Spirometric Lung Function Research Articles

Preschool oscillometry and lung function at adolescence in asthmatic children.

Reduced lung function in early childhood is associated with persistent symptoms and low lung function later in life. Impulse oscillometry (IOS) is feasible for assessing lung function also in preschool children, and some of the parameters, such as respiratory resistance at 5 Hz (Rrs5) and the frequency dependence of resistance (dRrs/df), have been suggested to reflect small airway dysfunction. Whether changes in preschool IOS predict later lung function remains unknown. The medical data of 154 asthmatic children with IOS performed at 2-7 years and spirometry at 12-18 years were analyzed. IOS and post-bronchodilator spirometry parameters were compared, and the association was estimated in a multivariate model. Measured at preschool age, particularly Rrs5 and dRrs/df were significantly correlated with post-bronchodilator forced expiratory volume in 1 sec (FEV1) at adolescence (Rrs5: r = -0.223, P = 0.005; dRrs/df: r = 0.234, P = 0.004). Although the number of children with decreased FEV1 was low, associations of increased Rrs5 (odds ratio (OR) 5.9, 95% confidence interval (CI) 1.7; 20.9) and decreased dRrs/df (OR 8.2, 95% CI 1.7; 39.6) with decreased FEV1 remained significant in multivariate analyses. Similar findings were observed also with other spirometric parameters. In asthmatic children, preschool IOS is associated with spirometric lung function at adolescence, but the scatter is wide. Normal preschool IOS seems to indicate favourable lung function outcome, whereas in some individuals IOS could potentially be of clinical use, at a younger age than spirometry, to screen lung function deficits and increased risk for later lung function impairment.

Effects of antenatal multiple micronutrient supplementation on lung function in mid-childhood: follow-up of a double-blind randomised controlled trial in Nepal.

A randomised trial of prenatal multiple micronutrient supplementation in Nepalese women increased birthweight and weight at 2 years of age in offspring, compared to those born to mothers who only received iron and folic acid supplements. Further follow-up of this cohort provided an opportunity to investigate the effect of antenatal multiple micronutrients on subsequent lung function by measuring spirometry at 7-9 years of age in C: hildren born during the trial. 841 children (80% of the cohort) were seen at mean±sd 8.5±0.4 years. Technically successful spirometry results were obtained in 793 (94.3%) children, 50% of whom had been randomised to micronutrient supplementation. Background characteristics, including anthropometry, were similar in the two allocation groups. Lung function was also similar, mean (95% CI) difference in z-scores (supplementation minus control) was -0.08 (-0.19-0.04), -0.05 (-0.17-0.06) and -0.04 (-0.15-0.07) for forced expiratory volume in 1 s (FEV1), forced vital capacity and FEV1/FVC, respectively. Compared with healthy white children, FEV1 and FVC in the "healthy" Nepalese children were ∼1 (∼13%) z-score lower, with no difference in FEV1/FVC. We conclude that, compared with routine iron and folic acid, multiple micronutrient supplementation during pregnancy has no effect on spirometric lung function in Nepalese children at 8.5 years of age.

Peak weight velocity in infancy is negatively associated with lung function in adolescence. Results from the GINIplus study.

Background: Weight gain during infancy increases the risk of asthma in childhood which might be related to lower lung function. This study aimed to investigate the association between dynamics of growth (peak weight velocity) during the first two years of life and spirometric lung function indices measured at 15 years of age.

To study the efficacy and safety of doxophylline and theophylline in bronchial asthma.

Asthma is a non communicable chronic disease prevalent all over the world. Two commonly used methylxanthines, theophylline and doxofylline were compared in the study in stable asthmatic patients at recommended doses by various spirometric lung function tests with forced expiratory volume at second one (FEVI) between 50 to 80% of predicted FEVI. A total of 100 patients were divided in two groups. Group I was administered 300 mg theophylline twice a day and Group II was administered doxofylline 400 mg twice a day orally for six weeks. Spirometric variables symptom score, and adverse effects were recorded at the baseline level and after six weeks of therapy. Data was compared and analysed statistically. The spirometric values of forced expiratory volume in 1 second (FEVI), forced vital capacity (FVC), and FEV1/FVC showed a statistically significant improvement over base line with the use of both theophylline as well as doxophylline, but were not statistically different from each other. There was a statistically significant improvement in peak expiratory flow rate (PEFR) after six weeks of treatment with doxophylline compared to theophylline. It was found that the doxophylline has a better safety profile as compared to theophylline. Adverse events occurred in a greater proportion of patients in the theophylline group. In the study it was concluded that both theophylline and doxofylline improved the lung function tests and symptoms in patients of mild Bronchial Asthma, but doxofylline has a better profile in terms of safety.

