Pulmonary Function Changes In Patients Research Articles

Pulmonary function changes in patients undergoing laparoscopic cholecystectomy

Background: Cholecystectomy, surgical removal of the gallbladder, is one of the most common elective procedures performed by general surgeons.Upper abdominal operations may induce postoperative restrictive ventilatory defects. They are more pronounced in open procedures, yet also seen in laparoscopic ones cholecystectomy.Methods: This observational study entitled “pulmonary function changes in patients undergoing laparoscopic cholecystectomy” was conducted after clearance from board of studies and ethical committee in the department of general surgery, Sharda hospital, school of medical sciences and research (Greater Noida) during the period 2019-2021. The study population has been calculated by using G-power software with 80% of the power and 5% of the significance level. The total sample size was determined to be 100 patients.Results: The study population consisted of 34 (34.0%) belonged to 19-30 years. There were 23 (23.0%) males and 77 (77.0%) females among study population. The mean forced vital capacity (FVC) (L), FEV1 (L), FEV1/FVC (%), FEF 25-75 (L) and SpO2 was compared between Pre-operative and post-operative using the paired t test. Mean FVC (L), FEV1 (L), FEV1/FVC (%), FEF 25-75 (L) and SpO2 decreased significantly from pre-operatively to post-operatively.Conclusions: To conclude my study, it has been observed that pulmonary function variables (FVC, FEV1, FEV1/FVC, FEF-25-75%) were significantly impaired after laparoscopic cholecystectomy.

Factors Associated with Pulmonary Function Changes in Patients Undergoing Microwave Ablation for Pulmonary Ground-Glass Nodules.

Purpose: Microwave ablation has become an alternative treatment for pulmonary ground-glass nodules (GGN) and is widely accepted by clinicians. However, its effect on lung function remains unknown. Therefore, this retrospective study aimed to explore pulmonary function changes and associated risk factors in patients undergoing computed tomography (CT)-guided microwave ablation (MWA) for treating pulmonary GGN. Materials and Methods: Thirty-five patients diagnosed with pulmonary GGN on thin-layer chest CT and enhanced CT were examined. Patients unable or unwilling to undergo thoracoscopic surgery underwent CT-guided simultaneous percutaneous core needle biopsy and MWA. Pulmonary function tests (PFT) were performed before ablation and 3 days and 6 months post-ablation. Forced expiratory volume in one second (FEV1), FEV1%, forced vital capacity (FVC), maximal voluntary ventilation (MVV), and peak expiratory flow (PEF) values pre- and post-MWA were analysed. Linear regression analysis was used to examine the correlation between ablation volume and changes in PFT findings 3 days post-ablation. Associations between patient characteristics, rates of postoperative complications, and PFT findings were analysed. Results: Forty-eight lesions were completely ablated and examined intraoperatively. There were significant differences in pre- and post-operative PFT findings on day 3 but not at 6 months. The mean ablation volume after 3 days of 11.4 ± 6.3 cm3 was positively correlated with changes in FEV1, MVV, and PEF values. Patients’ age (mean, 59.4 ± 13.0 years) positively correlated with changes in PEF values. The rates of change in FVC and MVV values were significantly higher with multiple pulmonary nodules than with isolated pulmonary nodule. PFT findings were similar between patients who experienced or did not experience complications (eg, pneumothorax and pleural effusion). Conclusions: Pulmonary function could be impaired shortly after MWA. PFT findings may correlate with age, ablation volume, and number of ablated lesions. In most patients, pulmonary function returned to the preoperative state after 6 months.

Long-term clinical course and outcomes of immunoglobulin G4-related lung disease

BackgroundImmunoglobulin G4-related lung disease (IgG4-RLD) is the pulmonary manifestation of a systemic fibroinflammatory disease characterized by lymphoplasmacytic infiltration with an abundance of IgG4-positive plasma cells. Long-term clinical course and outcomes of IgG4-RLD remain unclear. We aimed to identify clinical characteristics, treatment outcomes, and longitudinal pulmonary function changes in patients with IgG4-RLD according to the radiologic classification.MethodsChest computed tomography findings of 37 subjects were classified into five subtypes: solid nodular, bronchovascular, alveolar interstitial, round ground glass opacity, and alveolar consolidative. Radiologic treatment outcomes and longitudinal pulmonary function changes were compared among the different radiologic subtypes.ResultsThe mean age of the subjects was 55.6 years, and 78.4% were male. Among the five radiologic subtypes, alveolar consolidative and solid nodular type were most common, accounting for approximately 29.7% each of the total cases. Prednisone with or without azathioprine was administered to 31 patients (median treatment duration 14 months). In the treated patients, serial images showed complete response or partial response in 77.4%. However, relapse was documented in 25.0% of those who showed complete or partial response. In patients whose longitudinal lung function data were available (n = 20), the lung function was found to be stable during follow-up. Alveolar consolidative type showed the highest complete response rate, whereas alveolar interstitial type showed the lowest response rate, either complete or partial.ConclusionsMost patients showed a favorable outcome with regards to radiologic improvement and maintenance of pulmonary function; however, the response differed according to the radiologic subtype.

