Dynamic Lung Function Parameters Research Articles

Relationship of dynamic lung function parameters in pregnant women with different degrees of anemia: A cross-sectional study in Odisha

Background: Anemia has potential adverse effects on mother and fetus. Moderate-to-severe anemia in pregnancy reduces diaphragmatic strength and leads to exertional dyspnea. Aims and Objective: In the present study, we tried to establish a relationship between dynamic lung functions and different degrees of anemia in pregnant women of Odisha. Materials and Methods: A cross-sectional study was conducted during the year 2015–2016, consisting of 90 anemic pregnant females (30 in each trimester) within the age group of 20–35 years. 110 age-matched healthy pregnant women (35 in first and second and 40 in third trimester) were taken as controls. The dynamic lung function assessment was done in the subjects by Medspiror with Helios 401 software, and hemoglobin (Hb) was estimated. Forced vital capacity (FVC), forced expiratory volume (FEV1), FEV1/FVC, forced expiratory flow (FEF25–75%), peak expiratory flow rate (PEFR), and maximum voluntary ventilation (MVV) were the parameters studied. The statistical tests employed were the student’s t-test, analysis of variance, Bonferroni, Univariate linear regression, and multiple linear regression. Results: With increasing severity of anemia, a progressive decline in dynamic lung functions was seen in anemic pregnant women. FVC, FEV1, FEF25–75%, PEFR, and MVV values showed a significant decline (P < 0.001), while FEV1/FVC value was increased from control to severe anemic pregnant subjects (P < 0.001). With post hoc Bonferroni, all the parameters were not significant when compared within control and mild anemic pregnant. FVC, FEV1, PEFR, and MVV values were significantly reduced in moderate-to-severe anemia compared to control (P < 0.001) and in severe anemia compared to mild and moderate group (P < 0.001). FEV1/FVC was significantly increased in moderate-to-severe anemia compared to control (P < 0.001) and in severe anemia compared to mild group (P < 0.01). FEF 25–75% value was only reduced in severe anemic versus control. When linear regression analysis and multiple linear regression for dynamic lung function parameters were applied, by considering Hb% as an independent variable and adjusting the effect of age, body mass index, and trimester, there was a significant positive association in all the parameters (P < 0.001), except FEV1/FVC with significant negative association with one unit change in Hb% (P < 0.001). Conclusion: Moderate-to-severe anemia adversely affects pulmonary functions in pregnant women. Proper interventional strategies and anesthesia should be carried out to prevent adverse outcomes in anemic pregnant women.

Effect of Recumbent Body Positions on Dynamic Lung Function Parameters in Healthy Young Subjects.

The change in body position can alter pulmonary functions parameters, therefore it is important to understand the physiological basis of these alteration. Ideally, spirometry is done in sitting position until the subject is unable to do so. Hospitalized patients often assume recumbent body positions irrespective of underlying pathology. Hence, need arises to find out best recumbent body positions for the benefit of these patients to make breathing comfortable for them. The aim of this study was to find out whether the change from the supine position to crook lying and Fowler's position (45° dorsal elevation) causes change in spirometric parameters. The present work was carried out at Department of Physiology, King George's Medical University, Lucknow. A total 131 apparently healthy individuals were enrolled in this cross-sectional study. Lung function was assessed using a PC-based spirometer according to American Thoracic Society guideline in the supine, crook lying and Fowler's position (45° dorsal elevation). The study consisted of 131 subjects (male 66%, female 34%), with mean age of 20.15±2.71 years and BMI 21.20±3.28 Kg/m2. Repeated measures ANOVA with post hoc Bonferroni test was used to compare the mean values between each body position. Compared with the other two positions, Fowler's position showed significantly (p<0.05) higher values for FVC, FEV1, PEF, FEF25-75%. Recumbent body position influences spirometric parameters in young healthy subjects. We demonstrated that spirometric values are higher in the Fowler's position than in the supine or crook lying position. The results of this study will help in the selection of the best alternative position for the spirometry in bed ridden patients.

