Study Of Cardiopulmonary Function Research Articles

Impact of Thoracic Cage Dimension and Geometry on Cardiopulmonary Function in Patients With Congenital Scoliosis: A Prospective Study.

A prospective study of cardiopulmonary function in patients with congenital scoliosis (CS). To investigate the relationship of thoracic cage deformity and exercise tolerance in CS patients. Congenital thoracic scoliosis and chest deformity lead to restrictive pulmonary dysfunction and in some severe cases cause cardiopulmonary failure. However, it is still unknown the relationship between thoracic deformity and exercise performance. Patients with congenital thoracic spinal deformity were included and had radiological assessment of thoracic cage, pulmonary function testing, and cardiopulmonary exercise testing. Thoracic dimension including height, width, and depth were measured and geometry parameters were calculated. Two-tailed Pearson and Spearman correlation test and linear regression analysis were performed to investigate correlation of radiographic parameters, pulmonary function, and physical capacity. Sixty patients (41 females and 19 males) were included, with an average age of 18.9 years. Patients with smaller thoracic height (P < 0.001) and width (P < 0.01) and larger depth (P < 0.05) had significantly worse static pulmonary function. In exercise testing, these patients showed significant tendency of ventilation insufficiency, including lower minute ventilation (P < 0.05), faster breathing frequency (P < 0.05), and smaller tidal volume (P < 0.01). Thoracic depth was negatively correlated to exercise capacity, reflected by work rate (P < 0.001), peak oxygen intake (P < 0.001), and heart rate (P = 0.043). Patients with abnormal thoracic geometry, especially a lower ratio of height to depth and a lower ratio of width to depth, have significantly worse static pulmonary function and exercise capacity (all P < 0.05). Decreasing thoracic height and width results in restrictive pulmonary dysfunction. Distortion and asymmetry of the thoracic cage are associated with abnormal breathing pattern and reduction of exercise capacity. 3.

Cardiopulmonary Functional Status in Children with SCD at Baseline: Pulse Pressure As a Biomarker of Early Compromise

Background: Sickle cell disease (SCD) is a chronic illness associated with varying degrees of decrease in exercise capacity. Affected children are as much as 50% less physically active than controls. The reasons for the reluctance of SCD children to participate in sports and/or intense physical activities are complex, not entirely understood and not well studied in this young population with chronic anemia. The six minute walk test (6MWT) is an exercise test, validated as screening tool for assessing cardiopulmonary functional status in several pediatric cohorts of healthy children and in children with chronic illnesses including SCD. This test is a submaximal exercise test and reflects the patient’s capacity to undertake daily activities. We have previously reported that children with SCD experience a decrease in oxy-hemoglobin oxygen saturation as determined by pulse oximetry after the test.Material and methods: We performed a prospective, multicenter study of cardiopulmonary function in 409 children with SCD (age 5-20 years) and 70 age and race matched controls as part of the PUSH study. Each subject was at steady state, at least three weeks from an acute exacerbation and/or a blood transfusion. Subjects and controls underwent echocardiogram, hematologic testing, and 6MWT according to standard protocols. 6MW distance was compared between SCD cases and controls by the student t-test. A linear regression model was developed to assess the independent predictors of 6MW in patients.Results: SCD patients had lower 6MW distance (p<0.001), higher resting tricuspid regurgitation velocity and higher left ventricular mass index than controls. They also had lower resting systolic blood pressure (SBP) (p<.004) and diastolic blood pressure (DBP) (p<0.02). Height and BMI influenced 6MWT in both controls and subjects, but BMI lost its predictive value when adjusted for hemoglobin in the subjects. The independent predictors of 6MWT in SCD patients were hemoglobin, height and pulse pressure (Table 1). Among the children with SCD, the ability to increase pulse pressure during the 6MWT was associated with longer walk distance (p<0.001). These were the children in the lowest hemoglobin quartiles.Conclusions: Our data confirm that under basal circumstances SCD children have lower exercise capacity than age and race matched controls in a large, prospective cohort. We identify low hemoglobin as a main determinant of exercise capacity, as measured by the 6MWT. We identify a subset of patients that exhibit early compromise of exercise ability, recognizable by a lesser than expected widening of pulse pressure (ie: increase in systolic BP) upon exercising. A possible explanation is that these children are already at maximum cardiopulmonary abilities at rest, and cannot meet the demands of even minimal exercise. Table 1Independent predictors of 6MW distance (m) in SCD patients (N=368)*.VariableB (95%CI)P valueStandardized betaHeight (cm)**3.7 (2.6-4.9)<0.0010.35Pulse BP, mmHg1.4 (0.7-2.1)<0.0010.19Hemoglobin, mg/dL5.3 (1.1-9.4)0.0130.12*Analysis is adjusted for hydroxyurea therapy**Height over 130 cm did not have significant effect on 6MW distance. DisclosuresNo relevant conflicts of interest to declare.

