Forced Vital Capacity Values Research Articles

Identification of Post-Tuberculosis Lung Function Impairment Early during the Course of Treatment.

Tuberculosis (TB) is a leading cause of morbidity and mortality and an important contributory factor to chronic lung disease. TB-associated permanent lung damage manifests with varying levels of respiratory disability long after TB has been successfully treated, which is a condition known as post-TB lung disease (PTLD). This study assessed whether lung function impairment associated with PTLD occurs early during TB treatment. Using a cross-sectional design, we enrolled newly diagnosed adult TB patients aged ≥18 years who had received anti-TB medication for ≥2 months from a large treatment center in northern Nigeria. We used spirometry and the Global Lung Initiative 2012 reference equations for African Americans to assess and characterize lung function for enrolled participants (N = 94). The median age (range) of participants was 34 (18-72) years. Approximately 5.3% (n = 5) of participants exhibited features of abnormal lung function, 4.2% (n = 4) showed features of obstructive lung abnormality, and 1.1% (n = 1) showed restrictive lung abnormality. Compared with historical patients recruited ≥6 months after TB treatment in the same center, our participants had significantly lower forced expiratory volume in one second and forced vital capacity values. Our findings suggest an opportunity for early intervention for primary and secondary prevention of PTLD to reduce the impact of severe respiratory impairment.

Multi-level digital-twin models of pulmonary mechanics: correlation analysis of 3D CT lung volume and 2D Chest motion

Creating multi-level digital-twin models for mechanical ventilation requires a detailed estimation of regional lung volume. An accurate generic map between 2D chest surface motion and 3D regional lung volume could provide improved regionalisation and clinically acceptable estimates localising lung damage. This work investigates the relationship between CT lung volumes and the forced vital capacity (FVC) a surrogate of tidal volume proven linked to 2D chest motion. In particular, a convolutional neural network (CNN) with U-Net architecture is employed to build a lung segmentation model using a benchmark CT scan dataset. An automated thresholding method is proposed for image morphology analysis to improve model performance. Finally, the trained model is applied to an independent CT dataset with FVC measurements for correlation analysis of CT lung volume projection to lung recruitment capacity. Model training results show a clear improvement of lung segmentation performance with the proposed automated thresholding method compared to a typically suggested fixed value selection, achieving accuracy greater than 95% for both training and independent validation sets. The correlation analysis for 160 patients shows a good correlation ofRsquared value of 0.73 between the proposed 2D volume projection and the FVC value, which indicates a larger and denser projection of lung volume relative to a greater FVC value and lung recruitable capacity. The overall results thus validate the potential of using non-contact, non-invasive 2D measures to enable regionalising lung mechanics models to equivalent 3D models with a generic map based on the good correlation. The clinical impact of improved lung mechanics digital twins due to regionalising the lung mechanics and volume to specific lung regions could be very high in managing mechanical ventilation and diagnosing or locating lung injury or dysfunction based on regular monitoring instead of intermittent and invasive lung imaging modalities.

Secondhand Smoke Exposure and Its Impact on Pediatric Lung Function, Aerobic Fitness, and Body Mass: Evidence from a Cross-Sectional Study.

Several studies have documented the detrimental impacts of secondhand smoke (SHS) exposure to a range of pediatric respiratory conditions, including asthma, bronchitis, and reduced lung function. The aim of the study was to investigate the influence of SHS exposure on lung function, physical fitness, and body mass index (BMI) in children aged 10 to 14 years. This cross-sectional study included children aged 10 to 14 years at the Elementary School "Trilj" in Trilj, Croatia. Data on SHS exposure were collected using a questionnaire. Antropometric and spirometry measurements were performed. Physical fitness was assessed using the shuttle run (BEEP) test. This study included 157 children, 89 (56.69%) boys and 68 (43.31%) girls. Children exposed to every day SHS in households had significantly lower values of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, peak expiratory flow (PEF) (p < 0.001) and higher z-score BMI levels (p = 0.018) in comparison to unexposed children. Logistic regression showed that children unexposed to SHS had higher odds for better results in the BEEP test (OR 62.45, 95% CI 21.26-179.24, p < 0.001). Children with poorer physical fitness, expressed by lower BEEP score levels, had significantly lower FVC, FEV1, FEV1/FVC, and PEF (p < 0.001). Every day SHS exposure in children was associated with poorer lung function, higher BMI, and poorer physical fitness.

