Use Of Pulmonary Function Tests Research Articles

Re-examining the use of pulmonary function tests in treatment of acute asthma patients

Re-examining the use of pulmonary function tests in treatment of acute asthma patients

Response: Re-examining the use of pulmonary function tests in treatment of acute asthma patients

Response: Re-examining the use of pulmonary function tests in treatment of acute asthma patients

The use of pulmonary function testing as a quantitative measurement for therapeutic trials

The use of pulmonary function testing as a quantitative measurement for therapeutic trials

Pulmonary function testing in the screening of workers: guidelines for instrumentation, performance, and interpretation.

Medical surveillance of workers exposed to potential respiratory hazards may be a valuable tool in early recognition and prevention of certain occupational lung diseases. The use of pulmonary function tests, particularly spirometry, has been widely accepted as an integral part of respiratory surveillance. A National Aeronautics and Space Administration contract report on the Occupational Safety and Health Administration medical and workplace surveillance requirements and recommendations by the National Institute for Occupational Safety and Health is a recent detailed study of medical surveillance requirements and recommendations (unpublished study, 1983). This paper is a brief guide for those in the medical profession attempting to establish or improve their medical surveillance programs for occupational respiratory diseases. It describes procedures to use and techniques for interpreting test results, and finally includes a study of normal reference values. In addition, the references should provide additional information for establishing a respiratory medical surveillance program.

The Use of Pulmonary Function Testing and Questionnaires as Epidemiologic Tools in the Study of Occupational Lung Disease

Pulmonary function testing and questionnaires are valuable tools in epidemiologic studies of occupational lung disease. Accurate equipment and standardized methodology are vital to obtain reproducible responses. For spirometry, the FVC and FEV show the least intrasubject variability and on questionnaires, occupational and smoking history are more reproducible than symptoms. The limitations of any method used to define a lower limit of normal should be kept in mind and, whenever possible, groups should be compared by use of the distribution of observations in the two groups--not just the prevalence of "abnormal" findings.

The use of pulmonary function testing and questionnaires as epidemiologic tools in the study of occupational lung disease

The use of pulmonary function testing and questionnaires as epidemiologic tools in the study of occupational lung disease

Use of Pulmonary Function Tests in the Management of Sarcoidosis

The literature on pulmonary function testing in sarcoidosis is critically reviewed. The results indicate that pulmonary function tests are not a reliable means for detecting the presence of parenchymal sarcoidosis, nor do they provide an accurate estimate of the extent of parenchymal disease. There are at present no known pulmonary function criteria that allow the clinician to predict the natural cause of pulmonary sarcoidosis or the response to therapy. The major value of pulmonary function testing is to assess changes in the disease course of the individual patient through sequential measurements. Currently there is no conclusive evidence that measurements of arterial blood gas tensions or pulmonary compliance add significantly to the sensitivity and specificity of the vital capacity and diffusing capacity in the management of sarcoidosis.

Functional correlates of lung involvement in Wegener's granulomatosis: Use of pulmonary function tests in staging and follow-up

To examine the usefulness of pulmonary function testing in the clinical management of patients with Wegener's granulomatosis, 22 subjects with biopsy proved disease were evaluated using routine functional parameters. Although reduced lung volumes and diffusing capacity occurred frequently, the most common abnormality was in obstruction to airflow. Comparison of these functional parameters with roentgenographic and clinical findings revealed that reduced lung volumes were useful in detecting focal infiltrates, mass or cavitary lesions and diffuse interstitial involvement whereas airflow measurements were useful in detecting focal large airway lesions. In people with evidence of limitation of airflow, respiratory complications frequently developed in the form of acute tracheal obstruction or lobar collapse. In addition, serial evaluation of lung function during treatment revealed that although in most patients lung volumes and airflow obstruction improved or stabilized, a reduction of diffusing capacity was common. These studies suggest that routine pulmonary function testing may be a useful tool in the staging of patients with Wegener's granulomatosis and in following responses to therapy.

Functional correlates of lung involvement in Wegener's granulomatosis. Use of pulmonary function tests in staging and follow-up: Rosenberg DM, Weinberger SE, Fulmer JD, Flye MW, Fauci AS, Crystal RG: Am J Med 1980; 69: 387–394

Functional correlates of lung involvement in Wegener's granulomatosis. Use of pulmonary function tests in staging and follow-up: Rosenberg DM, Weinberger SE, Fulmer JD, Flye MW, Fauci AS, Crystal RG: Am J Med 1980; 69: 387–394

Use of Pulmonary Function Tests in Asthma and Cystic Fibrosis

Use of Pulmonary Function Tests in Asthma and Cystic Fibrosis

Airway resistance measurements in the internist's office. Routine determination in the diagnosis and care of breathless patients.

