parameters were compared with age-matched controls. The relationship between PFT and clinical parameters was also studied. Results: PFT parameters in the very preterm group were persistently reduced compared with age-matched controls (P<0.05). Half of the children had been diagnosed with asthma at the visit for the first PFT. Seventy-seven percent of patients in the very preterm group had bronchial hyperresposiveness. Birth weight, duration of oxygen therapy and mechanical ventilation in the neonatal in tensive care unit, and body weight at age 1 were associated with forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), or forced expiratory flow between 25% and 75% of expired vital capacity (FEF25%-75%) z-scores. Multiple regression analysis re vealed that body weight at age 1 was an independent predictor of FEV1 and FVC z-scores, and duration of oxygen therapy was inde pendently associated with FEF25%-75% z-scores (P<0.01 for all). Conclusion: No catch-up in lung function was observed in school-age children born very preterm. Lower body weight at age 1 might be an independent risk factor for reduced FEV1 and FVC, whereas long-term oxygen therapy might be associated with reduced FEF25%-75%. (Allergy Asthma Respir Dis 2021;9:69-75)

Aim: This study aims to reveal the relationship between Pulmonary Function Tests (PFTs) parameters and polysomnographic parameters. It aims to determine the guiding values in treatment selection, with the hypothesis that easily accessible PFTs parameters can be useful in clinical evaluation for patients with restrictive or obstructive type disorders. Material and Method: One hundred and forty-six patients with obstructive and/or restrictive pulmonary dysfunction who underwent polysomnography in the sleep clinic of our hospital between June 2019 and December 2019 were included in the study. Polysomnography (PSG) parameters and PFTs results were obtained. Age, gender, body mass index (BMI), Epworth Sleepiness Scale (ESS) score, PFTs parameters, apnea-hypopnea index (AHI), nocturnal oxygen saturation, tolerable positive airway therapy modality, and pressures were recorded. Results: Of 146 patients 34.9% were women and most (92.5%) had an obstructive disorder in PFTs. Of the patients with the obstructive disorder, 71 were being followed up with a diagnosis of chronic obstructive pulmonary disease (COPD) and 64 with a diagnosis of asthma. Interstitial lung disease was observed in 5 out of 11 cases (7.5%) with restrictive type disorder, and obesity resulted in restrictive disorder for the remaining 6 cases. Simple snoring was observed in 5.5%. Mild OSAS was observed at a rate of 30.1%. Moderate-severe OSAS was detected in 64.4% of the patients. When the relationship between optimal inspiratory/ expiratory positive airway pressure (IPAP/EPAP) values determined by automatic bilevel positive airway pressure (ABPAP) titration and PFTs parameters were analyzed, a moderate negative correlation was observed between IPAP value and forced vital capacity (FVC) (L) (r=-0.432, p=0035) Discussion: The results of this study show that PFTs parameters can be used to predict polysomnographic findings for patients with obstructive/restrictive disorders. Almost two-thirds of the patients with obstructive sleep apnea (OSA)-related symptoms in this group were observed to have moderate-severe obstructive sleep apnea syndrome (OSAS). Based on our results in ROC analysis, we believe that it would be appropriate to recommend titration with bilevel devices, especially for patients with forced expiratory volume in one second (FEV1)

Background: Usefulness of any test is determined by the availability of suitable standards. Lung function parameters are dependent on multiple anthropometric, genetic, and environmental factors. Some of these effects can be transient; hence, updating of normative standards for pulmonary function test (PFT) parameters on a regular basis in every ethnically distinct society is of overriding importance. Aims and Objective: To correlate lung function parameters [obtained from forced vital capacity (FVC) maneuver] with anthropometric variables and age, and to derive normative data for these parameters using the best possible combination of independent variables. Materials and Methods: This is a cross-sectional study of lung function in a non-hospital-based early adolescent male population. It included 91 male children in the age group of 10–15 years. Lung function parameters were obtained using a computerized spirometer with Fleisch-type pneumotachograph, which were subjected to correlational analysis with height, weight, and age. Regression analyses were performed for PFT parameters by introducing age/anthropometric data as independent variables. Results: All PFT parameters except forced expiratory volume in 1 s (FEV1)/FVC showed positive correlation with height, weight and age. Regression analysis yielded that height alone (FEV1 and MEF25), age alone (MEF50, MEF75, MMEF, and PEF), and age with height (FVC) contributed for the variance in these PFT parameters. Conclusion: A population-, age-, and sex-specific linear prediction equations are presented for various PFT parameters based on the cross-sectional study conducted in an early adolescent male population from south India.