Predicting asthma control: the role of psychological triggers.

Asthma triggers have been linked to adverse health outcomes in asthma, but little is known about their association with asthma control. Because trigger avoidance is an integral part of successful asthma management, psychological triggers in particular may be associated with suboptimal asthma control, given the difficulty of controlling them. We examined cross-sectional and longitudinal associations of perceived asthma triggers with self-report of asthma control impairment, symptoms, and spirometric lung function (forced expiratory volume in the 1st second, [FEV1]) in 179 adult primary care asthma patients. Perceived asthma triggers explained up to 42.5% of the variance in asthma control and symptoms, but not in FEV1 alone. Allergic triggers explained up to 12.1% of the asthma control and symptom variance, three nonallergic trigger types, air pollution/irritants, physical activity, and infection, explained up to 26.2% over and above allergic triggers, and psychological triggers up to 9.5% over and above all other triggers. Psychological triggers alone explained up to 33.9% of the variance and were the only trigger class that was consistently significant in all final multiple regression models predicting control and symptoms. Psychological triggers also predicted lower asthma control 3-6 months later, although controlling for initial asthma control eliminated this association. In free reports of individually relevant triggers, only psychological triggers were associated with suboptimal asthma control. Trigger factors are important predictors of self-reported asthma control and symptoms but not actual lung function. Particular attention should be directed to psychological triggers as indicators of patients' perceptions of suboptimal asthma control.

Prediction of pulmonary function after lobectomy

Aim-Background Lung cancer is the most common cause of cancer death in both men and women in our country. It has been estimated that there will be 7,000 lung cancer deaths every year in Greece. However, many patients with bronchogenic carcinoma also have coexistent obstructive lung disease. In these patients, preoperative prediction of functional status after lung resection is mandatory. The aim of our study was to determine the effect of lobectomy on postoperative spirometric lung function.

Pulmonary function tests in Petrol pump workers in Karad town

Objectives: Polluted environment at petrol pumps is likely to have adverse effects on health of workers. Petrol filling workers as well as office workers at petrol pumps are likely to have adverse effects on lung function. We wanted to study the actual fact. Methods: Pulmonary function tests were studied in petrol pump workers in Karad city and around. Petrol filling workers (direct exposure group, 48) and petrol pump office workers (indirect exposure group, 12) were included in study. Control group (50) of age matched healthy paramedical workers from KIMS, University was included. Approval from Institutional Ethical Committee was obtained. Informed written consent was taken from each participant. Spirometric lung function test were carried out in department of Physiology. Pulmonary function parameters included were FVC (Forced Vital Capacity), FEV1 (Forced Expiratory Volume in First second of FVC), FEV1% (FEV1 as % of FVC), PEFR (Peak Expiratory Flow Rate in liters/sec), FEF25-75% (Forced Expiratory Flow Rate during 25 to 75 % of expiration), FEF 0.2-1.2 (Forced Expiratory Flow between 0.2 -1.2 liters of expiration) and MVV (Maximum Voluntary Ventilation). After computing mean and SD of each parameter group comparison was done by using paired t test and ANOVA. Results: Impairment of lung function (Predominantly restrictive type) was found in both the study groups compared to controls. Conclusions: Exposure to polluted air and fumes of petrol/diesel causes lung function derangement in petrol pump workers.

