Jaeger Spirometer Research Articles

Circadian rhythm and variability of large and small airway spirometric variables in healthy individuals.

To assess the diurnal rhythm and variability of lung function in healthy individuals, encompassing both large and small airways. A prospective study enrolled 35 healthy adults without a history of smoking. Initial spirometry and a bronchodilation test were performed using the Jaeger spirometer, followed by a seven-day continuous home monitoring using the GOSPT2000. We evaluated repeatability using the intraclass correlation coefficient and agreement through linear regression and Bland-Altman analyses. Circadian rhythm and variability in spirometric measurements were analyzed using the coefficient of variation (CV) and daily variation rate. The GOSPT2000 demonstrated strong repeatability and high agreement with the Jaeger spirometer. Notable findings included a decrease in nocturnal forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV3 by 44, 59, and 53 mL, respectively. In contrast, peak expiratory flow at noon showed an increase of 0.143L/min. Small-airway variables, including forced expiratory flow at 50% and 75% of the FVC and maximum midexpiratory flow, showed no significant diurnal variation. The nocturnal CV for large-airway variables was ≤ 4%, while for small-airway variables, it was ≤ 11.89%. This study has established a spectrum of variability for both large and small airways in healthy populations. The variability of small-airway variables is higher than that of large-airway variables. The investigation into the diurnal rhythms and variability characteristics of both large and small airway variables in the healthy population can serve as a foundation for diagnosing asthma or assessing the efficacy of asthma treatments.

Age-related circadian rhythm and variability of large- and small-airway function in healthy non-smoking adults: Data from 7-day diurnal and nocturnal home monitoring using an electronic portable spirometer.

The aim of the study was to investigate the possible influencing factors of the large- and small-airway function variation in healthy non-smoking adults. Healthy non-medical non-smoking adults were enrolled in this prospective cohort study. Each participant took the portable spirometer test relying only on video teaching. Then conventional spirometry and bronchodilation test were conducted using a Jaeger spirometer, followed by 7-day diurnal and nocturnal home monitoring using a portable spirometer. A drop in both large- and small-airway function began at about 25 years of age, and a rapidly decline at about 50 years. The CV of FEV1 (r = 0.47, P = 0.0082) and small-airway function variables correlated with age (r ≥ 0.37, P < 0.05 for both MEFs and MEFs/FVC), especially for evening small-airway function variables. The CV of large (4.666 ± 1.946, P = 0.002 for FEV1; 4.565 ± 2.478, P = 0.017 for FEV3) and small airways (10.38 ± 3.196, P = 0.031 for MEF50 and 11.21 ± 4.178, P = 0.023 for MMEF) was higher in the 45- to 60-year subgroup than in the 30- to 45-year and 18- to 30-year subgroups. Age was the main influencing factor of both central and peripheral airway function variability, especially for the small-airway function in the evening. The LLN of small-airway variables varies depending on the age and circadian rhythm. People older than 45 years should pay more attention to monitoring small-airway function in the evening, which will be helpful for early clinical detection of those at high risk for asthma. ChiCTR2100050355.

A comparative study of clinical profile and symptom control in overweight and normal weight school-age children with mild persistent asthma.

ObjectivesTo find out the proportion of children with poor symptom control in overweight/obese and normal weight children with mild persistent asthma and to know the sociodemographic and clinical correlates of poor symptom control in them.Materials and MethodsChildren aged 6 to 12 years with mild persistent asthma with BMI Z score for age and sex more than +1 Z score on WHO BMI Z score chart for age and sex formed the cases. Age‐ and sex‐matched asthmatics with BMI Z score for age and sex between −2 Z and +1 Z score formed the controls. FEV1, FEV1/FVC were measured in both groups using Care Fusion Jaeger spirometer. Symptom control was assessed by ACT score. Statistical analysis was done using SPSS version 19 and Vassarstats.ResultsThe proportion of children with poor control was 19.1% in the overweight/obese group and 23.4% in the normal weight group. There was no significant correlation between BMI and symptom control as assessed by the ACT score. Overweight/obese children with good control showed a slightly lower FEV1/FVC ratio and higher median eosinophil count compared to children with normal weight. Gastroesophageal reflux and allergic rhinitis were more commonly seen in overweight/obese children. In the poor control group, FEV1, FEV1/FVC, and median eosinophil counts were not significantly different between overweight/obese and normal weight group but were less when compared to good control group.ConclusionThe proportion of poor symptom control was not high in overweight/obese asthmatic children compared to normal weight asthmatic children. No significant risk factors for poor symptom control could be identified in our study for either of the groups.