A STUDY ON PIRFENIDONE VERSUS NINTEDANIB IN PATIENTS WITH IDIOPATHIC PULMONARY FIBROSIS IN A TERTIARY CARE HOSPITAL: A CROSS SECTIONAL STUDY

Background: Idiopathic pulmonary fibrosis (IPF) is a chronic condition with a poor prognosis and have an average life expectancy of 3-4 years. Two antifibrotic treatments have been approved to treat IPF: nintedanib and pirfenidone. These medications lower the decline in lung function and lower the risk of acute respiratory deterioration, which is linked with a high morbidity and death.Individual clinical trials have not been powered to demonstrate mortality decreases, however analysis of pooled data from clinical trials and observational research imply that anti-fibrotic drugs increase life expectancy. This study describes the utility of anti-fibrotic drugs and compare their efficacy. Methods and Materials: This 6 month cross-sectional study conducted at Santhiram Medical College and General Hospital in Nandyal.In patients with IPF , Clinical, functional and radiological data were gathered at baseline and during the follow-up, as per our Center procedure.This study compares and evaluates the efficacy of nintedanib and pirfenidone. A total of 40 patients over the age of 18 with IPF diagnosis were included. Patients under 18 years , those with known fibrosing lung diseases, bronchial asthma, COPD, HIV, Tuberculosis, or other organ failures were excluded. Results: At baseline, IPF patients treated with Pirfenidone had Forced vital capacity(FVC) and Forced expiratory volume at 1 second(FEV1) predicted percentages of 63.57 ± 8.34% and 72.31 ± 4.91%, respectively. In IPF patients treated with Nintedanib, at baseline(time 0), FVC and FEV1 percentages were 60.15±8.82% and 72.31±4.91% respectively. There were no significant variations in FVC and FEV1 percentages at time 0 between patients treated with the two medications (p=0.23,p=0.7,respectively). At 3-month follow-up, patients treated with Pirfenidone had predicted FVC and FEV1 values of 65.73 ± 7.84% and 72.94 ± 4.45%, respectively, whereas patients treated with Nintedanib had predicted valuesof 65.75 ± 7.67% and 72.42 ± 4.45%. At 6-month follow-up, patients on Pirfenidone had predicted FVC and FEV1 values of 66.9 ± 8.72% and 73.5 ± 4.50%, respectively. Nintedanib treatment resulted in 67.7±8.46% and 72.94±4.51% outcomes. Conclusion: our study shown that pirfenidone and nintedanib are equally effective at reducing FVC decline over a 6-month time frame.While nintedanib was slightly more beneficial in lowering FVC decline during the 6-month period. Both drugs were well tolerated, while nintedanib showing good tolerance in the majority of IPF patients.

Correlation of the severity of the clinical presentation of SARS-CoV-2 pneumonia with respiratory function parameters in the post-COVID period.

Since COVID-19 first surfaced in 2019, it has seriously threatened public health. The most prevalent symptoms are respiratory ones. This study aimed to present the correlation between the severity of the clinical presentation of the disease and the results of respiratory function tests conducted within 6 months after hospital discharge. This retrospective study included 99 patients with confirmed SARS-CoV-2 virus infection. Of all patients 24.2% had accentuated bronchovascular pattern, 9.1% had unilateral, and 29.3% had bilateral pneumonia. In comparison, 35.4% patients had diffuse changes, which were described as acute respiratory distress syndrome (ARDS) on computed tomography (CT). Patients with unilateral, bilateral pneumonia or diffuse lung damage had significantly lower forced vital capacity (FVC) values. They were treated with non-invasive mechanical ventilation (NIV) or invasive mechanical ventilation (MV) and had lower FVC values (0.039). A negative, weak correlation existed between CT findings during the infection and Diffusing capacity for carbon monoxide (DLCO) measured after the infection (0.003). A negative, weak correlation was found between oxygen therapy, the use of NIV, and MV findings during the infection with DLCO. A negative correlation was noted between leukocyte values during the infection and forced expiratory volume in the first second (FEV1) and FVC after the infection. Patients with COVID-19 infection who need oxygen support and MV continue to suffer from loss of respiratory function after the resolution of COVID-19 infection. These findings highlight the negative predictive value of pulmonary tests in the long-term follow-up for the development of PC-ILD as well as decreased pulmonary capacity.

