Significant Difference In Forced Vital Capacity Research Articles

Effect of interesting respiratory rehabilitation training for the treatment of refractory Mycoplasma pneumoniae pneumonia in children

BackgroundsRefractory Mycoplasma pneumoniae pneumonia (RMPP) cause damage of pulmonary function and physical therapy assisting medical treatment is needed.ObjectiveThe aim of this study was to investigate the effect of interesting respiratory rehabilitation training on pulmonary function in children with RMPP.MethodsA total of 76 children with diagnoses of RMPP in our hospital from January 2020 to February 2021 were enrolled in this prospective study. According to the random number table method, they were divided into the control group and the study group, with 38 cases in each group. The control group were given conventional treatment, and the study group received interesting respiratory rehabilitation training in the basis of conventional treatment. The antipyretic time, disappearance time of pulmonary shadow and cough, length of hospital stay, pulmonary function (first second of expiratory volume (FEV1), forced vital capacity (FVC), FEV1/FVC) at 1 day before and after intervention, serum interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor (TNF-α), and quality of life (Pediatric Quality of Life Inventory, PedsQL 4.0 scale) were observed in the two groups.ResultsThe antipyretic time, disappearance time of pulmonary shadow and cough, length of hospital stay in the study group were shorter than those in the control group (P < 0.05). One day before intervention, there was no significant difference in FVC, FEV1, FEV1/FVC IL-6, CRP, and TNF-α between the two groups (P > 0.05). One day after intervention, FVC, FEV1 and FEV1/FVC in the study group were better than those in the control group (P < 0.05), and the levels of IL-6, CRP, and TNF-α in the study group were lower than those in the control group with significant difference (P < 0.05). One day before intervention, there were no significant differences in physiological function, emotional function, social function, and school function between the two groups (P > 0.05). After intervention, physiological function, emotional function, social function, and school function of the study group were better than those of the control group (P < 0.05).ConclusionThe interesting respiratory rehabilitation training can effectively improve the pulmonary function of children with RMPP, with strong flexibility, which is worthy of clinical application.

Study of Lung Function in COVID-19 Pneumonia Recovered Individuals

BACKGROUND&#x0D; Corona virus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). Pulmonary system is the most commonly affected organ system by COVID-19. SARS-CoV-2 results in disruption of ACE/ACE2 balance leading to RAAS activation. The present study was carried out to determine the lung function in the recovery phase of COVID -19 by spirometry in India.&#x0D; METHODS&#x0D; A prospective (Follow up) observational study was done on 100 patients from March 2021 to November 2021. COVID-19 patients with RT-PCR positive results aged between 25 to 60 years were enrolled in the study. All the subjects were health care workers working in King George Hospital, Visakhapatnam. They were followed for a period of 3 months.&#x0D; RESULTS&#x0D; The mean age was 48.35 ± 11.07 years. 71 % were males. The mean height was 162.85 ± 7.47 cm while the mean weight was 36.71 ± 1.12 kg. During enrolment, the mean forced vital capacity (FVC) was 2.22 ± 0.68 L, forced expiratory volume (FEV1) was 1.97 ± 0.63 L and FEV1/FVC% was 89.35 ± 13.27 %. There was no statistically significant difference in FVC between enrolment and various periods of follow up at 1 and 3 months. There was a statistically significant difference between FEV1 and FEV1/FVC% between enrolment and various periods of follow up at 1 and 3 months.&#x0D; CONCLUSIONS&#x0D; COVID-19 infection has an impact on the lung functions. PFT done 3 months later after clinical cure/discharge showed an improvement in FEV1 and FEV1/FVC% in the present study. Long-term follow-up of the lung function in post-COVID-19 survivors is recommended.