Pulmonary ventilation function parameters of children aged 5-14 years in Kunming, China: a comparative analysis of measured values versus predicted values based on Zapletal equation

Objective To study the percentage of the measured values of the main pulmonary ventilation function parameters in their predicted values based on Zapletal equation among healthy children aged 5-14 years in Kunming, China, and to provide a basis for accurate judgment of pulmonary ventilation function in clinical practice. Methods A total of 702 healthy children aged 5-14 years (352 boys and 350 girls) from Kunming were enrolled. The Jaeger spirometer was used to measure the nine indices:forced vital capacity (FVC), forced expiratory volume in one second (FEV1), ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC), maximal mid-expiratory flow (MMEF), forced expiratory flow at 25% of forced vital capacity (FEF25), forced expiratory flow at 50% of forced vital capacity (FEF50), forced expiratory flow at 75% of forced vital capacity (FEF75), peak expiratory flow (PEF), and maximal voluntary ventilation (MVV). The values obtained from the Zapletal equation of predicted values provided by the spirometer were used as the predicted values of children, and the percentage of measured values in predicted values was calculated. Results In the 702 children, the percentages of the measured values of the main pulmonary ventilation function parameters PEF, FVC, FEV1, FEV1/FVC, and MVV in their predicted values fluctuated from 102% to 114%, 94% to 108%, 98% to 113%, 98% to 107%, and 141% to 183% respectively. As for the main airway velocity parameters, the percentages of the measured values of FEF25, FEF50, FEF75, and MMEF in their predicted values fluctuated from 98% to 116%, 85% to 102%, 71% to 98%, and 83% to 100% respectively. The percentages of the measured values of PEF, FVC, FEV1, FEV1/FVC, MVV, FEF25, FEF50, FEF75, and MMEF in their predicted values had the lower limits of normal of 88.2%, 88.4%, 92.0%, 94.4%, 118.5%, 82.9%, 70.0%, 62.1%, and 70.1% respectively. Conclusions There are differences between pulmonary ventilation function parameter levels and normal values provided by Zapletal equation in healthy children aged 5-14 years in Kunming. As for the pulmonary ventilation function parameters of PEF, FVC, FEV, FEV1/FVC, MVV, FEF25, FEF50, FEF75, and MMEF in these children, the lower limits of normal of measured values in predicted values may be determined as 88.2%, 88.4%, 92.0%, 94.4%, 118.5%, 82.9%, 70.0%, 62.1%, and 70.1% respectively.

Serum Total Magnesium Level and its Correlation with Symptom Control in Children with Mild Persistent Asthma.

To determine the prevalence of hypomagnesemia in children with mild persistent asthma and to correlate the serum magnesium levels with symptom control in the above children. It was a cross sectional study carried out from 1st April 2015 to 31st July 2016 at the department of Pediatrics, JIPMER Hospital. Participants included six to 12-y-old children with mild persistent asthma registered at childhood asthma clinic. Pulmonary function tests were done in all children using Care fusion Jaeger spirometer. Symptom control was assessed by childhood asthma control test questionnaire and the asthma control test questionnaire (ACT) score. Serum magnesium was measured using photometric method. Proportion of children with well controlled, partially controlled and poorly controlled asthma, serum magnesium levels across the three levels of control and correlation of serum magnesium level with ACT score and pulmonary function tests were studied. The prevalence of hypomagnesemia in children with mild persistent asthma was 5.6%. The median serum magnesium level was 2.0mg/dl (IQR 1.9-2.1mg/dL). As assessed by the ACT score, 66% had well controlled, 23% had partially controlled and 11% had poorly controlled asthma. There was no significant difference in the serum magnesium levels in the above three groups. There was no significant correlation between serum magnesium levels and ACT score as well as pulmonary function tests. The prevalence of hypomagnesemia in the index study is much lower than earlier studies and there seems to be no significant association between serum magnesium levels and asthma symptom control.

Effects and significance of methacholine bronchial provocation tests and salbutamol bronchial dilation test on measurements of fractional exhaled nitric oxide in patients with asthma