Pulmonary function in patients with adolescent idiopathic scoliosis: an explorative study of a wearable smart shirt as a measurement instrument.

Adolescent idiopathic scoliosis (AIS) presents various challenges, including respiratory symptoms that impact pulmonary function. This study aims to explore the feasibility of using a smart shirt for continuous monitoring of lung volumes and heart rate during routine activities in AIS patients. A single-center exploratory feasibility study was conducted with AIS patients aged 16-22years with a thoracic curvature of ≥ 30 degrees and absence of respiratory comorbidities. A smart shirt was utilized to continuously monitor cardiopulmonary parameters during mild exercise, which included a standardized walking route with the ascent of multiple stairs. Five participants completed the study. Baseline spirometry measurements showed a range of values for forced vital capacity (FVC), forced expiratory volume in 1s (FEV1), and FEV1/FVC ratio. During mild exercise, participants exhibited variability in tidal volume, heart rate, breathing rate, and minute ventilation, with increases observed during stair climbing. Breathlessness levels also varied throughout the activity but did not correlate with the measured lung volumes. Overall, the use of the smart shirt for assessing pulmonary function in AIS patients was deemed feasible and well tolerated by participants during the test activities. The study confirms the feasibility of using a smart shirt for continuous measurement of cardiopulmonary parameters in AIS patients during daily activities. Incongruities between spirometry results and perceived dyspnea exists, which questions the nature of the perceived dyspnea. Further research is needed to validate these findings and explore the impact of AIS characteristics on measurement accuracy.

Randomized Controlled Trial on the Effects of Home-Based Breathing Exercises on Respiratory Function and Fatigue in COVID-19-Cured Young Patients.

This study investigates the effects of home-based Kakao Healthcare breathing exercises and stretching on respiratory function and fatigue in COVID-19-cured patients. A total of 35 participants performed four movements of home-based breathing exercises and five respiratory muscle stretching exercises four times a week for four weeks. Respiratory function was measured using forced vital capacity(FVC), forced expiratory volume in one second(FEV1), FEV1/FVC ratio, and peak expiratory flow(PEF). Fatigue was assessed using the Fatigue Severity Scale (FSS). Data analysis was performed using independent-sample and paired-sample t-tests in SPSS 24, with the significance level set at p < 0.05. After four weeks of home-based Kakao Healthcare breathing exercises, there were significant increases in respiratory FVC, FEV1, FEV1/FVC, and PEF function values observed in the training group (T.G.) after the exercise intervention (p < 0.05). Such an increase was observed when comparing these values with their corresponding pre-exercise measurements. In contrast, there were no statistically significant differences in respiratory function outcomes before and after exercise in the control group (C.G.) (p > 0.05). The FSS scores were statistically significant within the training group (T.G.) (p > 0.05). The 4-week Kakao Healthcare breathing exercise scheme was found to be capable of improving some respiratory functions in COVID-19-recovered patients, but it showed no significant improvement in fatigue levels.

The Effect of Conventional Open Thyroidectomy on Clinical Results and Respiratory Function Tests in Multinodular Goitre.

The primary aim of our study was to measure the effect of conventional open thyroidectomy performed for patients with multinodular goiter (MNG) on pulmonary volumes measured with respiratory function tests independent from surgical indications. A secondary aim was to determine whether there was a significant improvement in the complaints due to obstructive symptoms after MNG surgeries. This study was conducted between October 2020 and June 2022. Patients who were hospitalized to undergo surgery for giant multinodular goiter were prospectively included in the study. Patients were questioned about complaints of pressure, hoarseness, dyspnea, sleep apnea, snoring, and dysphagia before the surgery and during the follow-up 6 months after surgery. In addition, pulmonary function tests were performed preoperatively, 48 hours after surgery and 6 months after surgery. Forced expiratory volume in 0.5 seconds forced expiratory volume in 1 second and forced vital capacity values in pulmonary function test (PFT) measurements were recorded. A total of 55 patients, 42 females and 13 males, mean age 49.54 ± 13.6 years, were included in the study. Although there was a significant decrease in clinical symptoms caused by the thyroid volume within 6 months in patients who were operated for giant MNG there was no significant change in pulmonary function tests. There was a positive correlation between the thyroid volume and nodule weight in patients with MNG. Our results suggest that it is not necessary to follow up with patients without obstructive findings in preoperative pulmonary function tests with pulmonary function tests in the postoperative period.