Effects of Pulmonary Rehabilitation on Lung Functions in Patients with COPD

Background: The importance of pulmonary rehabilitation (PR) as a therapeutic measure for COPD patients is well known. Objective: To evaluate the effects of PR program by pursed lip breathing (PLB) and diaphragmatic breathing (DB) on FVC, FEV1, FEV1/FVC ratio in male patients with moderate stable COPD. Methods: This prospective study was conducted in the Department of Physiology, BSMMU, Dhaka from July 2010 to June 2011 on 116 male stable moderate COPD patients aged 50 to 65 years. They were enrolled from the out patient department of the Department of Medicine of BSMMU and NIDCH Dhaka. They were grouped as control (56 patients without PR) and experimental (60 patients with PR). The experimental patients were advised to perform PR program for 30 minutes duration per session at home twice daily, for consecutive 60 days along with the standard drug treatment of COPD. On the contrary, the control patients were advised to continue their standard drug treatment alone for consecutive 60 days. For the assessment of spirometric lung function status, FVC, FEV1, FEV1/FVC ratio of all subjects were recorded on day 0 and day 60 for both the group by a portable digital MicroDL Spirometer and the statistical analysis was done by independent sample ‘t’ test and paired Student’s ‘t’ test. Results: FVC and FEV1 value were significantly increased in comparison to the control patients after 60 days of follow up. On the other hand, post exercise value of FEV1/FVC ratio was decreased but it was not statistically significant. Conclusion: The study reveals improvement of lung functions with this sort of combination of PR program in stable COPD patients. DOI: http://dx.doi.org/10.3329/jbsp.v8i2.18657 Bangladesh Soc Physiol. 2013, December; 8(2): 70-76

Indoor molds and lung function in healthy adults

Indoor mold exposure is common worldwide and constitutes an important health problem. There are very few studies assessing the relation between mold exposure and lung function levels among non-asthmatic adults. Our objective was to assess the relations between dampness and mold exposures at home and at work and lung function. In particular, we elaborated the importance of different exposure indicators. In a population-based study, 269 non-asthmatic adults from South Finland answered a questionnaire on indoor dampness and mold exposures at home or at work and other factors potentially influencing lung function, and performed spirometry. Multiple linear regression model was applied to study the relations between exposures and spirometric lung function levels. In linear regression adjusting for confounding, FEV1 level was reduced on average 200ml related to mold odor at home (effect estimate -0.20, 95% CI -0.60 to 0.21) and FVC level was reduced on average 460ml (-0.46, -0.95 to 0.03) respectively. Exposure to mold odor at home or at work or both was related to reduced FEV1 (-0.15, -0.42 to 0.12) and FVC (-0.22, -0.55 to 0.11) levels. Women had on average 510ml reduced FEV1 levels (-0.51, -1.0 to 0.03) and 820ml reduced FVC levels (-0.82, -1.4 to -0.20) related to mold odor exposure at home. Mold odor exposure was related to lower lung function levels among non-asthmatic adults, especially among women.

Gender Difference in Spirometric Lung Functions in Chronic Obstructive Pulmonary Disease Patients Attending Rims Hospital Out-Patient Department

Gender Difference in Spirometric Lung Functions in Chronic Obstructive Pulmonary Disease Patients Attending Rims Hospital Out-Patient Department

Association body mass index and spirometric lung function in chronic obstructive pulmonary disease (COPD) patients attending RIMS Hospital, Manipur

Background: Weight loss is highly prevalent in chronic obstructive pulmonary disease (COPD) patients and studies have consistently shown significantly greater mortality rates in underweight and normal-weight COPD patients with than in overweight and obese COPD patients. Objective: To study association between mass index (BMI) and severity of COPD as assessed by spirometric lung function tests. Materials and Methods: 50 patients with COPD (25 women and 25 men), ages ranging from 40 to 65 years attending OPD and ward of Department of Respiratory Medicine, RIMS were included in the study. This preliminary study was conducted in the Department of Physiology, RIMS. Lung function was measured with Computerized Spirometer Helios 701 (Recorders and Medicare System, Chandigarh). Body mass index was calculated and related to recently developed reference values. Statistical analysis was performed using SPSS version 16.0 Independent t-tests and Pearson's correlation coefficient was used. Results: Mean body weight values were 59.66 ΁ 13.10 kg and 42.54 ΁ 2 kg, and BMI values were 21.75 ΁ 3.33 and 19.10 ΁ 1.0788 in males and females, respectively.33.3% of the patients had malnutrition and their flow parameters were found to be lower as compared to well-nourished subjects. FVC, FEV 1 and FEV 1 % predicted were all positively correlated to low BMI. Conclusions: Low BMI is prevalent in COPD patients. Inclusion of BMI in assessment of COPD severity in addition to measurement of FEV 1 is supported.