Certain limitations of conventional spirometry1 imply that sophisticated appraisal of the presence and degree of physiologic dysfunction in patients with obstructive ventilatory disorders should include definition of the important pressure-volume-flow determinants of lower airway resistance. Macklem and Mead2 have analyzed the complexities inherent in the use of pulmonary function tests dependent upon a forced expiratory maneuver as an index of airway dynamics. The usefulness of the whole-body, volume-displacement plethysmograph as a source of more critical estimates of airway resistance and airway responsiveness3-8 has been documented beyond cavil. Payne and associates8 further suggest that estimates of bronchodilator drug potency, based upon spirometric changes alone, may be misleading in terms of locus of action by reflecting summation of various organ responses rather than the airway only.

Unusual disease of pulmonary arteries with dyspnea: Structure-function relationships

In three patients referred for evaluation of dyspnea of unknown origin, specific tests of pulmonary function yielded results which were diagnostic of pulmonary vascular obstruction at a time when results of other studies were within normal limits. The abnormalities in pulmonary function included decreased pulmonary diffusing capacity and pulmonary capillary blood volume, and increased wasted ventilation and difference between arterial and end-expired carbon dioxide tensions. Exercise studies were also important in demonstrating physiologic abnormalities. Histologic studies of lung tissue confirmed the presence of pulmonary vascular obstruction. The patients had similar lesions in the small pulmonary arteries; there was no evidence of involvement in other organs, but serum γA-globulins were increased, suggesting the possibility of an abnormal immune process. Proper use of pulmonary function tests thus permitted early diagnosis of an unusual disease and objective evaluation of its course.

The Use of Pulmonary Function Tests with Special Reference to Anesthesia.*

Professor of Medicine and Director of the Cardio-Respiratory Laboratory, University of Southern California School of Medicine *Presented before the Twenty-Ninth Congress of Anesthetists, Annual Meeting of the Members of the International Anesthesia Research Society, Los Angeles, California, October 11–14, 1954. **Manufactured by Warren E. Collins Co., Boston, Mass.

The Use of Pulmonary Function Tests for Disability Appraisal: Including Evaluation Standards in Chronic Pulmonary Disease

An accurate evaluation of the degree of pulmonary function impairment can be made from the following physiological tests: (1) Ventilation measurements from spirogram tracings (total vital capacity, three second vital capacity, maximal breathing capacity and the shape of the exhalation curve following a deep breath), (2) the degree of bronchospasm present, (3) the residual volume and alveolar nitrogen per cent after seven minutes oxygen breathing, (4) the arterial blood oxygen saturation at rest and immediately after step-up exercise, (5) the oxygen uptake during step-up exercise and (6) the character and duration of dyspnea after step-up exercise. A numerical ventilation factor has been derived from the three second vital capacity (a timed measurement), the maximal breathing capacity and the residual per cent of total lung volume. In about 75 per cent of the group of 500 coal miners studied the ventilation factor was correct in predicting the degree of pulmonary function impairment as compared to an evaluation based on comprehensive studies including arterial blood and respiratory gas analysis. Improved techniques and apparatus for measuring maximal breathing capacity and residual air volumes by the oxygen open circuit method are presented. The step-up exercise test is quite satisfactory for obtaining the exercise measurements in pulmonary function evaluation, equal to or superior to the treadmill. Vital capacity as a volume measurement should not be used as a single test of lung function in chronic pulmonary disease, as it can be misleading and responsible for false interpretations. Evaluation standards for the normal and four grades of pulmonary function impairment are given for the physiological tests which appear to be most useful in pulmonary function appraisal.

Pulmonary function in a group of young patients with bronchial asthma

Pulmonary function studies were performed on 6 asthmatic patients, 11 to 16 years of age, at times when they considered themselves to be free of asthmatic symptoms. Decreased ventilatory function, increased residual air volumes and RA TC ratios, hyperventilation, defective intrapulmonary mixing of gases, and arterial anoxemia were observed. On the basis of the pattern of disturbance of pulmonary function and the response to bronchodilator administration, persistent obstruction of the small intrapulmonary airways apparently accounted for the findings. Moderately advanced pulmonary insufficiency accompanied by pulmonary arterial hypertension was noted in one patient in whom permanent emphysema was thought to be present. The possible bearing of persistent obstruction of the bronchioles on the pathogenesis of emphysema in bronchial asthma is discussed, and the use of pulmonary function tests (M.B.C.) as a guide to management of the patient with bronchial asthma is suggested.