Left atrial (LA) physiology and hemodynamics are intimately connected to cardiac and lung function in health and disease. This study examined the relationship between MRI-based left atrial (LA) size and function with MRI-based lung volume and pulmonary function testing (PFT) parameters in the population-based KORA study cohort of 400 participants without overt cardiovascular disease. MRI quantification assessed LA size/function in sequences with and without ECG synchronization, alongside lung volume. Regression analysis explored the relationship of LA with MRI lung volume and PFT parameters. Among 378 participants (average age 56.3 ± 9.2 years; 42.3% women), non-gated LA size averaged 16.8 cm2, while maximal and minimal LA size from gated measurements were 19.6 cm2 and 11.9 cm2 respectively. The average MRI-derived lung volume was 4.0 L, with PFT showing a total lung capacity of 6.2 L, residual lung volume of 2.1 L, and forced vital capacity of 4.1 L. Multivariate regression analysis, adjusted for age, gender, and cardiovascular risk factors, revealed an inverse association between maximum LA size, non-gated LA, and LA area fraction with lung volume (ß = − 0.03, p = 0.006; ß = − 0.03, p = 0.021; ß = − 0.01, p = 0.012), with no significant association with PFT parameters. This suggests that MRI-based assessment may offer greater sensitivity in detecting subclinical LA impairment than PFT.

Fitting adequate prediction equations for pulmonary function test (PFT) parameters is crucial in the analysis of lung function tests and their interpretation. Our work aimed at studying the necessity of building population specific prediction equations, rather than using prediction equations built-in in commercial equipment. We used as an example results of studies carried out among Israeli schoolchildren. Second to sixth grade children (7-13 years old), 1064 boys and 1211 girls, were studied in Tel-Aviv. PFT (forced vital capacity, forced expiratory volume in 1st second, peak expiratory flow, forced expiratory flow in 50% volume, forced expiratory flow in 75% volume) performed by these children were adjusted for height, weight and age, for each sex separately, by a multiple regression procedure. Predicted PFT parameters of 300 boys and 301 girls aged 7-13 years, living along the southern shore of Israel, were calculated using the equations built for the same aged Tel-Aviv children as well as the prediction equations built-in in the spirometer used. The ratios between the observed PFT parameters in the southern children and their expected values, using the Israeli population specific equations, were around 1.00. Using the built-in equations resulted in ratios around 0.90. The development of population specific prediction equations for PFT parameters is necessary. Such equations should be used both in clinical assessment to minimize misclassification (healthy/sick child) and in epidemiological studies.

The aim of this study was to assess the feasibility of combined xenon-enhanced ventilation (V) and iodine-enhanced perfusion (Q) dual-energy computed tomography (DECT) to evaluate regional V and Q status in patients with chronic obstructive pulmonary disease (COPD). Combined V and Q DECT imaging was performed in 52 prospectively enrolled male COPD patients. Virtual noncontrast images, V maps, and Q maps were anatomically coregistered with deformable registration and evaluated using in-house software. After normalization of the V and Q values of each pixel, normalized V and Q, V/Qratio, and VQmin (ie, the smaller of the V and Q in each pixel) maps were generated. For visual analysis, the V/Qratio pattern was determined to be matched, mismatched, or reversed mismatched and compared with the regional disease patterns--emphysema with/without bronchial wall thickening, bronchial wall thickening, or normal parenchyma--in each segment. The mean V, Q, V/Qratio, and VQmin values and the standard deviation of the V/Qratio (V/QSD) of each patient were quantified and compared with pulmonary function test (PFT) parameters using the Pearson correlation test. Segments with normal parenchyma showed a matched V/Qratio pattern, whereas segments with bronchial wall thickening commonly showed a reversed mismatched V/Qratio pattern. In the emphysema areas, the matched, mismatched, and reversed mismatched patterns were mixed without a dominant pattern. In quantitative analysis, the mean V, Q, VQmin, and V/Qratio values were significantly and positively correlated with PFT parameters (r = 0.290-0.819; P < 0.05). The V/QSD was significantly and negatively correlated with PFT parameters (r = -0.439 to -0.736; P < 0.001). VQmin values showed the best correlation with PFT parameters (r = 0.483-0.819; P < 0.001). Visual and quantitative assessment of the regional V, Q, V/Qratio, and VQmin is feasible with combined V and Q DECT imaging and significantly correlate with PFT results in COPD patients. Assessing disease patterns using conventional computed tomography images may not provide correct evaluation of regional V and Q in COPD patients with emphysema.

BackgroundDiseases affecting the lungs and airways contribute significantly to the global burden of disease. The problem in low- and middle-income countries appears to be exacerbated by a shift in global manufacturing base to these countries and inadequate enforcement of environmental and safety standards. In Ghana, the potential adverse effects on respiratory function associated with occupational wood dust exposure have not been thoroughly investigated.MethodsSixty-four male sawmill workers and 64 non-woodworkers participated in this study. The concentration of wood dust exposure, prevalence and likelihood of association of respiratory symptoms with wood dust exposure and changes in pulmonary function test (PFT) parameters in association with wood dust exposure were determined from dust concentration measurements, symptoms questionnaire and lung function test parameters.ResultsSawmill workers were exposed to inhalable dust concentration of 3.09 ± 0.04 mg/m3 but did not use respirators and engaged in personal grooming habits that are known to increase dust inhalation. The sawmill operators also showed higher prevalence and likelihoods of association with respiratory symptoms, a significant cross-shift decline in some PFT parameters and a shift towards a restrictive pattern of lung dysfunction by end of daily shift. The before-shift PFT parameters of woodworkers were comparable to those of non-woodworkers, indicating a lack of chronic effects of wood dust exposure.ConclusionsWood dust exposure at the study site was associated with acute respiratory symptoms and acute changes in some PFT parameters. This calls for institution and enforcement of workplace and environmental safety policies to minimise exposure at sawmill operating sites, and ultimately, decrease the burden of respiratory diseases.