A study of cardiopulmonary function and working capacity of sojourners acutely exposed to different altitude levels in Ethiopia

Forced vital capacity (fvc, L/sec), forced expiratory volume (fev1, L/sec), fev1%, forced expiratory flow rate (fef 200—1200 ml,. L/sec), forced mid-expiratory flow rate (fmf 25—75 %, L/sec), peak expiratory flow rate (pefr, L/min), minute ventilation (ve, L/min), oxygen saturation of arterial blood (SaO2%), working capacity (Kgm/min/m2 body surface area), pulse rate (beats/min) and arterial blood pressure (mmHg) were studied in eight male sojourners descending to 1370—490 m and ascending to 2550—3300 m from their altitude of residence (2440 m). Of the lung function indices, mean fef 200—1200 ml increased from 6.54 L/sec at 2440 m to 7.18 L/sec and 8.33 L/sec, respectively, at 2550 m and 3100 m. It was not measured at 3300 m for lack of electric power supply. Mean values of fef 200—1200 ml were found to be correlated to the altitudes of investigation significantly (r=0.7316). The increase in fef 200—1200 ml probably reflects that large airways tend to open up more widely perhaps concomitant with enlargement of alveolar spaces at 2550 m and above to compensate for the reduced pao2 and reduced O2 uptake. Mean ve showed a 4—5-fold increase with exercise essentially at all levels of altitude. Acute altitudinal effect became quite evident at 3300 m. At rest, ve increased from 5.62 L/min at 2440 m to 7.78 L/min at 3300 m. During exercise, increase in ve with ascent apparently protects the low O2 saturation (91.9% at rest and 86.9% in this study). Although the mean of exercise ve was markedly increased only at 3300 m, its overall correlation with altitude (r=0.6698) and mean working capacity (r=-0.6426) was quite significant (two-tailed P=0.0236). SaO2% was found to be correlated with mean (r=0.7955) and individual measurements (r=0.7628) of working capacity. Mean working capacity was reduced by about 20% with ascent and increased by about 9% with descent. It was negatively correlated with ascent (r=-0.9101). This signifies that physical performance is quite limited by hypoxia with ascent. Mean pulse rate, which was 75 beats /min at 2440 m increased to 82 beats/min at 490 m. It decreased to 72 beats/min at 3300 m. This is probably attributable to the decrease in ambient temperature and relative humidity with ascent and to the increase with descent. Arterial blood pressure (mean systolic/diastolic) was found to be 100.1 / 62.13 mmHg at 2440 m, 93.1/59.4 mm Hg at 490 m, 99.6/59.4 at 1370 m and 101.46—102.5/62.5—63.1 mmHg at 2550–3300 m. This pattern of change seems to be attributable to changes in peripheral vascular resistance which is apparently secondary to changes in ambient temperature and relative humidity. One of the sojourners experienced only generalised fatigue. This suggests that physiological alterations occurring at 3300 m cannot apparently induce acute mountain sickness in residents of medium altitude. Key words/phrases: Cardiopulmonary functions, high altitude, Sojourners, working capacity SINET: Ethiopian Journal of Science Vol.25(1) 2002: 71-82

Growth of pulmonary circulation in normal pig--structural analysis and cardiopulmonary function.