Evaluation of EMG Activity of Superficial Respiratory Muscles and Vital Capacity Parameters During Different Pelvic Tilts in Standing, Sitting and Lying Postures

Background: Postures such as kyphosis and lordosis of the spine affect the vital capacity parameters. These spinal alignment alterations may enhance the efficacy of the respiratory muscle contraction and the volume of air available in the lung. Aim: To examine the effects of different pelvic tilt positions in varying postures on the vital capacity parameters and respiratory muscles. Setting and Design: This was a cross-sectional one-way repeated measures design. The study was conducted at MYAS-GNDU Department of Sports Sciences and Medicine, GNDU, Amritsar. Subjects and Methods: Twenty healthy male individuals aged between 18 and 24 years participated in the study. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, and peak expiratory flow (PEF) were measured using Spiro Excel when performing anterior, posterior, and neutral pelvic tilts in standing, sitting, and lying postures, and their superficial respiratory muscle activity was measured with surface electromyography. Statistical Analysis: Repeated measures analysis of variance was applied and Bonferroni correction was used for post hoc analysis. Results: There was a significant difference in FVC and FEV1 during standing, sitting, and lying postures in all pelvic tilts, with the highest in sitting. Whereas, FEV1/FVC showed a significant difference when performing anterior and posterior tilts in standing, sitting, and lying, with the highest in standing. Increase in PEF was only seen in posterior pelvic tilt in sitting. External oblique muscle showed a significant activity in standing, lying, and sitting with varying pelvic tilts. Conclusion: The sitting posture could be more effective for pulmonary rehabilitation due to increased vital capacity, followed by standing and lying.

Effects of the Myofascial Release Techniques for a Diaphragm on Maximal Respiratory Pressure and Forced Vital Capacity

Purpose : This study aimed to investigate the immediate effects of myofascial release techniques(MRT) on the diaphragm on maximal respiratory pressure and forced vital capacity(FVC) in healthy adults. Methods : A total of 20 healthy male subjects participated in this study. A spirometer(Pony FX MIP/MEP, Cosmed Inc., Italy) was used to measure the maximal respiratory pressure maximal inspiratory pressure(MIP), maximal expiratory pressure(MEP), and forced vital capacity(FVC). The data were collected before and after MRT. Results : FVC and MIP data were normally distributed, and a paired t-test was employed to analyze the statistical differences between before and after MRT. MEP data were not normally distributed, and the Wilcoxon signed-rank test was used to analyze the statistical differences between before and after MRT. There was a significant difference in FVC(P = 0 . 003) but no s ignificant d ifference in MIP(P = 0.448) and MEP(P = 0.200). Conclusion : MRT could be an effective manual technique for decreasing FVC. However, MRT did not induce any changes in MIP and MEP. Therefore, active endurance exercise may be an essential element to increase aerobic capacity in healthy adults.

Effect of Box Breathing Technique on Lung Function Test

Background: Box breathing exercise is a technique of slow breathing rhythm also known as square breathing used universally. It increases the performance and concentration level, it also acts as a powerful stress relief. It is tested with a spirometer for the lung function test that measures the airflow of the upper and lower respiratory tract. This method builds up carbon dioxide in blood which calms down and regulates the ANS (Autonomic Nervous System), which enhances the cardio- inhibitory response of the vagus nerve that improves the mood. The main aim of the study was to analyze the effect of box breathing technique on lung function&#x0D; Materials and Methods: The present study was carried out among the participants at the age of 18-25 years from Saveetha Dental College. A total of 30 participants were included in this study (15 males, 15 females). The experimental training procedures consisted of 2 sessions of box breathing day and night for a period of 30 days. Participants were informed of the procedures of the box breathing technique. RMS Helios spirometer was used to measure lung volumes and capacities. Statistics analysis was done using SPSS software, paired t test. P value of less than or equal to 0.05 was considered significant statistically.&#x0D; Results: There was a significant increase among the participants FVC (Forced Vital Capacity), FEV1 (Forced Expiratory Volume), FIVC (Forced Inspiratory Vital Capacity) parameters after 2 sessions on each day of box breathing technique for a period of 30 days. Other parameters increased to 10% but not significantly.&#x0D; Conclusion: The present study illustrates the potential for box breathing practice to improve lung performance and reduce stress in healthy individuals. Despite the significant difference in FVC, FEV, FIVC levels supporting improved lung function, further investigation is needed to delineate mechanisms that underlie these benefits

Rituximab Versus Mycophenolate in the Treatment of Recalcitrant Connective Tissue Disease–Associated Interstitial Lung Disease