Influence of Emphysema and Air Trapping Heterogeneity on Pulmonary Function in Patients with COPD.

PurposeTo explore the influence of emphysema and air trapping heterogeneity on pulmonary function changes in patients with stable chronic obstructive pulmonary disease (COPD).Patients and methodsOne hundred and seventy-nine patients with stable COPD were enrolled in this prospective study. All patients underwent low-dose inspiratory and expiratory CT scanning and pulmonary-function tests. CT quantitative data for the emphysema index (EI) on full-inspiration and air trapping (AT) on full-expiration were measured for the whole lung, the right and left lungs, and the cranial-caudal lung zones. The heterogeneity index (HI) values for emphysema and air trapping were determined as the ratio of the difference to the sum of the respective indexes. The cranial-caudal HI and left–right lung HI were compared between mild-to-moderate (GOLD stage I and II) and severe (GOLD stage III and IV) disease groups. The associations between HI and pulmonary-function measurements adjusted for age, sex, height, smoking history, EI and AT of the total lung were assessed using multiple linear regression analysis.ResultsThe absolute values for cranial-caudal HI (AT_CC_HI) and left–right lung HI (AT_LR_HI) on full-expiration were significantly larger in the mild-to-moderate group, while no significant intergroup differences were observed on full-inspiration. COPD patients with lower-zone and/or left-lung predominance showed significantly lower pulmonary function than those with upper-zone and/or right-lung predominance on full-expiration, whereas no significant differences were observed on full-inspiration. The absolute values of AT_CC_HI and AT_LR_HI significantly correlated with pulmonary-function measurements. Higher AT_CC_HI and lower AT_LR_HI absolute values indicated better pulmonary function, after adjusting for age, sex, height, smoking history, EI and AT of the total lung.ConclusionSubjects with more heterogeneous distribution and/or upper-zone predominant and/or right-lung predominant patterns on full-expiration tend to have better pulmonary function. Thus, in comparison with emphysema heterogeneity, AT heterogeneity better reflects the pulmonary function changes in COPD patients.

Evaluation of pulmonary functions in pediatric patients with beta-thalassemia major

Background Thalassemia is a challenging health problem all over the world, especially in Mediterranean areas. Its effect on pulmonary function has not been well studied. Aim of the work To describe pulmonary function changes in patients with β-thalassemia major. Patients and methods This study included 60 patients with β-thalassemia major who received regular blood transfusion (40 males and 20 females) and 30 control children (20 males and 10 females). All participants were subjected to full history taking, clinical examination, and laboratory investigations (complete blood count, serum iron, and serum ferritin). In addition, all underwent pulmonary function tests. Results Forced expiratory volume at first second, forced vital capacity, and forced expiratory flow 25–75% were significantly decreased in males and females in the patient group when compared with those in the control group. However, forced expiratory volume at first second/forced vital capacity was significantly increased in male and female patients when compared with those in the control group. Transfusion and chelation therapy seems to be the cause of reduced pulmonary function. Conclusion Children with β-thalassemia had reduced pulmonary function, and this could be attributed to chelation therapy that affects serum iron and ferritin.

Polysomnographic and pulmonary function changes in patients with sleep problems after septoplasty with turbinectomy.

To compare Polysomnography and Pulmonary function tests before and after Septoplasty with Turbinectomy in patients complaining of nasal obstruction and sleep problems due to deviated septum with hypertrophic inferior turbinate. 90 patients underwent Septoplasty with Turbinectomy due to nasal obstruction and sleep problems involved in this study, their sleep quality evaluated by polysomnography before and after the surgery, their pulmonary functions assessed by spirometry before and after the operation. The postoperative pulmonary function values; FVC, FEV1, PEFR and postoperative polysomonographic values; AHI, Snoring index/hour, SpaO2 were higher than the preoperative values, and the results were statistically significant (p-values <0.001). Septoplasty with partial inferior turbinectomy might be a useful operation in the management of nasal obstruction and sleep problems that caused by a deviated nasal septum and hypertrophied inferior turbinate.