Study of dynamic lung function parameters in normal, overweight, and thin school boys

Background: In India, childhood undernutrition and obesity both are major health concerns. Lung functions are affected in both thin and obese children. Body mass index (BMI)-for-age is a simple tool suggested by the World Health Organization for categorizing children and adolescents below 19 years. Aim: The aim of the study was to compare dynamic lung function parameters of overweight and thin boys with normal boys. Materials and Methods: One hundred and fifty school boys of age group 12–16 years were included as a convenience sample after screening 234 students. BMI-for-age chart developed by the World Health Organization was used to categorize participants into normal (n = 50), overweight (n = 50), and thinness (n = 50) group. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV3, peak expiratory flow rate (PEFR), and forced expiratory flow (FEF) at the midportion of FVC (FEF25-75) were measured by MEDSPIROR. Unpaired t-test and Pearson correlation (r) were used according to the necessity. Results: Thin boys had lower FVC (P = 0.019), FEV1 (P = 0.048), FEV3 (P = 0.007), PEFR (P = 0.0002), and FEF25-75 (P = 0.003) compared to normal boys. Overweight boys showed significantly increased FVC (P = 0.019), FEV1 (P < 0.0001), and FEV3 (P = 0.0005) compared to normal boys. BMI of thin boys showed positive correlation with FVC (r = 0.49, P = 0.0003), FEV1(r = 0.40, P = 0.003), and FEV3 (r = 0.53, P < 0.0001). Correlation coefficients were not significant for BMI and dynamic lung function test parameters in normal and overweight boys. Conclusions: Thin boys have lower dynamic lung functions than normal boys. Increase in body weight may help in increasing their lung function status.

Respiratory reserve capacity in the proliferative phase of the menstrual cycle with reference to obesity

Background The role of estrogen in pulmonary function test (PFT) is well known in the normal course of the menstrual cycle. A significant increase in both progesterone (37%) and estradiol (13.5%) was observed in exercising women in previous studies, whereas no change in plasma follicle stimulating hormone and luteinizing hormone was observed. Therefore, this study was intended to see the limitations of the pulmonary system in adaptability to exercise in the proliferative phase of the menstrual cycle in obese and nonobese women. Participants and methods Healthy young women aged between 19 and 25 years and in the proliferative phase of their menstrual cycle leading a sedentary lifestyle were considered in the study group. Ten women in each group were studied on the basis of their BMI. They underwent treadmill exercise testing and computerized spirometry for assessment of their dynamic lung functions. Results It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters - maximum mid expiratory flow (MMEF), peak expiratory flow rate, and mid expiratory flow 25-75% - in either of the groups. Conclusion This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in the proliferative phase, which is further accentuated by exercise, and obesity, at least borderline, does not have much influence on respiratory system adaptability.

Peripheral CD4+ cell prevalence and pleuropulmonary manifestations in systemic lupus erythematosus patients

Systemic lupus erythematosus (SLE) is an autoimmune disease involving several organs, including the lungs. Previous results confirmed changes of peripheral T cell subsets in lupus patients; however no data are available about their possible relationship with pulmonary involvement. To determine pulmonary manifestations and potential relationship in changes of peripheral CD4+ T cell subsets. Patients with SLE (N = 28) were enrolled in complex pulmonary examination. Patients were divided into groups with pleuropulmonary manifestations (SLEpulm N = 13 age: 44.9 ± 3.3 years, female: male = 11:2) or without (SLEc N = 15 age: 27.2 ± 3.7 years, female: male = 12:3). Peripheral blood was taken for T helper (Th)1, Th2, Th17, CD4+CD25hi+ and regulatory T (Treg: CD4+CD25hi+ CD127-) cell analysis from SLE patients and healthy volunteers (controls, N = 40). SLEpulm patients were older, had more pulmonary symptoms and significantly decreased pO2 as compared to SLEc group. Ventilatory disorder was present in 92% of SLEpulm patients, with significantly decreased lung volumes, signs of airway involvement and decrease in DLco. Significant increase in Th1/Th2, while decrease in Th17/Treg ratios was present in all SLE compared to controls. In SLEpulm CD4+CD25hi+ subset without changes in Treg number was significantly increased as compared to SLEc and this subgroup of T cell showed significant positive correlation with dynamic lung function parameters and DLco (p < 0.05). In lupus patients pleuropulmonary manifestations are prevalent and lung function and blood gas measurements should be regularly performed in the daily clinical assessment. Significant increase of activated CD4+CD25hi+ T cells, but not Treg is associated with decreased lung function parameters in SLEpulm patients.

Effect of exercise on the pulmonary system in proliferative phase of menstrual cycle in a group of perimenopausal women

Background: Hormonal levels influence dynamic lung function parameters. Significant increase in both progesterone (37%) and estradiol (13.5%); where as, no change in plasma follicle stimulating hormone (FSH) and luteinizing hormone (LH) was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the pulmonary system in adaptability to exercise in proliferative phase of menstrual cycle in perimenopausal women. Material and Methods: The present study was conducted as a part of cardiopulmonary efficiency studies on two groups of nonathletes (n = 10) and athletes (n = 10) comparable in age and sex. Menstrual history was ascertained to confirm proliferative phase of menstrual cycle. Dynamic lung functions were measured in both groups before exercise and immediately after exercise. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum mid-expiratory flow (MMEF), peak expiratory flow rate (PEFR), and MEF 25-75% in either of the groups. Conclusion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase, which is further accentuated by exercise.