Forced vital capacity and body mass index of Xinjiang children and adolescents: an analysis based on seven successive national surveys, 1985–2014

BackgroundPulmonary function is very important for the healthy development of children and adolescents. However, fewer studies have been conducted on pulmonary function trends in children and adolescents in remote areas. The aim of this study was to estimate the forced vital capacity (FVC) trend and its relationship with body mass index (BMI) among young people in Xinjiang during 1985–2014 using data from seven successive national surveys.MethodsA total of 19,449 Xinjiang children and adolescents aged 7–18 years were extracted from the Chinese National Survey on Students’ Constitution and Health. Height, weight, and FVC were measured repeatedly in each survey. FVC comparisons between adjacent surveys by age and sex were conducted by nonparametric Kruskal-Wallis after Kolmogorov-Smirnov of normality. One-way ANOVA and least significant difference(LSD) method was used to compare differences in FVC levels of Xinjiang children and adolescents with different BMI. The relationship between BMI and FVC was investigated using a nonlinear regression model.ResultsThe FVC levels of Xinjiang children and adolescents peaked in 2000, with overall FVC levels being 8.7% higher in 2000 than in 1985. Since then, a substantial decline occurred, contrasting to 2000, with FVC levels decreasing by 27% in 2014, which was still lower than that in 1985 by 20.73%. The proportion of overnutrition boys increased from 0.2% in 1985 to 22.1% in 2014, and girls from 0.5% in 1985 to 14.5% in 2014. An inverted U-shape association between FVC and BMI values was obtained for Xinjiang children and adolescents.ConclusionsTargeted measures should be carried out in schools to control BMI levels to ensure good lung function in children and adolescents in Xinjiang. Future studies should pay more attention to other factors affecting FVC, such as dietary behaviour, physical activity, and racial differences among children and adolescents.

The Effect of Static Apnea Diving Training on the Physiological Parameters of People with a Sports Orientation and Sedentary Participants: A Pilot Study.

Diver training improves physical and mental fitness, which can also benefit other sports. This study investigates the effect of eight weeks of static apnea training on maximum apnea time, and on the physiological parameters of runners, swimmers, and sedentary participants, such as forced vital capacity (FVC), minimum heart rate (HR), and oxygen saturation (SpO2). The study followed 19 participants, including five runners, swimmers, sedentary participants, and four competitive divers for reference values. The minimum value of SpO2, HR, maximum duration of apnea, and FVC were measured. Apnea training occurred four times weekly, consisting of six apneas with 60 s breathing pauses. Apnea duration was gradually increased by 30 s. The measurement started with a 30 s apnea and ended with maximal apnea. There was a change in SpO2 decreased by 6.8%, maximum apnea length increased by 15.8%, HR decreased by 9.1%, and FVC increased by 12.4% for the groups (p < 0.05). There were intra-groups changes, but no significant inter-groups difference was observed. Eight weeks of apnea training improved the maximum duration of apnea, FVC values and reduced the minimum values of SpO2 and HR in all groups. No differences were noted between groups after training. This training may benefit cardiorespiratory parameters in the population.

Comparison of a portable, pneumotach flow-sensor–based spirometer (Spirofy™) with the vitalograph alpha Touch™ spirometer in evaluating lung function in healthy individuals, asthmatics, and COPD patients—a randomized, crossover study

BackgroundSpirofy™ is India’s first portable, pneumotach flow-sensor-based digital spirometer developed to diagnose asthma and chronic obstructive pulmonary disease (COPD). In this study, we compared the performance of the Spirofy™ device with that of the Vitalograph Alpha Touch™ spirometer in measuring the lung capacities of healthy individuals, asthmatics, and COPD patients. We also assessed the inter-device variability between two Spirofy™ devices.MethodsIn a randomized, three-way crossover, open-label study, we measured the differences in forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) between the Spirofy™ and Vitalograph Alpha Touch™ spirometers. A proportion of the FEV1/FVC ratio distribution of < 0.7 was used to compare the diagnostic accuracies of the Spirofy™ with Vitalograph™ Alpha Touch™ spirometers.ResultsNinety subjects participated in this study. The mean ± SD FVC values obtained from the Spirofy™ 1, Spirofy™ 2, and Vitalograph Alpha Touch™ devices were 2.60 ± 1.05 L, 2.64 ± 1.04 L, and 2.67 ± 1.04 L, respectively. The mean ± SD FEV1 values obtained from the Spirofy™ 1, Spirofy™ 2, and Vitalograph Alpha Touch™ devices were 1.87 ± 0.92 (L), 1.88 ± 0.92 (L), and 1.93 ± 0.93 (L), respectively. A significant positive correlation was found between the FVC and FEV1 values recorded by Vitalograph Alpha Touch™, Spirofy™ 1, and Spirofy™ 2. As compared to Vitalograph Alpha Touch™, the Spirofy™ device showed good sensitivity (97%), specificity (90%), and overall accuracy (93.3%) at an FEV1/FVC ratio < 0.7. No inter-device variability was observed between the two Spirofy™ devices.ConclusionSpirofy™ is a portable and easy-to-use device and is as accurate as the standard Vitalograph Alpha Touch™ spirometer for the diagnosis of COPD and asthma.Trial registrationCTRI/2021/09/036492 (Clinical Trials Registry - India)