The V50/V25 Ratio, a Marker of Small Airway Disease, Is Highly Predictive of Survival after Allogeneic Hematopoietic Cell Transplantation

ObjectivesOverweight and obesity are known to cause various patterns of alteration to the pulmonary function test (PFT) parameters. We sought to investigate gender differences in PFT parameters and examine the relationship between body mass index (BMI) and PFT parameters.MethodsWe conducted a retrospective study of 126 patients referred for a PFT by various medical specialties between January and December 2015. PFT was measured using spirometry, and BMI was calculated using Quetelet’s index.ResultsFemale patients exhibited lower mean values for all PFT parameters compared to male patients. The forced vital capacity (FVC)% predicted was less than 80% for all patients while the ratio of forced expiratory volume in 1 second (FEV1)/FVC was higher with increased BMI. BMI was positively correlated with peak expiratory flow in all patients, and with FEV1/FVC ratio in males but not in females.ConclusionsIn our studied population, males exhibited higher mean values of PFT parameters than females. Increased BMI may be associated with a restrictive pattern on spirometry.

BackgroundInterstitial lung disease (ILD) encompasses a broad group of progressive lung disorders marked by inflammation and fibrosis, leading to irreversible damage. Early screening plays a pivotal role in identifying disease onset and optimizing patient outcomes. This study assessed the correlation of diffusing capacity for carbon monoxide (DLCO) with the six-minute walk test (6-MWT) and pulmonary function test (PFT) parameters. Moreover, the correlation between 6-MWT and PFT parameters was evaluated.MethodsThis cross-sectional study, involving 30 patients with high-resolution computed tomography-proven ILD, was performed over a period of 24 months (October 2022 to September 2024) in the Department of Respiratory Medicine of Government Medical College, Nagpur, in Nagpur, India. All patients underwent 6-MWT and PFT. Vital parameters were assessed before and immediately after 6-MWT, and the six-minute walk distance (6-MWD) was calculated.Results6-MWT had a weakly positive and significant correlation with forced vital capacity (FVC) (r=0.38; p=0.037), but not with forced expiratory volume in one second (FEV1) and DLCO (p>0.05). DLCO had a positive and non-significant correlation with total lung capacity, FEV1, and FVC, while correlation with FEV1/FVC ratio was negative and non-significant (p>0.05). Actual 6-MWD was significantly lower than the predicted value (p<0.001). Immediately after 6-MWT, there was a significant decrease in oxygen saturation, while systolic blood pressure, pulse rate, and respiratory rate increased significantly compared to baseline 6-MWT values (p<0.001), with diastolic blood pressure being comparable at both intervals (p>0.05).Conclusion6-MWT had a weak but significant correlation with FVC, while the correlation between other parameters was not significant. These tests highlight functional limitations and physiological derangements, thus strengthening their role in ILD management.

Context:For the follow-up of patients with idiopathic interstitial pneumonias (IIP), it is unclear which parameters of pulmonary function tests (PFT) and exercise testing would correlate best with high-resolution computed tomography (HRCT)..Aim:To find out the correlation of symptom scores, PFTs and exercise testing with HRCT scoring in patients diagnosed as idiopathic interstitial pneumonia.Settings and Design:Cross-sectional study done in pulmonary medicine outpatients department of a tertiary care hospital in South India.Materials and Methods:Consecutive patients who were diagnosed as IIP by a standard algorithm were included into the study. Cough and dyspnea were graded for severity and duration. Pulmonary function tests and exercise testing parameters were noted. HRCT was scored based on an alveolar score, an interstitial score and a total score. The HRCT was correlated with each of the clinical and physiologic parameters. Pearson's/Spearman's correlation coefficient was used for the correlation of symptoms and parameters of ABG, PFT and 6MWT with the HRCT scores.Results:A total of 94 patients were included in the study. Cough and dyspnea severity (r = 0.336 and 0.299), FVC (r = −0.48), TLC (r = −0.439) and DLCO and distance saturation product (DSP) (r = −0.368) and lowest saturation (r = −0.324) had significant correlation with total HRCT score. Among these, DLCO, particularly DLCO corrected % of predicted, correlated best with HRCT score (r = −0.721)..Conclusion:Symptoms, PFT and exercise testing had good correlation with HRCT. DLCO corrected % of predicted correlated best with HRCT.