ObjectiveInterstitial lung disease (ILD) is a major cause of morbidity and mortality in connective tissue diseases (CTDs). We aimed to assess the effect of rituximab ± mycophenolate mofetil (MMF) compared with MMF on pulmonary function and prednisone dosage in patients with CTD‐related ILD (CTD‐ILD).MethodsThis retrospective study included 83 patients from Stanford and Centre Hospitalier de l’Universite de Montreal. Fifteen patients received rituximab ± MMF (rituximab group), and 68 patients received MMF only (control group).ResultsMedian ILD duration at the start of treatment was longer in the rituximab group at 47 months (range: 4‐170) versus 6.5 months (range: 0‐164) in controls. Forced vital capacity (FVC) decreased by 3.0% (range: 11%‐21%) after treatment in the rituximab group, whereas it increased by 2.0% (range: 14%‐25%) in the control group (p = 0.025). Diffusing capacity of carbon monoxide (DLCO) decreased by 3.0% (range: 10%‐12%) after treatment in the rituximab group, whereas it increased by 4.5% (range: 30%‐36%) in the control group (p = 0.046). Mixed model analysis controlling for ILD duration, baseline DLCO, systemic sclerosis, pulmonary hypertension, and prednisone use showed no significant difference in FVC or DLCO between groups at 6 months or 1 year. The average daily prednisone dose score decreased after treatment in the rituximab group, whereas it remained unchanged in the control group (p = 0.017).ConclusionRituximab ± MMF did not significantly change pulmonary function compared with MMF alone, but it did result in a relative decrease in average daily prednisone dose in a population with recalcitrant CTD‐ILD.

Spirometric values in healthy preschool children.

Spirometry is the most commonly used test to evaluate lung function. Foreign refe rence standards are currently available for preschool children. 1. To measure spirometric variables in healthy Chilean preschool children, 2. To compare these results with predictive ones according to GLI (Global Lung Initiative), Eigen (USA) and França (Brazil), and 3. If there is a sig nificant difference with these, to develop reference equations. Questionnaires were distributed to parents in several schools and kindergartens in Santiago. Children with a history of prematurity, asthmatic symptoms, chronic lung disease (including asthma), and chronic non respiratory disease were excluded. Spirometry was performed according to ATS/ERS 2007 guideli nes, with MedGraphics equipment, USA. Family and environmental background, weight and height were recorded, as well as values obtained in forced vital capacity (FVC), forced expiratory volume in 0.5, 0.75 and 1 second (FEV0.5, FEV0.75, and FEV1, respectively). 276 spirometries were performed, 202 met acceptability criteria, 112 girls, average age 5.01 ± 0.57 years, height 108.7 ± 5.6 cm. When comparing by gender, there was only a significant difference in FVC, which was higher in boys. The average values obtained in the total group were: FVC 1.22 ± 0.22 liters, FEV1 1.16 ± 0.18 liters, FEV0.75 1.07 ± 0.17 liters. These parameters were higher in percentage than the predictive ones according to GLI, Eigen, and França, except FVC with Eigen, therefore, predictive equations were de veloped. Spirometric values of preschoolers living in Santiago were higher than foreign reference values. We proposed these reference standards to be used in our country.

The effect of scoliosis surgery on pulmonary function in spinal muscular atrophy type II patients.

Various results of the previous literature related to surgical effect on pulmonary function of spinal muscular atrophy (SMA) patients might be due to different SMA type, different fusion level and technique. The aim of this study was to determine the value of scoliosis surgery for SMA type II patients with regard to pulmonary function, under the same fusion level, fusion technique and average long-term follow-up. Ten SMA II patients who underwent spinal correction procedures from 1993 to 2010 were identified. Data on clinical features and pulmonary function, including forced vital capacity (FVC) and forced expiratory volume in 1st second (FEV1), were collected. The data on pulmonary function were divided into preoperative, postoperative short-term (0-5years), mid-term (5-10years), and long-term (>10years). Statistical comparisons were made using the Wilcoxon test for pulmonary function and body weight analysis. Questions were answered by parents on how surgery influenced the frequency of respiratory infection and the ability to sit at school. The average length of postoperative pulmonary function follow-up was 12.3years (range 4.9-15.9years). There was no significant difference in FVC or FEV1 between preoperative and each postoperative period. However, a significant decline from mid-term to long-term was observed (p=0.028). Body weight increased significantly in all postoperative periods and was moderately correlated to pulmonary function (r=0.526 for FVC). The answers to the questionnaire revealed that 80% of the patients had obvious improvement in the frequency of respiratory infection and 100% were tolerable sitting at school. Surgical correction for scoliosis in SMA II patients results in pulmonary function being maintained during long-term follow-up. In addition, the advantages of surgery also include body weight gain, better sitting tolerance, and reduced frequency of respiratory infection.