Response of the respiratory system to exercise in proliferative phase of the menstrual cycle in a group of perimenopausal obese homemakers

Background: The role of hormones on lung function tests was well-known in the normal course of the menstrual cycle. Significant increase in both progesterone (37%) and estradiol (13.5%), whereas no change in plasma follicle-stimulating hormone and luteinizing hormone was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the respiratory system in adaptability to exercise in proliferative phase of the menstrual cycle in perimenopausal obese homemakers. Materials and Methods: Healthy young adult females between 42 and 45 years who regularly undergo training and participate in competitive middle distance running events for at least past 3 years were considered in the control, whereas the study group did not have any such regular exercise program were obese homemakers. The two groups were in perimenopausal age group. They were made to undergo computerized spirometry after undergoing maximal exercise testing on a motorized treadmill. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum mid-expiratory flow, peak expiratory flow rate, mid-expiratory flow 25-75% in either of the groups. Discussion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase, which is further accentuated by exercise.

Hormonal Influence on the Adaptability of the Pulmonary System to Exercise in Short Term Smokers

The role of hormones on PFT was well known in the normal course exercise. This study was intended to see the limitations of the pulmonary system in adaptability to exercise in short term smokers. It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters MMEF, PEFR, MEF 25% to 75% in either of the groups. This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of stress hormones which is further accentuated by exercise.

Response of the respiratory system to exercise in proliferative phase of menstrual cycle in a group of perimenopausal obese homemakers

Background: The role of hormones on lung function tests were well known in the normal course of the menstrual cycle. Significant increase in both progesterone (37%) and estradiol (13.5%), whereas no change in plasma follicle-stimulating hormone and luteinizing hormone was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the respiratory system in adaptability to exercise in proliferative phase of menstrual cycle in perimenopausal obese homemakers. Materials and Methods: Healthy young adult females between 42 and 45 years who regularly undergo training and participate in competitive middle distance running events for at least previous 3 years were considered in the control, whereas the study group did not have any such regular exercise program were obese homemakers. The two groups were in perimenopausal age group. They were made to undergo computerized spirometry after undergoing maximal exercise testing on a motorized treadmill. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters Maximum Mid Expiratory Flow rate (MMEF), peak expiratory flow rate, mid-expiratory flow 25-75% in either of the groups. Conclusion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase, which is further accentuated by exercise.

Hormonal influence on the adaptability of the pulmonary system to exercise in proliferative phase of menstrual cycle in a group of perimenopausal women

Background: The role of estrogen on pulmonary function test (PFT) was well-known in the normal course of the menstrual cycle. Significant increase in both progesterone (37%) and estradiol (13.5%), whereas no change in plasma follicle stimulating hormone (FSH) and luteinizing hormone LH was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the pulmonary system in adaptability to exercise in proliferative phase of menstrual cycle in perimenopausal women. Materials and Methods: Dynamic lung functions were assessed in two groups of perimenopausal women viz., athletes and non-athletes after treadmill exercise testing using computerized spirometry. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum mid expiratory flow MMEF, peak expiratory flow rate PEFR, and MEF 25-75% in either of the groups. Conclusion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase which is further accentuated by exercise.

Multifactorial intervention for children with asthma and overweight (Mikado): study design of a randomised controlled trial

BackgroundIn children, the prevalence’s of both obesity and asthma are disconcertingly high. Asthmatic children with obesity are characterised by less asthma control and a high need for asthma medication. As the obese asthmatic child is becoming more common in the clinical setting and the disease burden of the asthma-obesity phenotype is high, there is an increasing need for effective treatment in these children. In adults, weight reduction resulted in improved lung function, better asthma control and less need for asthma medication. In children this is hardly studied. The Mikado study aims to evaluate the effectiveness of a long term multifactorial weight reduction intervention, on asthma characteristics in children with asthma and a high body weight.Methods/designThe Mikado study is a two-armed, randomised controlled trial. In total, 104 participants will be recruited via online questionnaires, pulmonary paediatricians, the youth department of the Municipal Health Services and cohorts of existing studies. All participants will be aged 6–16 years, will have current asthma, a Body Mass Index in the overweight or obesity range, and no serious comorbidities (such as diabetes, heart diseases). Participants in the intervention arm will receive a multifactorial intervention of 18 months consisting of sessions concerning sports, parental involvement, individual counselling and lifestyle advices including dietary advices and cognitive behavioural therapy. The control group will receive usual care. The primary outcome variables will include Forced Expiratory Volume in one second and Body Mass Index - Standard Deviation Score. Secondary outcomes will include other lung function parameters (including dynamic and static lung function parameters), asthma control, asthma-specific quality of life, use of asthma medication and markers of systemic inflammation and airway inflammation.DiscussionIn this randomised controlled trial we will study the potential of a multifactorial weight reduction intervention to improve asthma-related outcome measures in asthmatic children with overweight. Moreover, it will provide information about the underlying mechanisms in the relationship between asthma and a high body weight in children. These findings can contribute to optimal management programs and better clinical guidelines for children with asthma and overweight.Trial registrationClinicaltrial.gov NCT00998413