Efficacy and safety of levosalbutamol in patients with mild to moderate asthma compared with racemic salbutamol: results of a crossover placebo-controlled study

Aim. Effectiveness and safety of levosalbutamol metered dose inhaler (MDI) in comparison with placebo and salbutamol. Materials and methods. In this multicenter, randomized, placebo-controlled, 3-period crossover study, all asthma patients (n=91) received levosalbutamol (90 mcg), salbutamol (180 mcg), and placebo using standard MDI. Pulmonary function testing – forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) – was performed 45 and 15 minutes before and 5, 10, 15, 30, 60, 90, 120, 180, 240, 300 and 360 minutes after dosing. The primary efficacy endpoint was the baseline-corrected area under FEV1 curve from 0 to 6 hours (AUC(0–6h)). Secondary endpoints were the baseline adjusted FEV1 and FVC peak values, as well as the onset of drug action. Results. The FEV1 AUC0–6 hours analysis confirmed similar bronchodilatory levosalbutamol and salbutamol effect (p=0.595), significantly improved compared with placebo (p0.001). The peak values of FEV1 and FVC after levosalbutamol or salbutamol dosing were similar (p=0.643) and significantly higher compared with placebo group (p0.001). The active therapy effect was observed 5 minutes after dosing and throughout the entire observation period up to 6 hours, however, there was some tendency towards a longer duration of action of levosalbutamol compared to salbutamol. Levosalbutamol was well tolerated by patients; after levosalbutamol dosing twiсе fewer adverse reactions were observed compared to salbutamol. Conclusion. Levosalbutamol at a 90-mcg dose showed efficacy similar to that of salbutamol at a dose of 180 mcg, assosiated with a good safety profile.

Comparing the Effects of Virtual Reality Breathing Exercise and Incentive Spirometry Exercise on Improving Pulmonary Function in Children with Spastic Diplegic Cerebral Palsy.

Children with cerebral palsy (CP) have a higher incidence of respiratory dysfunction than healthy children. Virtual reality breathing therapy is an assistive technology that is becoming popular in the rehabilitation of children with CP. This experimental study included a total of 32 children with spastic diplegic CP who were divided into two groups: the virtual reality breathing training (VRBT) group and the incentive spirometry (IST) group. Individuals classified as levels I to III on the gross motor function classification system (GMFCS) were recruited using the simple random sampling method. The results of comparing the values of forced vital capacity (FVC), forced expiratory volume at one second (FEV1), and the ratio of FVC/FEV1 showed a significant difference between groups. A significant difference was found in the VRBT group compared to the IST group, except for the peak expiratory flow (PEF) values, which showed a nonsignificant difference between the groups. There were significant differences in FVC and FEV1 between the VRBT and IST groups. It has been concluded that VRBT has additional benefits in improving pulmonary functions.

Can We Use the Maximum Phonation Time as a Screening of Pulmonary Forced Vital Capacity in Post-COVID-19 Syndrome Patients?