Morphometric analysis of the postnatal development of the pig lung, with emphasis on alveoli and vessels, shows features of growth similar to man, but occurring at a much faster rate in the pig, which telescopes in the first 3 mo the changes seen in human childhood and adolescence. During the first weeks, arteries (birth to 2 wk) and alveoli (1--12 wk) increase in number, whereas increase in size continues until adulthood. Wall thickness decreases soon after birth in arteries 15--200 micrometer, and by 8 wk in those 200-1,000 micrometer. At this age the adult left ventricular predominance in weight is already present. Throughout growth the venous wall thickness does not change. Cardiopulmonary function studies in pigs, from 2 to 16 wk, show that, during the period of rapid postnatal lung growth, there is no change in tidal volume, dynamic compliance, and thoracic gas volume as related to body weight; right ventricular and pulmonary arterial pressures also remain unchanged, whereas pulmonary vascular resistance decreases during the 1st mo.

A Study of Cardio-Pulmonary Function During Orthostatic Hypotension in Patients with Cervical Spinal Cord Injury

Investigations were made on the admitted patients with complete quadriplegics while patients were on supine and on elevated position with and without applying abdominal bandage respectively.Clinical data including blood pressure, puls rate, respiratory rate, blood gass analysis were examined on each condition.The data showed tachycardia, hyperventilation, marked hypotension, increased PO2 and decreased PCO2 on the patients standing without abdominal bandage as compared with patients on lying position. The data of patients applying abdominal bandage were in between them.The results suggest there may be some regulation to enhance more efficient gaseous exchange other than decreasing vascular resistance to maintain circulatory volume in the brain of these patients who can remain in consciousness during marked hypotension.

Study of cardiopulmonary function on exposure to high altitude. I. Acute acclimatization to an altitude of 3,5000 to 4,000 meters in relation to altitude sickness and cardiopulmonary function.

A study was made of acute altitude acclimatization in 32 normal subjects. Of 24 studied in detail, 8 had major or persistent altitude sickness, which persisted at two weeks in 6. Clinical severity of sickness varied with the extent of lung congestion and decrease in peak expiratory flow. The latter decreased by 58 liters per min (P < 0.001) at two days but later increased slightly during the three-week period of study. In most subjects, it returned to the original value on return to sea level. Blood pressure increased in most subjects at 24 to 48 hours and remained increased for three weeks and decreased to original values on return to sea level.

Study of cardiopulmonary function on exposure to high altitude. II. Effects of prolonged stay at 3,500 to 4,000 meters and reversal on return to sea level.

Study of cardiopulmonary function on exposure to high altitude. II. Effects of prolonged stay at 3,500 to 4,000 meters and reversal on return to sea level.

Respiratory Impairment following Thoracoplasty: Case Report in a Child with Cardiopulmonary Function Studies and Comments on Prognosis

Respiratory Impairment following Thoracoplasty: Case Report in a Child with Cardiopulmonary Function Studies and Comments on Prognosis

CARDIOPULMONARY FUNCTION STUDIES IN WORKERS DEALING WITH ASBESTOS AND GLASSWOOL.

CARDIOPULMONARY FUNCTION STUDIES IN WORKERS DEALING WITH ASBESTOS AND GLASSWOOL.

Cardiopulmonary insufficiency associated with myotonic dystrophy

A thirty-one year old man with a long history of myotonic dystrophy was observed to have somnolence, cyanosis, Cheyne-Stokes breathing and a cardiac arrhythmia. Cardiopulmonary function studies revealed a decrease in vital capacity and total lung volume and a reduction in maximal breathing capacity. In addition hypercapnia, hypoxemia, and pulmonary hypertension were observed. It is suggested that dystrophy of the respiratory muscles and possibly of the myocardium in this patient produced the syndrome of alveolar hypoventilation.