Pulmonary Function Tests in Two Wheeler Drivers Travelling on Pune Banglore National Highway (NH4) India

Pulmonary function tests were studied in two wheeler drivers daily travelling on national highway 4(NH4). 50 drivers were included in study after applying exclusion criteria. Control group (50) of age matched healthy paramedical workers from KIMS, University was included. Approval from Institutional Ethical Committee was obtained. Informed written consent was taken from each participant. Spirometric lung function test were carried out in department of Physiology at KIMSU, Karad. Pulmonary function parameters included were FVC (Forced Vital Capacity), FEV1 (Forced Expiratory Volume in First second of FVC), FEV1% (FEV1 as % of FVC), PEFR (Peak Expiratory Flow Rate in liters/sec), FEF25-75% (Forced Expiratory Flow Rate during 25 to 75 % of expiration), FEF 0.2-1.2 (Forced Expiratory Flow between 0.2 -1.2 liters of expiration) and MVV (Maximum Voluntary Ventilation). After computing mean and SD of each parameter group comparison was done. Impairment of lung function (Mixed type i. e restrictive & obstructive) was found in the study group compared to control group. The impairment was more after long term exposure. Protective measures like use of face mask and periodical health check up was advised.

English

To evaluate pulmonary function tests and blood parameters and their relationship with sociodemographic data for radiology staff continuously exposed to ionizing radiation. Thirty-eight personnel from Suleyman Demirel University Training and Research Hospital, Radiology Unit, were included in this study. Sociodemographic data were evaluated by a questionnare that was developed by the researchers. Height and weight measurements were performed with a standard scale and meter. Routine blood parameters and spirometric lung function measurements of the cases were recorded. Statistical significances were determined by independent t-test, analysis of variance (ANOVA), bivariate correlation and Kruskal-Wallis tests using SPSS 18.0. The mean age was 32.42 ± 5.5 years; 19 patients (50%) were male and 19 patients (50%) were female. Body mass index (BMI) was calculated as 25.68 ± 0.47 for men and 24.58 ± 1.13 for women. Forced vital capacity (FVC), forced expiratory volume in the 1st second (FEV1), peak expiratory flow (PEF) and maximum mid-expiratory flow (FEF25-75) showed negatively statistically significant differences between gender (p < 0.01). In addition, FEV1 and FEF25-75 also demonstrated statistically negatively significant difference with the type of task (p < 0.05). A statistically significant negative difference was found between FEF25-75 value and time to start smoking (p < 0.05). Among FVC, FEV1, PEF and FEF25-75 values and alcohol usage, statistically significant positive difference was detected (p < 0.05). Statistically significant positive difference was found among FVC, PEF and FEF25-75 values and sports activity (p < 0.05). According to BMI groups, statistically significant positive difference with FVC, FEV1 and PEF values were found (p < 0.05). Statistically significant correlations were found among FVC value and haemoglobin level (Hgb), haematocrit level (Hct) and mean corpuscular volume (MCV), among FEV1 value and Hgb, MCV, among PEF value and red blood cell count (RBC), Hgb, Hct, MCV, red cell distribution width (RDW), and between FEF25-75 value and MCV. Although respiratory functions of radiology staff are affected by many factors, continuous exposure to ionizing radiation is one of the important parameters. Radiology staff should be informed about factors that negatively affect the respiratory functions.

Forced Expiratory Volume in 6 s (FEV6) and FEV1/FEV6 Values as a Viable Alternative for Forced Vital Capacity (FVC) and FEV1/FVC Values During Pregnancy in South East Nigeria: A Preliminary Study.