To study the effects and significance of methacholine (Mch) bronchial provocation tests and salbutamol bronchial dilation test on measurements of fractional exhaled nitric oxide (FeNO) in patients with asthma. This was a prospective study conducted between November 2014 and August 2015. A total of 135 patients with asthma visiting the respiratory clinic of Zhujiang Hospital were enrolled. The patients received either Mch bronchial provocation test or salbutamol bronchial dilation test based on their FEV1/FVC values and cooperative degree. Mch bronchial provocation test was performed by using Astograph Jupiter-21 (Astograh group) or APS-Pro airway reaction testing apparatus (APS group), and salbutamol bronchial dilation test was performed by using Jaeger spirometer (Dilation group). We compared the differences between FeNO values measured before examinations (Pre-FeNO) and 5 min after completion of these examinations (Post-FeNO). The geometric mean of Pre-FeNO and Post-FeNO was 28.07 ppb and 24.08 ppb respectively in the Astograh group, with a significant decrease of the FeNO value after the examination (Z=-3.093, P=0.002). A significant difference between Pre-FeNO and Post-FeNO was found in patients who had positive provocation results in the Astograh group (Z=-2.787, P=0.005), but not in the patients with negative results (Z=-1.355, P=0.176). The geometric mean of FeNO in the APS group decreased significantly from 27.95 ppb to 23.15 ppb after the examination was completed (Z=-5.170, P=0.000); both in patients with positive saline or Mch provocation results and in patients with negative provocation results, the differences between Pre-FeNO and Post-FeNO in the APS group being significant (Z=-2.705, -3.709, -2.371, P=0.002, 0.000, 0.018). No difference of FeNO change(ΔFeNO) was observed between the 2 Mch bronchial provocation test groups (U<918.000, P=0.117). The geometric mean of Pre-FeNO was 36.74 ppb and that of Post-FeNO was 34.79 ppb in the Dilation group; the difference being not significant (Z=-1.281, P=0.200). Our results confirm that salbutamol bronchial dilation test has minor effect on the measurement of FeNO, but Mch bronchial provocation tests can significantly decrease measured FeNO value in patients with asthma, and therefore Post-FeNO values should be interpreted with caution.

Spirometry and bronchodilator responsiveness in wheezing preschool children

Methods We carried out a retrospective analysis of incentive spirometry tests in recurrent wheezing children, aged 2-5 years, from our center, performed between September 2012 and March 2014. Lung function was assessed before and after 400 mg of inhaled salbutamol using a Jaeger spirometer v.4.65 (CareFusion). Wheezing symptoms, parental asthma, prematurity, passive smoking exposure, atopy and controller medication use were evaluated. Categorical frequency analysis and non-parametric tests were used.

Effects of teriparatide on lung function and pain relief in women with multiple osteoporotic vertebral compression fractures

Background:Osteoporosis is predominantly a condition of the elderly. In this study, we evaluated the effects of teriparatide on lung function and pain relief in elderly women with multiple osteoporotic vertebral compression fractures.Methods:A total of 37 patients who received teriparatide treatment during the period January 2010 to December 2011 were enrolled. Dual-energy X-ray absorptiometry scans were used to measure bone mineral density (BMD) and lung function was measured using a MasterScreen Body Jaeger spirometer. Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) values were recorded. The Oswestry Disability Index (ODI) and the Visual Analog Scale (VAS) for pain were used to evaluate physical health and pain intensity, respectively, at baseline and after 6 months of teriparatide treatment.Results:Mean BMD at the lumbar spine increased from 0.716 g/cm2 at baseline to 0.829 g/cm2 after 6 months of treatment. In addition, both mean FVC and FEV1 values after 6 months of treatment were significantly higher than baseline values (99.01% and 100.06% vs. 87.62% and 90.62%, respectively). Teriparatide treatment also resulted in a significant reduction in self-reported pain intensity and a significant improvement in physical health as measured by VAS and ODI scores, respectively.Conclusions:In addition to increasing BMD, teriparatide treatment improves the lung function and results in diminished pain intensity in women with multiple osteoporotic vertebral compression fractures.

Prevalence of Respiratory Symptoms and Spirometric Values in Aluminium Potroom Workers

The goal of this study was to examine the prevalence of chronic respiratory symptoms in potroom workers and to compare these results with changes in spirometric parameters. A modified questionnaire on respiratory symptoms from the British Medical Research Council was used to take the medical history data about respiratory symptoms. Spirometric parameters were determined on the same day (as a part of regular checkups) using the Jaeger spirometer. The study included 215 potroom workers from the aluminium factory in Podgorica, Montenegro. All subjects were men, but they differed in age and duration of work. The group used for comparison consisted of 81 unemployed male applicants for jobs in the factory who had never been exposed to this kind of air pollution before. Potroom workers mostly complained of breathlessness associated with the workplace (56.7 %) or weather changes (rain, cold wind, and humidity) (41.9%) and of dyspnoea when climbing stairs (51.2 %), but only 22.3 % reported using medication to treat these episodes. Most workers reported to have been smoking at the time of the study (62.4 %). Spirometric data showed only insignificant variations compared to the expected values (CECA standards). Chronic obstructive pulmonary disease (COPD), characterised by FEV1/VC % <88 % was found in only 17 (7.9 %) potroom workers, while asthma was identified in 9 (4.2 %). Although the prevalence of chronic respiratory symptoms reported by the examined potroom workers was quite high at the group level, they were not associated with ventilatory impairments.