Assessment of pulmonary function among sasang constitutional types: A population-based study in Korea

IntroductionThe visceral theory in Sasang constitutional medicine proposes the hypothesis that specific types of Sasang constitutions have different functional activities in the internal organs. This population-based cohort study examined whether there were differences in the lung function according to the Sasang constitutional types (SCTs) using the pulmonary function test (PFT). MethodsA total of 1320 individuals who participated in the Korean Genome and Epidemiology Study and completed the PFT were included. SCTs were classified by an integrated diagnostic model. We determined the values of the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC (%) for each of the SCTs. Individuals who had pulmonary diseases based on the chest X-ray examination were excluded. ResultsTae-Eum (TE) type had a significantly lower FVC than So-Eum and So-Yang types (P=0.034) even after adjusting for confounding factors including age, sex, weight, height, smoking, and presence of diabetes mellitus. FEV1 did not differ among the SCTs (P=0.65). In the analysis stratified by gender, there was no significant difference in FVC, FEV1, and FEV1/FVC in males, whereas females with the TE type had the lowest value of FVC among the SCTs (P=0.016). ConclusionsThis study found that females with the TE type had the poorest lung function, in terms of the lung volume.

Medium term effects of including manual therapy in a pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD): a randomized controlled pilot trial.

Study design: Randomized clinical trial.Objective: To investigate the effect of including manual therapy (MT) in a pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD).Background: The primary source of exercise limitation in people with COPD is dyspnea. The dyspnea is partly caused by changes in chest wall mechanics, with an increase in chest wall rigidity (CWR) contributing to a decrease in lung function. As MT is known to increase joint mobility, administering MT to people with COPD carries with it the potential to influence CWR and lung function.Methods: Thirty-three participants with COPD, aged between 55 and 70 years (mean = 65·5±4 years), were randomly assigned to three groups: pulmonary rehabilitation (PR) only, soft tissue therapy (ST) and PR, and ST, spinal manipulative therapy (SM), and PR. Outcome measures including forced expiratory volume in the 1st second (FEV1), forced vital capacity (FVC), 6-minute walking test (6MWT), St. George's respiratory questionnaire (SGRQ), and the hospital anxiety and depression (HAD) scale were recorded at 0, 8, 16, and 24 weeks.Results: There was a significant difference in FVC between the three groups at 24 weeks (P = 0·04). For the ST+SM+PR group versus PR only the increase was 0·40 l (CI: 0·02, 0·79; P = 0·03). No major or moderate adverse events (AE) were reported following the administration of 131 ST and 272 SM interventions.Discussion: The increase in FVC is a unique finding. Although the underlying mechanisms responsible for this outcome are not yet understood, the most likely explanation is the synergistic effect resulting from the combination of interventions. These results support the call for a larger clinical trial in the use of MT for COPD.

Effect of Magnitude of Backpack Load and Duration of Carriage on Pulmonary Function Parameters among Urban Young Adults of West Bengal, India: An Ergonomic Study