Adaptability of the pulmonary system to exercise in proliferative phase of the menstrual cycle in a group of perimenopausal women: A preliminary study

Background: The role of estrogen on pulmonary function tests was well-known in the normal course of the menstrual cycle. Significant increases in both progesterone (37%) and estradiol (13.5%), whereas no change in plasma follicle stimulating hormone and leutinizing hormone FSH and LH was observed in exercising women in previous studies [10],[11] Therefore, this study was intended to see the limitations of the pulmonary system in adaptability to exercise in the proliferative phase of the menstrual cycle in perimenopausal women. Materials and Methods: Healthy young adult females between 42 years and 45 years who regularly undergo training and participate in competitive middle distance running events for at least past 3 years were considered in the athlete group, whereas the non-athlete group did not have any such regular exercise program. The two groups were in perimenopausal age group. They were made to undergo computerized spirometry after undergoing maximal exercise testing on a motorized treadmill. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum mid expiratory flow rate MMEF, peak expiratory flow rate, mid expiratory flow 25% to 75% in either of the groups. Discussion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase, which is further accentuated by exercise.

Comparison of adaptability of the pulmonary system to exercise in proliferative phase of menstrual cycle in a group of trained and untrained perimenopausal women

Background: The role of estrogen on pulmonary function test (PFT) was well-known in the normal course of the menstrual cycle. Significant increase in both progesterone (37%) and estradiol (13.5%), whereas no change in plasma follicle stimulating hormone and leutinising hormone (FSH and LH)was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the pulmonary system in adaptability to exercise in proliferative phase of the menstrual cycle in perimenopausal women. Materials and Methods: 10 Subjects in each group were subjected to treadmill exercise testing and cardio-respiratory parameters were recorded. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum mid expiratory flow (MMEF), peak expiratory flow rate, mid expiratory flow 25-75% in either of the groups. Conclusion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase, which is further accentuated by exercise.

Lungenfunktionsmessung bei Kindern vor und nach einem altersadaptierten SCUBA Tauchgang im Schwimmbad

The number of children that SCUBA dive is increasing. Airway narrowing while SCUBA diving can cause dangerous complications like pulmonary barotrauma and arterial gas embolism. Statistics show that children are at an increased risk. Since data are scarce, the goal of this study was to gain new knowledge about acute lung function changes in children while SCUBA diving. 41 children aged 8 - 14 years underwent lung function testing (spirometry and residual volume measurement) before and after a single age-adapted SCUBA dive in a swimming pool. A significant reduction of the dynamic expiratory lung function parameters FEV (1) (p < 0.01), FEV (1)/VC (p < 0.05), MEF 75 % (p < 0.05), MEF 50 % (p < 0.01) und MEF 25 % (p < 0.05) was measured. No statistically significant change of the residual volume was found. A decrease of FEV (1) > 10 % (12 % - 21 %) was found in 5 children (12.2 %). The majority of the children (87.8 %) did not show any relevant lung function changes. Five children had a considerable reduction of FEV (1). Signs indicate the importance of bronchial hyperreactivity (BHR) as a key factor. Children with asthma or BHR should not SCUBA dive. A detailed medical examination is recommended (including an unspecific bronchial provocation test) before starting to dive.