Respiratory muscle strength in adolescents with idiopathic scoliosis

Methods Vital capacity (VC) was measured using Jaeger's spirometer and values were compared to Zapletal's recommendations [2]. Maximal static respiratory pressures including maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), were measured according to W. Tomalak's recommendations for Polish children [3]. Measurements were made using a portable, digital pressure meter equipped with the Omega PX25 pressure transducer (ZETA product – model MMM2).

Assessment of a low-cost home monitoring spirometer for children.

Electronic devices are now available to measure and store lung function parameters in the home. Before adopting a device for clinical or research use, it is important to validate it in the target patient group. The aim of this study was to assess a low-cost, portable, logging spirometer, the VM Plus (VM), against a standard laboratory Jaeger spirometer (JS) for use in children with respiratory disease. Seventy children with stable asthma or cystic fibrosis performed spirometry on the two devices, and results for peak expiratory flow (PEF) and forced expiratory volume in 1 sec (FEV(1)) were compared. Comparison was made both using the two devices separately (separate method) and with the devices connected in series (series method). Reproducibility of the VM measurements was also assessed. Correlation between measurements was close (R values: separate, PEF, 0.91; FEV(1), 0.94; series, PEF, 0.97, FEV(1), 0.99), but PEF readings on the VM Plus were substantially higher than with the JS (mean difference: separate, 54.8 L/min; series, 28.2 L/min). This reflects well-reported differences in PEF measurements between the Mini-Wright PEF meter, on which the VM Plus spirometer is based, and conventional spirometers. Limits of agreement (series method) were: PEF, -13.2 to +69.6 L/min; FEV(1), -0.03 to +0.19 L. Reproducibility of VM Plus measurements was acceptable: coefficient of variation for PEF was 4%; for FEV(1), 4.3%; coefficient of reproducibility for PEF, 39 L/min; for FEV(1), 0.26 L. The VM Plus provides reasonably accurate, reproducible measurements of PEF and FEV(1), but intrinsic bias, particularly in PEF measurement, needs to be taken into account. Its potential to document longitudinal changes in lung function in children with respiratory disease at home merits further study.

Comparison of a New Desktop Spirometer (Diagnosa®) with a Laboratory Spirometer

Background: The Diagnosa is a fully integrated system, able to determine spirometry, ECG, blood pressure and body composition. Real time data can be transferred via Internet to a remote receiving center. Objectives: The aim of this study was to perform biological testing of the spirometry component in subjects with normal and pathological pulmonary function. Methods: A group of 45 patients (mean age 43.3 years, 30 males) was tested on both the Diagnosa and the standard Jaeger Masterlab spirometer according to the guidelines of the American Thoracic Society. Three subgroups of 15 subjects each (normal spirometry, obstructive and restrictive airflow limitation) were selected. Results: All measurements performed with the Diagnosa (FVC, FIVC, FEV₁, PEF, FEF₂₅, FEF₅₀, FEF₇₅) correlated closely (r = 0.92–0.99) with those performed with the Jaeger spirometer and showed good limits of agreement (the largest difference between the two devices being 0.2 liter for FEV₁). Analysis of the 3 subgroups showed no difference for any parameters compared to the overall group. Electronic transfer of all data was successful. Conclusions: The Diagnosa spirometer is comparable to a standard laboratory spirometer and can be used reliably for telemedicine purposes.

Lung function reference values in Singaporean children aged 6-18 years.

A study was undertaken to produce reference values of lung function in Chinese children and a means of calculating adjusted standard deviation scores of lung function for Malay and Indian ethnic groups. A cross sectional study of lung function (forced expiratory volume in one second and forced vital capacity) measured with a Jaeger spirometer was performed in a representative sample of Singaporean children made up of 1403 Chinese, 335 Malays, and 206 Indians. The relation between natural logarithms of lung function and height was approximately linear until 150 cm in boys and 140 cm in girls. At these heights there were abrupt changes in the gradients of both lines. Separate regression lines were derived for heights above and below these inflection points. Significant differences in lung function were seen in Chinese compared with Malay and Indian children. In particular, values were considerably lower among Indian boys. The relation between lung function and height in Chinese children is best described by two regression equations over separate height ranges. Information is provided for the calculation of reference values and standard deviation scores, together with the correction factors that need to be applied to derive these values in Malay and Indian children.