Thoracic Deformity Correction and Changes of Vital Capacity, Forced Expiratory Volume in 1 Second, and Expiratory Flow in Adolescent Idiopathic Scoliosis Five Years or More after Posterior Spinal Fusion with Thoracoplasty

Introduction The purpose of this study is to investigate thoracic deformity correction and pulmonary function changes in patients with adolescent idiopathic scoliosis (AIS) five years or more after undergoing posterior spinal fusion with thoracoplasty for correction of a thoracic deformity. Methods Subjects were 57 patients with AIS who underwent posterior spinal fusion between 2004 and 2010. 24 patients who had undergone thoracoplasty at least five years earlier agreed to participate in this research. X-rays, pulmonary function tests, and thoracic cage computed tomography (CT) were performed, and the Scoliosis Research Society Outcomes Questionnaire (SRS-22) was administered. CT axial images were used at the apex of the main thoracic (MT) curve. Apical vertebral rotation was evaluated using rotation angle to the sagittal plane (RAsag). Thoracic deformities were evaluated using the rib hump index (RHi) and the posterior hemithoracic symmetry ratio (PHSr). Results There were no significant differences between the preoperative and the final observation forced vital capacity (FVC) or the preoperative and the final observation %FVC. The forced expiratory volume in 1 s (FEV1) and %FEV1 were significantly improved at the final observation: FEV1 (preoperative: 1.88 L, final observation: 2.05 L, p = 0.045) and %FEV1 (preoperative: 57.1%, final observation: 66.2%, p = 0.001). FEV1/FVC was also significantly improved at the final observation (preoperative: 83.0%, final observation: 86.4%, p = 0.019). The peak expiratory flow (PEF) was significantly improved at the final observation (preoperative: 3.67 L/s, final observation: 4.38 L/s, p = 0.029). On the CT assessment for thoracic deformities, there were no significant changes in RAsag or RHi. PHSr was significantly increased at the final observation compared with the preoperative period. Conclusions With posterior spinal fusion in combination with thoracoplasty for AIS, although the correction of deformities was limited, the pulmonary function testing demonstrated the preservation of vital capacity (VC) and improvements in the forced expiratory volume in 1 s and expiratory flow.

A three years longitudinal follow-up study of pulmonary function changes in patients with chronic obstructive pulmonary disease

To investigate the characteristics and the risk factors of pulmonary function in patients with chronic obstructive pulmonary disease (COPD) for a 3 year follow-up. Subjects diagnosed as COPD were followed up for 3 years in the Management Center of Chronic Respiratory Disease at XINQIAO Hospital from September 2009 to June 2012.This was a retrospective study. Parameters related to respiratory function mainly first second forced expiratory volume (FEV1), COPD assessment test (CAT), 6 minutes walking distance (6MWD) and acute exacerbation were recorded during follow-up. Although the majority of patients were treated with drugs such as inhaled corticosteroid combined with long-term bronchial dilatation during the three years, FEV1 decreased progressively. The average annual decline of FEV1 was(31.80±61.99)ml, translating into a mean annual decline of(3.74±6.18)%. However, there were significant differences in changes of FEV1. Approximately, FEV1 in 78.3% (47/60) patients decreased, only 21.7%(13/60) patients kept stable FEV1. There was a correlation between decrease of FEV1, FEV1%predicted and the exacerbation (r=0.298, 0.361, 0.273; P<0.05). Logistic regression showed that the positive bronchodilator reversibility and the initial FEV1 were the independent factors associated with significant changes in FEV1 (respectively, OR=5.54, 95%CI 1.55-19.73; OR=8.28, 95%CI 1.42-48.32). The changes of pulmonary function in patients with COPD are heterogeneous, although most patients are treated in a standard way. Nearly 80% patients still represent deterioration of pulmonary function. Decline of FEV1 is closely related to the initial pulmonary function and bronchodilator reversibility.