Sentinel health department project in Baden-Wuerttemberg (Germany) – a useful tool for monitoring children's health and environment

In the Federal State of Baden-Wuerttemberg, Germany, an environmental health surveillance system has been established focusing on children aged 10 years. Four study regions (two larger cities, one small city, and one rural area) were designated in order to get information about the body burden of persistent chemicals (toxic metals and chlorinated compounds) in children and about lung function, frequency of respiratory diseases, and allergies. From 1992/1993 to 2002/2003, seven cross-sectional investigations were carried out, and more than 10,000 children took part in the study. DDE, HCB, PCB-138, PCB-153 and PCB-180 were measured in individual blood samples of about 400 children per year, whereas PCDD/PCDF and coplanar PCBs were determined in pooled blood samples. From 1993 to 2003, blood concentrations of these compounds decreased 2 to 4-fold. Concerning regional differences, slightly lower concentrations of DDE, PCBs and PCDD/PCDF could be seen in children from the municipal population of Mannheim compared to other regions. Breast feeding was associated with considerably higher concentrations of PCBs and most other chlorinated compounds. Static and dynamic lung function parameters showed no differences between the investigated areas. For prevalences of respiratory diseases and allergies, no time trend was observed except for pertussis, which showed a decrease in 2002/2003 probably due to an increase of vaccination rates. In addition, the prevalence of atopic sensitization against aero allergenes remained unchanged at about 35% during the observation period. In conclusion, this environmental health survey delivers objective data about spatial and temporal trends and provides information about possible sources of children's exposure to toxic compounds in the environment. Adaptations of the survey to new problems are discussed.

Der Einfluss von Operationslagerungen und Spinalanästhesie auf die Lungenfunktion

Various surgical positions, e.g., lithotomy, prone, or head-down positions influence respiratory mechanics. The aim of the present paper was to investigate whether particular surgical positions (lithotomy, lithotomy with head-down tilt, prone, prone with a roller placed under the abdomen) as well as spinal anaesthesia in lithotomy position impair the pulmonary function to a greater extent than supine position and whether they have to be considered as increasing the perioperative risk in elderly patients and patients with ventilatory disorders. In two separate experimental series, we examined a) the influence of the surgical positions on the pulmonary function in 45 subjects (25 without and 20 with ventilatory disorders) and b) the effects of spinal anaesthesia in 25 urologic patients (9 without and 16 with ventilatory disorders). Static and dynamic lung function parameters were determined. Under spinal anaesthesia, the arterial O2 saturation and the end-expiratory partial pressure of CO2 were measured additionally. The most pronounced lung function decrease occurred with the transition from seated to supine position. Lithotomy and prone positions impaired the respiratory function only slightly. In elderly persons and in patients with ventilatory disorders, the spirometric changes tended to be stronger than in young persons, but were not considered to increase the perioperative pulmonary risk. A combination of lithotomy position and spinal anaesthesia did likewise not remarkably impair the respiratory function. Lithotomy and prone positions as well as spinal anaesthesia are not considered to be an additional risk factor for pulmonary function.

Angiotensin-converting enzyme: an indicator of bleomycin-induced pulmonary toxicity in humans?

In order to evaluate bleomycin-associated lung damage in humans, lung function parameters and serum levels of the endothelial-bound angiotensin-converting enzyme (ACE) were determined by serial measurements in 11 patients who were treated for testicular cancer. None developed clinical or radiological evidence of pulmonary damage. While the static and dynamic lung function parameters were unchanged, carbon monoxide diffusion capacity ( DL CO ) decreased significantly ( P < 0.01) during a total of 126 days of pulsed regimen, indicating damage to the alveolar-endothelial membrane. S-ACE was unchanged within each treatment course but increased significantly ( P < 0.05) from the initial value to the last treatment course. Two months after cessation of treatment S-ACE returned to pretreatment values. Although the changes were modest they might mirror treatment-associated endothelial damage.

Ventilation/perfusion relations in patients with small cell anaplastic carcinoma of the lung, obtaining complete remission during combination chemotherapy

81 m Kr ventilation lung scans, 99 m Tc perfusion lung scans and lung function tests were performed in 25 patients with small cell lung cancer during combination chemotherapy in order to characterize the physiological changes in responding patients. After 3 months of chemotherapy 12 patients had obtained complete remission (CR), with total disappearance of all visible tumor tissue at the chest X-ray, 5 had obtained partial remission, 2 had progressive disease and 6 had died. Prior to treatment a mixed pattern of restrictive and obstructive lung function decrease was observed. The patients had a significant decrease in both ventilation and perfusion ( P < 0.01) of the affected lung and a ventilation perfusion mismatch was seen. Three months after initiation of treatment the patients who obtained CR had a statistical improvement ( P < 0.01) of TLC, VC and FEV in 1 sec, rendering them statistically inseparable from a healthy control group. The ventilation of the affected lung in patients obtaining CR increased statistically ( P < 0.01), but only a minor increase in perfusion ( P < 0.1) was seen so that the ventilation-perfusion ratio remained distorted. It is concluded that even though an increase of static and dynamic lung function parameters, including the ventilation of the affected lung, are seen in patients with small cell lung cancer obtaining complete remission during combination chemotherapy, a marked functional decrease of the perfusion and a ventilation-perfusion mismatch remain.