ObjectiveTo verify the accuracy of the maximum phonation time of the vowel /a/ (MPT/a/), fricative /s/ (MPT/s/), number counting (MPTC), and number reached in this count (CN) to estimate forced vital capacity (FVC) in patients with Post-COVID-19 Syndrome. MethodCross-sectional study involving adult patients, who were admitted to the Intensive Care Unit and referred to the Post-COVID-19 Rehabilitation Outpatient Clinic. Voice function was assessed using a Vocal Handicap Index (VHI) self-assessment questionnaire and MPT tests. To perform the phonatory tests, the patients remained in a standing posture and were instructed to inhale as much air as possible and, during a single exhalation, at usual pitch and loudness, sustain the emission of /a/ and /s/; and in another breath, to perform the ascending numerical count, starting from the number one up to the highest number they could reach. Pulmonary function was assessed by spirometry. The ROC curve was plotted, and FVC values lower than the normal limit by Z-score (5th percentile) were classified as impaired lung function. The predictive values and likelihood ratios were calculated. ResultsA total of 70 patients participated, with 20-30% having a high VHI. Approximately 24% had an FVC impairment and significantly low values of MPT/a/, MPT/s/, MPTC, and CN. The test results showed overall accuracy of 70% and the cutoff points of 9.69, 6.78, 10.60 and 13, respectively, with high sensitivity, predictive negative value and low specificity, predictive positive value, and positive likelihood ratio. ConclusionsOur results suggest that the MPT has moderate discriminatory power for FVC impairment, indicating that it is not a reliable indicator of pulmonary function in the population studied. Therefore, in patients with an MPT of less than 10.60 seconds, or a CN lower than 13, other criteria should be added to improve the diagnostic accuracy and support the decision to perform more complex investigations.Keywords

ВЛИЯНИЕ НИЗКОЙ МАССЫ ТЕЛА НА ПАРАМЕТРЫ ВНЕШНЕГО ДЫХАНИЯ И УРОВЕНЬ ЭОЗИНОФИЛОВ ПЕРИФЕРИЧЕСКОЙ КРОВИ У ДЕТЕЙ И ПОДРОСТКОВ С БРОНХИАЛЬНОЙ АСТМОЙ

Current data on the relationship between the body mass index (BMI) and low body weight (BW) and the lung function and peripheral blood eosinophils count in children and adolescents with bronchial asthma (BA) are contradictory. The purpose of this research was to study the relationship between BMI, spirometry parameters and the level of peripheral blood eosinophils in children and adolescents with BA. Materials and methods used: a single-center observational cross-sectional pilot study of 240 children and adolescents with BA of median age 12.0 [9.0; 15.0] y/o, of which 165 (68.8%) were boys, who were divided into two groups based on anthropometric measurements performed to calculate BMI and zBMI: G1 of those with normal BW (BMI -1Z to +1Z) and G2 with LBW (BMI below -1Z). The following spirometry parameters were analyzed: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC ratio (absolute values and Z-scores). Results: absolute values of FVC and FEV1 in LBW patients were slightly lower than in patients with normal BW, the differences were trendy (p=0.055 and p=0.108, respectively). At the same time, zFVC and zFEV1 in low BW patients were statistically significantly lower than in patients with normal BW, amounting to 0.440±1.210 and 1.06±1.130 (p&lt;0.001) for zFVC, respectively, and for zFEV1 -0.241 [-0.974; 0.576] and 0.304 [-0.397; 1.00] (p=0.002). The values of both FEV1/FVC and zFEV1/FVC between these BMI groups did not have statistically significant differences (p=0.462 and p=0.300). Analysis of the relationships between zBMI and z-values of spirometric parameters revealed a significant direct relationship between zBMI and zFVC (R=0.308, p&lt;0.001), as well as a direct, significant, but less pronounced relationship between zBMI and zFEV1 (R=0.20, p=0.002). The relationship between zBMI and zFEV1/FVC was negative (R=-0.11) and did not have statistical significance (p=0.097). The absolute content of eosinophils in peripheral blood was significantly higher in patients with low BW (p=0.006) and had a significant negative relationship with zBMI (R=-0.217, p=0.023). Conclusion: zFVC and zFEV1 values are lower in children and adolescents with BA and low BW and the absolute count of eosinophils in peripheral blood is higher than in patients with normal BW. Therefore, maintaining nutritional status may be an important component of the formation of the respiratory system and an adequate immune response in children and adolescents with BA.

Pulmonary Function at Minimum 10 Years After Segmental Pedicle Screw Instrumentation for Thoracic Adolescent Idiopathic Scoliosis.