Clinical Dyspnea and Cardiopulmonary Function Studies

An attempt has been made to utilize the modern concepts of dyspnea producing factors as applied to a variety of cardiac and pulmonary diseases. In the cardiac patients, myocardial failure and pulmonary artery hypertension represent the two primary factors acting, alone or in combination, to produce dyspnea. At the first stage of the disease, both of them may be reversible as a result of conservative or surgical treatment, while their protraction will lead to increased lung rigidity of irreversible nature and permanent dyspnea. In bronchopulmonary diseases, the disturbed mechanical factors of breathing open the stage for dyspnea, while the appearance of pulmonary artery hypertension and heart failure usually represents irreversible damage. Although a good clinical approach is of paramount importance, it is clear that in most dyspneic patients, at least a minimum of relatively simple cardiopulmonary function tests are required for the correct understanding and adequate therapeutic approach. This minimum includes the spirographic record, arterial blood O2, pCO2 and pH analysis. For the evaluation of cardiac dyspnea, the cardiac catheterization is still the most useful tool.

The surgeon and cardiopulmonary physiology.

Cardio-pulmonary function studies of patients have now come to maturity. An accurate method of predicting the normal lung compartments for a particular patient has been devised. Deviations from this are significant. Mitral stenosis results in an increase in residual volume and this is directly proportional to the extent of the functional impairment, the pulmonary capillary pressure and the mean pulmonary artery pressure. In patients with “litre” hearts the large heart of itself displaces residual air and the augmented residual volume is then reduced by an amount commensurate with the enlargement. The progress of a disease such as mitral stenosis and the effect for example of surgery can be assessed by repeated residual volume determinations which are devoid of psychogenic factors. Occult pulmonary edema is revealed by vital capacity and maximum breathing studies before and after the use of a bronchodilator aerosol where increases in both occur. Frank pulmonary edema decreases the residual volume first and then the vital capacity. Constrictive mediastinal pericarditis is shown by cardiac catheterization as a notch on the right ventricle dicrotic wave. Diseases with pulmonary fibrosis can be differentiated from emphysema by a decreased total lung capacity and a relatively normal alveolar nitrogen, timed vital capacity and residual volume. A diminished oxygen removal at rest and exercise occurs in the alveolocapillary block syndrome even if the hemoglobin saturation is normal. It also occurs where there is impaired perfusion of a lung or parts of a lung because of vascular obstruction or impaired cardiac output. It remains low on exercise if the defect is fixed such as occurs in malignant involvement of the pulmonary artery. If the neoplasm is operable it does not interfere with the pulmonary blood flow and the O2 removal is normal at rest and increases on exercise. Cardio-pulmonary function studies before and after exercise determine the finiteness of thoracic surgery. Angiocardiography shows perfusion changes in the lungs. Brachial artery gas analysis indicates hyperventilation with decreased CO2 and decreased pulmonary diffusability if the oxygen content is low (and the heart normal). In bilateral lung cyst a low oxygen removal indicates ventilation of useless (nonperfused) lung zone. In mitral stenosis the alveolar diameter is doubled due to an increased pulmonary capillary pressure which in turn reflects itself as an increased residual volume.

Preoperative and postoperative cardiopulmonary function studies in patients with bronchiectasis.

Preoperative and postoperative cardiopulmonary function studies in patients with bronchiectasis.

Cardiopulmonary function studies in a patient with ligation of the left pulmonary artery

A case is reported in which cardiopulmonary function studies were performed on a patient two years after the left pulmonary artery was ligated. Cardiac catheterization revealed normal pressures in the pulmonary artery as well as in the chambers of the right side of the heart. The results of pulmonary function tests were almost completely within normal limits. The only abnormalities found were a slight increase in cardiac index and hyperventilation under all conditions of observation. However, bronchospirometry disclosed a marked Table III Results of Cardiocirculatory Studies Normal Observed Pressures in mm. of mercury Pulmonary artery, systolic <30 23 Right ventricle, systolic <30 24 Right auricle, mean <5 3 Cardiac index at rest (cardiac output, L./min./b.s. m 2) 3.05 + 0.6 4.23 limitation of gas exchange in the left lung, with carbon dioxide output limited to a lesser degree than oxygen consumption. These findings are consistent with the assumption that anastomoses from the bronchial artery result in a considerable blood flow through the pulmonary capillary bed of the left lung.