Avaliação da função pulmonar em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea

Pulmonary complications are still a major postoperative problem for cardiac surgeries with cardiopulmonary bypass (CPB). This study aimed at evaluating pulmonary function changes in patients undergoing myocardial revascularization, as compared to those submitted to valve replacement.Participated in this study patients undergoing myocardial revascularization (MR Group, n=15) and valve replacement (VR Group, n=15) who were evaluated by the ratio between oxygen blood pressure and its inspired fraction (PaO2/FiO2), oxygen alveolar-arterial gradient (GA-aO2), pulmonary shunt, best compliance PEEP and static PEEP, evaluated in the preoperative period, after anesthetic induction, 1, 3 and 6 postoperative hours and 1st and 2nd postoperative days. Data were analyzed by analysis of variance for repeated measures (p < 0.05).Alveolar-arterial gradient and pulmonary shunt results were significantly higher for the MR group as compared to the VR group. PaO2/FiO2 ratio was significantly higher in the VR group. There were no differences between groups in static compliance. Postoperative best compliance PEEP was significantly higher in the MR group as compared to the VR group.Our study has shown that patients submitted to myocardial revascularization presented pulmonary function changes different from those submitted to valve replacement.

Pulmonary function changes in patients with psoriasis on methotrexate therapy.

Methotrexate is known to induce pulmonary fibrosis. The present study was undertaken to assess pulmonary toxicity, if any, in psoriasis patients on methotrexate therapy and correlate the dose and duration of the treatment with any changes in pulmonary function. Ten patients who had taken methotrexate for one year and ten patients receiving methotrexate were included in the present study. Detailed lung function studies including arterial blood gas analysis were carried out. In both groups, the only pulmonary function abnormalities detected were FEF200-1200, FEF25-75%, residual volume (RV), and RV/TLC%, which showed a decline after six months of treatment. However, this was not significant. No changes were detected in the arterial blood gas values following methotrexate therapy. Therefore, the present study did not find any significant deterioration of lung functions in psoriasis patients on methotrexate therapy.

525 Pulmonary function changes in patients with lung cancer treated by combined radiation and chemotherapy

525 Pulmonary function changes in patients with lung cancer treated by combined radiation and chemotherapy

Pulmonary function changes in long-term survivors of bone marrow transplantation

Purpose : This study was undertaken to evaluate long-term pulmonary function changes in patients undergoing bone marrow transplantation (BMT), to assess their clinical significance, and to identify factors influencing these changes. Methods and Materials : Pulmonary function tests (PFT) were evaluated before and after BMT in 11 adult patients undergoing BMT between 1985 and 1991. Forced expiratory volume at 1 s (FEV 1), forced vital capacity (FVC), diffusing capacity (DLCO), and total lung capacity (TLC) were evaluated. One hundred and three patients (92.8%) received total body irradiation (TBI) to a total dose of 14 Gy in nine equal fractions. The lung dose was restricted to <6.5 Gy in 95% of patients with partial transmission lung shielding. Seventy-eight percent of patients had acute graft-versus-host disease (aGVHD), 69% chronic graft-vs.-host disease (cGVHD), and 63% posttransplant pulmonary infection. Effects of GVHD, TBI, radiation dose to the lungs, dose rate of TBI, posttransplant pulmonary infection. Busulfan use for conditioning, age, and history of smoking were evaluated for their influence on pulmonary function. Results : Posttransplant FEV 1, FVC, and TLC were lower than pretransplant values (< 0.05) at 6 months and 1 year posttransplant with subsequent recovery. DLCO was significantly lower at all posttransplant intervals. FEV 1 did not fall significantly in patients without acute or chronic GVHD and recovered earlier than in patients without posttransplant pulmonary infection. Recovery of FVC, TLC, and DLCO was also delayed in patients with acute and chronic GVHD and posttransplant pulmonary infection. Multiple regression analysis revealed an association between a higher radiation dose to the lungs, and decreased FVC at 2 years ( p = 0.01). Progressive obstructive pulmonary disease was not observed. Conclusion : An initial decline in PFTs with subsequent recovery was observed. Factors associated with delayed recovery and incomplete recovery of PFTs were GVHD, posttransplant pulmonary infection, and higher radiation dose to the lungs. The conditioning regimen used at Medical College of Wisconsin, including relatively high TBI doses with partial transmission pulmonary shielding, appears to be well tolerated by the lungs in long-term survivors. No progressive decline in PFTs or symptomatic decline in pulmonary function was observed during the time interval studied.