A prospective multi-center cohort study. This study evaluates the 10-year pulmonary function outcomes for patients with structural thoracic adolescent idiopathic scoliosis (Lenke curve types 1-4, 6) after segmental pedicle screw instrumentation. Adolescent idiopathic scoliosis with thoracic curves is associated with reduced pulmonary function preoperatively. It remains unclear how much pulmonary improvement can be obtained using pedicle screw instrumentation at long-term follow-up. Out of 64 consecutively surgically treated patients with thoracic AIS (Lenke 1-4, 6) using pedicle screw instrumentation, 50 (mean age at final FU 14.7 ± 1.9, 44 females) participated in a prospective 10-year follow-up study. They were evaluated using clinical examination, spinal radiographs, and spirometry preoperatively and at 10-year follow-up. The preoperative percentage predicted values were adjusted for the height loss caused by the scoliosis according to curve size. Preoperatively 49% (20/41) had forced vital capacity (FVC) or forced expiratory volume in one second (FEV1) below 80% of the predicted normal values representing pulmonary function impairment. Major curve correction averaged 76% (SD 9%). FVC improved from preoperative 3.29 L (SD 0.78L) to 3.87 L (0.79L) at 10-year follow-up (P<0.001). This improvement averaged 510mL (SD 560mL) in patients having both preoperative and 10-year follow-up measurements available. The percentage predicted values for FVC showed an improvement from 83% preoperatively to 86% at 10-year follow-up (P=0.048). At 10-year follow-up 38% (19/50) of the patients had FVC or FEV1 below 80% of the predicted values. FVC improved by a mean of 510ml from preoperative to 10-year follow-up in patients undergoing pedicle screw instrumentation for thoracic AIS. Despite 76% scoliosis correction and significant improvement of absolute lung volume values, more than one-third of these surgically treated otherwise healthy young adults fulfilled the criteria for pulmonary function impairment at 10-year follow-up. II.

지역사회 거주 여성 노인의 폐 기능과 근감소증과의 상관성 연구

Purpose: This study aimed to compare pulmonary function between functionally sarcopenic and non-sarcopenic older individuals and to demonstrate the association of sarcopenia with pulmonary function in community-dwelling older women. Methods: The SARC-F questionnaire, handgrip strength, and gait speed were examined to assess sarcopenia. To evaluate pulmonary function, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow(PEF) were measured. Independent t-tests or Mann-Whitney U tests were used to compare variables of pulmonary function (FVC, FEV1, FEV1/FVC, and PEF), and logistic regression analysis was performed to demonstrate the association between functional sarcopenia and pulmonary function. Results: Functionally sarcopenic older women showed significantly lower values of FVC, FEV1, and PEF than non-sarcopenic older women(p&lt;.05). In addition, older women with low FVC, FEV1, and PEF were less likely to have sarcopenia(p&lt;.05). Conclusion: This study demonstrated differences in pulmonary function between functionally sarcopenic and non-sarcopenic older women. In addition, a reduction in pulmonary function (FVC, FEV1, and PEF) measured by spirometry was associated with the presence of functional sarcopenia in older women. Future longitudinal studies are needed to investigate the effects of improving pulmonary function on functional sarcopenia through the management and intervention of pulmonary function in older women with sarcopenia.

A study on the outcome of preoperative pulmonary function tests on a patient undergoing rheumatic mitral valve surgery.

Evaluation of pulmonary function by spirometer in adult patients undergoing cardiac surgery is a simple test to assess pulmonary reserve that has important implications in operative morbidity. However, there is no established consensus regarding which patients should undergo preoperative pulmonary function tests (PFTs), including forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC). The primary aim was to evaluate the outcome of preoperative PFTs on patients undergoing rheumatic mitral valve surgery. One hundred patients undergoing rheumatic mitral valve surgery, meeting the inclusion criteria, were included in this prospective observational study. The pulmonary function of the patients was assessed using a spirometer before surgery. Preoperative pulmonary artery systolic pressure (PASP) and arterial blood gas (ABG) analyses were also performed. The correlation of PFTs with early postsurgical outcome, comprising mortality within 30 days of surgery and morbidity defined as the existence of at least one of the postoperative complications, such as low cardiac output state indicated by increased requirement of inotropes, prolonged ventilation (>24 hours), postoperative new-onset hemodynamically significant arrhythmias, renal dysfunction, and post-op infection, was assessed. With the increasing New York Heart Association (NYHA) class of the patient, there was a decline of FEV1% and FVC%, which was statistically significant (P < 0.0001). There was a significant positive correlation of FVC% with preoperative saturation of peripheral oxygen (SpO2) and preoperative saturation of peripheral carbon dioxide (PaO2) and FEV1% with preoperative SpO2 and preoperative PaO2. Patients who had postoperative prolonged ventilation had lower values of FVC% and FEV1%, which was statistically significant (P < 0.001). The patients who expired had significantly lower values of FVC% and FEV1%. Preoperative lung function has an implication on intraoperative morbidity during cardiac surgery although a common consensus on its application is lacking. Preoperative spirometry can be one of the parameters for predicting postoperative morbidity and mortality in patients undergoing rheumatic mitral valve surgery. Spirometry might have a role to play in predicting patient outcomes in rheumatic mitral valve surgeries; however, larger well-powered studies are needed.