Background:Forced expiratory volume in 6 s (FEV6) and FEV1/FEV6 ratio have traditionally been used as a surrogate for forced vital capacity (FVC) and FEV1/FVC in the assessment of spirometric lung function in nonpregnant subjects. However, the existence of this relationship during pregnancy is yet to be ascertained.Aim:The aim of this study was to determine if FEV6 and FEV1/FEV6 can effectively be used instead of FVC and FEV1/FVC in the interpretation of lung function test during pregnancy.Subjects and Methods:This study was a descriptive cross-sectional study carried out among 200 pregnant women who were recruited by using systematic random sampling during the period between April and October 2011. One hundred matched nonpregnant women served as control. A standard spirometer was used to determine the FVC, FEV6, FEV1/FVC, and FEV1/FEV6. Data analysis was done using SPSS version 11.0 (Chicago, IL, USA). Values were recorded as mean (standard deviation), and also median and interquartile ranges. The one-way analysis of variance, Mann–Whitey U and the Kruskal–Wallis were used to test for significance where applicable. P <0.05 were considered to be significant.Results:All the values were within normal range, but the FVC and FEV6 decreased significantly while the FEV1/FVC and FEV1/FEV6 increased as pregnancy progressed. However, for first and last trimester, FVC differed significantly from FEV6. The values of the FVC were comparable to the values of FEV6. The FEV1/FVC and FEV1/FEV6 ratio were similar and well above the 0.7 cutoff for obstructive lung diseases.Conclusion:FEV6 requires a short exhalation time and can effectively be used in place of FVC in evaluation of lung function test during pregnancy. The FEV1/FEV6 may be applied as a proxy for FEV1/FVC in pregnant and nonpregnant women.

The impact of switching to the new global lung function initiative equations on spirometry results in the UK CF Registry

The Quanjer et al. Global Lung Function Initiative (GLI)-2012 multi-ethnic all-age reference equations for spirometry are endorsed by all major respiratory societies and are the new gold standard. Before the GLI equations are implemented for use in CF patients, the impact of changing equations from those currently used needs to be better understood. Annual review data submitted to the UK CF Trust Registry between 2007 and 2011 were used to calculate %predicted FEV1, FVC and FEV1/FVC using three widely used reference equations (Wang-Hankinson and Knudson) and the new GLI-2012 equations. Overall, Knudson and Wang equations overestimated %predicted values in paediatric patients, such that a greater proportion of patients had lung function values in the normal range. Within individual patients, the impact of switching equations varied greatly depending on the patients' age, and which equations were used. A unified approach to interpreting spirometric lung function measurements would help facilitate more appropriate comparison both within and between centres and countries. Interpretation of longitudinal measurements using a continuous reference equation across all-ages, like the GLI, may further improve our understanding of CF lung disease.

Association of Ambient Air Quality with Pulmonary Function of Youngster Footballers

Air pollution has remained a major health concern in Kolkata. The present study was carried out to analyze the association between the levels of air pollutants and pulmonary function of youngster footballers living in two different air pollutant zones of Kolkata, West Bengal. Air pollution data of the two ambient air quality-monitoring stations located at Rabindrabharati and Victoria Memorial was collected for the period from January 2012 to March 2012. Study was conducted on two hundred and twenty boys of the age range 14-16 years living within 3km radius of the two monitoring stations. Sample consisted of 60 footballers (30 from Rabindrabharati and 30 from Victoria Memorial) and 160 sedentary boys (80 from Rabindrabharati and 80 from Victoria Memorial). They were investigated for their spirometric lung functions by the method and technique recommended by American Thoracic Society. Results were expressed as mean ± SD and independent samples T test was conducted to compare between two groups. Results revealed that particulate matter (PM10), oxides of sulfur (SO2) concentrations were significantly higher in Rabindrabharati zone, whereas no significant differences were noted in oxides of nitrogen (NO2) and carbon monoxide (CO) concentrations though values were higher at Rabindrabharati than Victoria Memorial. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced mid expiratory flow (FEF25-75%), maximum voluntary ventilation (MVV) were significantly lower both in footballers (P<0.05) and sedentary boys (P<0.01) of Rabindrabharati zone. Exposure to high air pollutant concentration might be associated with reduced pulmonary function in both sedentary and trained boys in spite of the fact that regular participation in training program may improve pulmonary function.