Background: The college students (18-25 years) compelled to carry backpack load and are susceptible to physiological stress. Acceptable load limit is 10-15% of Body Weight (BW) among children and adolescents. Pulmonary function is an important physiological parameter which governs the cumulative stress on the body. The relationship between backpack carriage and pulmonary function parameters has not been explicitly studied among young adults. Objectives: The study aimed to investigate the changes in Forced Vital Capacity(FVC), Forced Expiratory Volume in one second (FEV1) and Tiffeneau index (FEV1%) with different duration of carriage at the level of 15% and 10% load of BW compared to no load condition. Methods: Pulmonary function tests were performed using Mini Spir (software Winspiro PRO) at 0-1 min, 10-11 min, 15-16 min of carriage among males (n=13) and females (n=19) with 15% load of BW; females (n=10) with 10% load of BW. Repeated measures ANOVA and paired two tailed student’s t test were performed. Results: Repeated measures ANOVA revealed, there was significant difference in FVC and FEV1 at different durations, when females carried both 15% and 10% load of BW. While carrying 15% load of BW at 0-1 min,10-11 min,15-16 min, females showed significant difference in FEV1 (p=0.004; p=0.0001; p=0.0001, respectively), FVC (p=0.031; p=0.003; p=0.0002, respectively) and FEV1% (p=0.026; p=0.010; p=0.047, respectively); males showed significant difference in FEV1 at 15-16 min (p=0.044) compared to no load. Females carrying 10% load of BW showed significant difference in FEV1 at 0-1 min (p=0.027) and 15-16 min (p=0.020), FVC in 15-16 min (p=0.024) compared to no load. Obstructive pattern was observed among females (n=10) with increased load. Conclusion: Males must not carry 15% static load of BW for more than 15 min and females should carry load lower than 10% of BW.

Correlation between Haller index and echocardiographic and spirometric findings in children with pectus excavatum

In this study, we evaluated the correlation between severity of deformity and cardiopulmonary function with regards to echocardiographic and spirometric findings. Twenty-five children, mean age 13.6 years, presenting with pectus excavatum between August 2012 and May 2013, were included. Haller index (HI) was calculated for each patient. Patients with an index of <2.5 were accepted as Group 1, 2.5-3.6 as Group 2, and >3.6 as Group 3. Left ventricle dimension, ejection fraction, and shortening fraction were evaluated with echocardiography. Using spirometry, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and FEV1/FVC ratio were calculated. Groups were compared using these parameters. There were 18 males and 7 females. The mean index was 3.48±0.78. Though there was no significant difference in the index with regards to sex, the index increased with age. Eight percent of patients were in Group 1, 52% in Group 2 and 40% in Group 3. A significant decrease in ejection and shortening fractions was evident as the index increased. A statistically significant relation between HI and cardiac dysfunction was evident (p<0.01). As the index increased, there was significant decrease in FEV1 and the FEV1/FVC ratio, while there was no significant difference in FVC. As the deformity worsened, incidence of pulmonary dysfunction was found to be higher. This study revealed that pectus excavatum leads to cardiac and pulmonary problems, and functions of the left ventricle may be affected by the deformity. Furthermore, the relation between the severity of the deformity and cardiovascular function is evident.

Pulmonary Functions of Children with Asthma Improve Following Massage Therapy

This study aimed at evaluating the effect of massage therapy on the pulmonary functions of stable Egyptian children with asthma. This study was an open, randomized, controlled trial. The study was conducted in pediatric allergy and chest unit of the New Children's Hospital of Cairo University, Egypt. Sixty (60) children with asthma were divided randomly into two equal groups: massage therapy group and control group. Subjects in the massage therapy group received a 20-minute massage therapy by their parents at home before bedtime every night for 5 weeks in addition to the standard asthma treatment. The control group received the standard asthma treatment alone for 5 weeks. Spirometry was performed for all children on the first and last days of the study. Forced expiratory flow in first second (FEV1), forced vital capacity (FVC), FEV1/FVC and peak expiratory flow (PEF) were recorded. At the end of the study, mean FEV1 of the massage therapy group was significantly higher than controls (2.3-0.8 L versus 1.9-0.9 L, p=0.04). There was no significant difference in FVC (2.5-0.8 L versus 2.7-0.7 L, p=0.43). However, FEV1/FVC ratio showed a significant improvement in the massage therapy group (92.3-21.5 versus 69.5-17, p<0.01). PEF difference was not significant (263.5-39.6 L/minute versus 245.9-32 L/minute, p=0.06). A beneficial role for massage therapy in pediatric asthma is suggested. It improved the key pulmonary functions of the children, namely, FEV1 and FEV1/FVC ratio. However, further research on a larger scale is warranted.