Spirometry test values can be estimated from a single chest radiograph.

Physical measurements of expiratory flow volume and speed can be obtained using spirometry. These measurements have been used for the diagnosis and risk assessment of chronic obstructive pulmonary disease and play a crucial role in delivering early care. However, spirometry is not performed frequently in routine clinical practice, thereby hindering the early detection of pulmonary function impairment. Chest radiographs (CXRs), though acquired frequently, are not used to measure pulmonary functional information. This study aimed to evaluate whether spirometry parameters can be estimated accurately from single frontal CXR without image findings using deep learning. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC as spirometry measurements as well as the corresponding chest radiographs of 11,837 participants were used in this study. The data were randomly allocated to the training, validation, and evaluation datasets at an 8:1:1 ratio. A deep learning network was pretrained using ImageNet. The input and output information were CXRs and spirometry test values, respectively. The training and evaluation of the deep learning network were performed separately for each parameter. The mean absolute error rate (MAPE) and Pearson's correlation coefficient (r) were used as the evaluation indices. The MAPEs between the spirometry measurements and AI estimates for FVC, FEV1 and FEV1/FVC were 7.59% (r = 0.910), 9.06% (r = 0.879) and 5.21% (r = 0.522), respectively. A strong positive correlation was observed between the measured and predicted indices of FVC and FEV1. The average accuracy of >90% was obtained in each estimation of spirometry indices. Bland-Altman analysis revealed good agreement between the estimated and measured values for FVC and FEV1. Frontal CXRs contain information related to pulmonary function, and AI estimation performed using frontal CXRs without image findings could accurately estimate spirometry values. The network proposed for estimating pulmonary function in this study could serve as a recommendation for performing spirometry or as an alternative method, suggesting its utility.

Pulmonary function testing in preoperative high-risk patients

BackgroundPostoperative respiratory failure is the most frequent complication in postsurgical patients. The purpose of this study is to assess whether pulmonary function testing in high-risk patients during preoperative assessment detects previously unknown respiratory impairments which may influence patient outcomes.MethodsA targeted patient screening by spirometry and the measurement of the diffusing capacity of the lung for carbon monoxide (DLCO) was implemented in the anesthesia department of a tertiary university hospital. Patients of all surgical disciplines who were at least 75 years old or exhibited reduced exercise tolerance with the metabolic equivalent of task less than four (MET < 4) were examined. Clinical characteristics, history of lung diseases, and smoking status were also recorded. The statistical analysis entailed t-tests, one-way ANOVA, and multiple linear regression with backward elimination for group comparisons.ResultsAmong 256 included patients, 230 fulfilled the test quality criteria. Eighty-one (35.2%) patients presented obstructive ventilatory disorders, out of which 65 were previously unknown. 38 of the newly diagnosed obstructive disorders were mild, 18 moderate, and 9 severe. One hundred forty-five DLCO measurements revealed 40 (27.6%) previously unknown gas exchange impairments; 21 were mild, 17 moderate, and 2 severe. The pulmonary function parameters of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and DLCO were significantly lower than the international reference values of a healthy population. Patients with a lower ASA class and no history of smoking exhibited higher FVC, FEV1, and DLCO values. Reduced exercise tolerance with MET < 4 was strongly associated with lower spirometry values.ConclusionsOur screening program detected a relevant number of patients with previously unknown obstructive ventilatory disorders and impaired pulmonary gas exchange. This newly discovered sickness is associated with low metabolic equivalents and may influence perioperative outcomes. Whether optimized management of patients with previously unknown impaired lung function leads to a better outcome should be evaluated in multicenter studies.Trial registrationGerman Registry of Clinical Studies (DRKS00029337), registered on: June 22nd, 2022.