Genome-wide genetic ancestry measurements to predict lung function in European populations

To the Editor: A number of models have been proposed to predict spirometric lung function using age, sex, height and self-reported ethnicity [1, 2]. These models are particularly important to derive per cent predicted lung function and establish the severity of lung diseases such as chronic obstructive pulmonary disease (COPD) [3]. Compared to self-reported race and/or ethnicity, genetic data can provide more accurate and objective measurements of ancestry and has the potential to alleviate some of the problems related to the lack of consensus on the definition of race and ethnicity worldwide [4]. A recent report suggested that genetically determined ancestry improves predicted lung-function measurements in African Americans [5]. Here, we test whether genetic ancestry derived from genome-wide genotyping data is useful to predict lung function in a diverse European population. The population used in this study is part of a lung expression quantitative trait loci (eQTL) mapping study [6, 7]. Briefly, research participants were recruited from three academic sites: Laval University (Quebec, QC, Canada), University of British Columbia (Vancouver, BC, Canada), and Groningen University (Groningen, the Netherlands), henceforth referred to as Laval, UBC, and Groningen, respectively. All subjects were genotyped for ∼1.2 million single nucleotide polymorphisms (SNPs) using the Illumina Human1M-Duo BeadChip (Illumina, Inc., San Diego, CA, USA). Subjects from Laval and UBC provided written informed consent and the study was approved by the ethics committees of the respective study sites. At Groningen, the study protocol was consistent with the research code of the University Medical Center Groningen and Dutch national ethical and professional guidelines (“Code of conduct; Dutch federation of biomedical scientific societies”; http://www.federa.org). Prior to the analysis, standard genotyping quality controls and exclusion of patients with disorders that affected lung function (other than COPD) were …

Prospektive Untersuchung klinischer Verlaufsparameter von Patienten mit Alpha-1-Antitrypsinmangelsyndrom unter i. v. Prolastin-Heimtherapie

Prognostic parameters and indicators of deterioration of prolastin substituted alpha 1 antitrypsin deficient COPD (AAT) are poorly defined. In particular, there is a lack of information how patients with AAT report exacerbations or how intravenous therapy with prolastin is tolerated and leads to a stabilization of the clinical course of the disease. In a prospective study seven patients were followed over 36 months who received i. v. prolastin at home. Both clinical parameters such as exacerbations and spirometric lung function tests were used to monitor the clinical course of the disease. During the time period given 2.1 exacerbations/year were documented, the average lung function loss over the period of 36 month was mean FEV1 1.02 ± 0.61 l/s to 0.94 ± 0.63 l/s and mean vital capacity 2.95 ± 0.82 l to 2.87 ± 0.81 l. Complications related to home based infusion therapy did not occur. No non elective hospitalisations were reported. Taken together, this prospective feasibility trial could show that home based i. v. therapy in patients with AAT is safe and leads to less exacerbations and loss of lung function as compared to the historical cohort.

79 UK Biobank: Use and extension of occupational information to investigate occupationally-related chronic obstructive pulmonary disease (COPD) in the UK

ObjectiveTo investigate the causes and burden of work-related COPD in the UK through the use and extension of UK Biobank cohort information on occupational exposure.Methods UK Biobank is a population-based...

Lung function after preterm birth: development from mid-childhood to adulthood

As a result of advances in perinatal care, more small preterm infants survive. There are concerns that preterm birth and its treatments may harm pulmonary development and thereby lead to chronic airway obstruction in adulthood. To assess the development of spirometric lung function variables from mid-childhood to adulthood after extreme preterm birth. Two population-based cohorts born at gestational age ≤28 weeks or with birth weight ≤1000 g performed lung function tests at 10 and 18 and at 18 and 25 years of age, respectively, together with matched term-born controls. The results are presented as z scores, normalised for age, sex and height. Longitudinal development was compared for groups born at term and preterm, split by a history of absence (n=20), mild (n=38) or moderate/severe (n=25) neonatal bronchopulmonary dysplasia (BPD). The preterm-born cohorts, particularly those with neonatal BPD, had significantly lower forced expiratory volume in 1 s and mid-expiratory flow than those born at term at all assessments (z scores in the range -0.40 to -1.84). Within each of the subgroups the mean z scores obtained over the study period were largely similar, coefficients of determination ranging from 0.64 to 0.82. The pattern of development for the BPD subgroups did not differ from each other or from the groups born at term (tests of interaction). Airway obstruction was present from mid-childhood to adulthood after extreme preterm birth, most evident after neonatal BPD. Lung function indices were tracking similarly in the preterm and term-born groups.