Assessment of Air Way Resistance Indexes and Exercise-Induced Asthma after a Single Session of Submaximal Incremental Aerobic Exercise

Assessment of Air Way Resistance Indexes and Exercise-Induced Asthma after a Single Session of Submaximal Incremental Aerobic Exercise The present study aimed at assessing air way resistance indexes that include FEV1 (Force expiration Volume in one second), FVC (Forced vital capacity) and FEV1/FVC and exercise-induced asthma (EIA) after one session of sub maximal incremental aerobic exercise. Fifty healthy male subjects (age 19-26) from the faculty of Physical Education, University of Shahid Chamran served as the participants of the study. They were randomly assigned to either exercise or control groups. Body height, body mass and pulmonary factors were measured in the pre-test conditions. The study protocol included a sub maximal incremental Astrand - Rhyming test on an ergocycle. After performing this test by the exercise group, FEV1, FVC and FEV1/FVC, were measured again for both groups and compared with pre test evaluations. The data were analyzed through descriptive and inferential statistics (dependent and independent t test). Results showed that there was a significant difference in FEV1 between the two groups after the exercise protocol (p ≤ 0.05). There was no significant difference in FVC between the two groups after exercise, and a significant difference was registered in FEV1 and FEV1/FVC between pre-test and post-test results in the group that performed the aerobic test protocol (p ≤ 0.05). Our results indicate that one sub maximal incremental aerobic exercise session causes a significant change in FEV1 and FEV1/FVC, and causes exercise-induced asthma.

Response: The Relationship between Lung Function and Metabolic Syndrome in Obese and Non-Obese Korean Adult Males (Korean Diabetes J 2010;34:253-60)

We appreciate the comments on our study The Relationship between Lung Function and Metabolic Syndrome in Obese and Non-Obese Korean Adult Males, which was published in Korean Diabetes J 2010;34:253-260. We reported that insulin resistance, and other metabolic risk factors appear to be related to forced vital capacity (FVC), irrespective of obesity in Korean males. The age, height, and disease were the major determinants of ventilatory function [1]. In our study, there was a significant difference of age between metabolic syndrome (MetS) and non-MetS. So, we studied the relationship between MetS and FVC after adjusting for age. After adjusting age, there was still a significant difference in FVC between MetS and non-MetS groups (93.1 ± 12.1 vs. 97.0 ± 11.5, P < 0.05). Furthermore, insulin resistance and other metabolic components such as waist circumference were independently associated with FVC in a multi-linear regression analysis after adjusting for age and height, the major determinants of ventilatory function, and this was consistent with previous studies [2-5]. It has been reported that lung function is affected by several factors such as body composition and fat distribution, physical activity level, handgrip strength and respiratory muscle power [6-9]. Our study was performed on a limited cross-section of the population, so we could not control the potential biases due to differences in physical activity or respiratory muscle power. However, several studies have reported that insulin resistance is independently associated with lung function [3,10]. These studies reported that the lung function is still inversely associated with insulin resistance after adjusting for compounding factors such as age, height, smoking, and physical activity. Furthermore, Lazarus et al. [11,12] reported that skeletal muscle weakness served as a marker for future risk of insulin resistance, and that impaired lung function can aid in the prediction of development of insulin resistance. They suggested that some metabolic change that eventually leads to insulin resistance may initially induce diminished muscle strength and diminished ventilatory function [12]. So diminished muscle strength may be not confounding factor, but an early marker of insulin resistance. Several reports have suggested that impaired lung function is associated with glucose intolerance, hypertension, and cardiovascular disease, and that lung function is a reliable long-term predictor of mortality in the general population. We suggested that decreased FVC is associated with increased metabolic risk and insulin resistance in Korean males. Further prospective study to elucidate the relationship between lung function and metabolic risk is needed.

Assessment of pulmonary function in patients before and after laparoscopic and open esophagogastric surgery

Laparoscopy is a technique used in various surgical procedures. Few studies in the literature compare stress between laparoscopic and open surgery used for esophagogastric surgical procedures. Pulmonary function is known to be significantly affected in open surgeries, increasing postoperative morbidity and mortality. The current study aimed to assess pulmonary function in patients before and after open and laparoscopic esophagogastric surgery. For this study, 75 patients were divided into two groups: 50 patients undergoing laparoscopy and 25 patients undergoing open surgery. The following parameters were determined by spirometry before and after surgery: forced expiratory volume in the first second (FEV(1)), forced vital capacity (FVC), and forced expiratory flow in the midexpiratory phase (FEF(25-75%)). A decrease in FEV(1,) FVC, and FEF((25-75%)) was observed in the two groups on postoperative days 2, 3, and 4, as compared with the preoperative period. Likewise, FEV(1) and FVC showed a significant reduction on postoperative days 2, 3, and 4 in the patients who underwent to open surgery, but only on the day 2 in those who underwent to laparoscopic surgery. A significant decrease in FEF((25-75%)) was observed only on postoperative day 2 in the group that underwent open surgery. Significant differences in FEV(1) between the groups were observed on postoperative days 2, 3, and 4. No significant difference in FVC was noted between the groups, and a difference in FEF((25-75%)) was observed only on postoperative day 4. Postoperative pulmonary dysfunction was more important for the patients undergoing open surgery than for those undergoing laparoscopic surgery.

MULTIDISCIPLINARY PAIN ABSTRACTS: 1 . Anesthesia (1)

Stellate ganglion block is a procedure frequently used for the management of patients with chronic sympathetically mediated pain affecting the arm, neck or head. In this study, the authors looked at the effect of the stellate ganglion block on ipsilateral phrenic nerve function, and hence diaphragmatic strength, in 11 adult patients with chronic sympathetically mediated pain. Pre‐block and post‐block forced vital capacity (FVC) measurements were recorded using a pneumotachograph and a Magstim nerve stimulator was used to generate pre‐block and post‐block twitch mouth pressures (P[TWM]). This device can be used to stimulate the phrenic nerves and hence the diaphragm. The resulting change in airway pressure was measured at the mouth and has previously been shown to reflect diaphragm strength. There was no statistically significant difference in FVC or P(TWM) before or after the stellate ganglion block. In conclusion, a stellate ganglion block has no adverse effect on ipsilateral phrenic nerve function or diaphragm strength in healthy adult patients.

Effects of ambient ozone on lung function in children over a two-summer period.

There is a general consensus that short term exposure to ozone (O3) causes a decrease in lung function parameters such as forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). The objective of this study was to assess the reproducibility of lung function decrements after ambient O3 exposure over a two-summer period. The authors studied 797 children with a mean age of 8.2 yrs (95% confidence interval: 6.9-9.5) from the second and third grades of ten elementary schools in Austria and southwestern Germany. At the outset the various study locations were stratified into three groups with low (L), medium (M) and high (H) O3 exposure (range of mean O3 concentration in the locations April-October 1994: 24-30 (L); 33-38 (M); 44-52 (H) parts per billion (ppb)). Four lung function tests were performed on each child between March 1994 and November 1995. The increases in FVC and FEV1 recorded from one test period to the next were expressed as mL x day(-1). A significantly lower FVC and FEV1 increase was observed in children exposed to high ambient O3 concentration during the summer season. (FVC in summer 1994: 0.83 (L); 0.56 (M); 0.55 (H) mL x day(-1); p=0.004; and summer 1995: 0.80 (L); 0.63 (M); 0.56 (H) mL x day(-1); p=0.011; FEV1 in summer 1994: 0.48 (L); 0.34 (M); 0.18 (H) mL x day(-1); p=0.004 and summer 1995: 0.68 (L); 0.45 (M); 0.41 (H) mL x day(-1), p=0.006). There was no significant difference in FVC or FEV1 increase between the groups during the winter period. Adjusting for sex, age, height and passive smoke exposure, linear regression revealed a statistically significant negative association of average ambient O3 concentration with the FVC and FEV1 increase in both summers. During the winter period no association of O3 with FVC or FEV1 was observed. In conclusion, in two consecutive summer periods the authors found reproducible lung function decrements in children exposed to high levels of ambient ozone. Reoccurrence of ozone associated lung function deficits might increase the likelihood of persisting effects on the childrens' airways.