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Lung Function Measurements (lung + function_measurement)
Selected AbstractsThe influence of maternal respiratory infections during pregnancy on infant lung function,PEDIATRIC PULMONOLOGY, Issue 10 2007Nienke Van Putte-Katier MD Abstract Introduction We studied whether maternal respiratory infections during pregnancy adversely influence lung growth and development of the offspring, resulting in poor early life lung function. Methods Infants were participants of the Wheezing Illnesses Study Leidsche Rijn (WHISTLER). Lung function measurements (single occlusion technique) were performed during natural sleep. Questionnaire data were used to obtain information on maternal respiratory infections during pregnancy. Multivariate analysis was conducted to assess the relationship between maternal respiratory infections during pregnancy and resistance and compliance of the respiratory system, adjusting for potential confounding variables. Results Lower values of compliance (Crs) were found in infants of mothers with respiratory infections during pregnancy; Crs fell by 5.5% (P,=,0.031). The difference in Crs between infants of mothers with and without respiratory infections during pregnancy remained unchanged and statistically significant after adjusting for potential confounding variables. The more respiratory infections the mother experienced during pregnancy, the lower the value of Crs was in her offspring (P for trend,=,0.016). Using Crs corrected for body weight the relationship with maternal infections was non-significant, however still showing a trend. Conclusions The results of this study may indicate that mothers who experience respiratory infections during pregnancy have newborns with lower compliance of the respiratory system. Pediatr Pulmonol. 2007; 42:945,951. © 2007 Wiley-Liss, Inc. [source] Improved lung function after thoracocentesis in patients with paradoxical movement of a hemidiaphragm secondary to a large pleural effusionRESPIROLOGY, Issue 5 2007Lee-Min WANG Background and objectives: Previous studies have shown little or no improvement in pulmonary function and arterial blood oxygenation after therapeutic thoracocentesis. This study investigated changes in pulmonary function, arterial blood gases and dyspnoea after therapeutic thoracocentesis in patients with paradoxical movement (PM) of a hemidiaphragm due to pleural effusion. Methods: Twenty-one patients with pleural effusion and PM of a hemidiaphragm and 41 patients with pleural effusion but without paradoxical movement (NPM) were studied before and 24 h after thoracocentesis. Lung function measurements included lung mechanics, blood gas exchange and the Borg dyspnoea scale. Results: At thoracocentesis a mean of 1220 mL of pleural fluid was removed from the PM group and 1110 mL from the NPM group. Post-thoracocentesis the PM group showed small but significant improvement (P < 0.05) in FEV1 (63% vs 73%), FVC (67% vs 77%), PaO2 (66 mm Hg vs 73 mm Hg), A-a O2 gradient (38 mm Hg vs 30 mm Hg), and the Borg scale (5.1 vs 2.1). The NPM group showed no significant change in any parameter. Conclusions: Statistically significant improvement in pulmonary function following thoracocentesis was observed in patients with pleural effusion and PM of the hemidiaphragm. Patient selection may therefore explain the different outcomes of thoracocentesis reported in previous studies. [source] Trial of nurse-run asthma clinics based in general practice versus usual medical careRESPIROLOGY, Issue 3 2004Louis S. PILOTTO Objective: The aim of this study was to assess the ability of nurse-run asthma clinics based in general practice compared with usual medical care to produce at least a moderate improvement in the quality of life of adults with asthma. Methodology: A randomized controlled trial involving 80 asthma clinic and 90 usual medical care asthma participants, aged 18 years and older was conducted in 11 general practices in Adelaide. The main outcome measure was the St George's respiratory questionnaire (SGRQ), from which quality-of-life scores were used to assess therapeutic benefit. Lung function measurements and health services utilization data were also collected. Results: One hundred and fifty-three participants (90%) were reviewed at follow up after 6,9 months. There was little difference between groups in baseline measures or for the 6-month follow-up, outcomes,, including, the, mean, difference, in, total, SGRQ, scores, (,0.5,, 95%, confidence, interval, (CI) ,4.0, 2.9) and the mean difference in percentage predicted FEV1 (2.3%, 95% CI ,0.7, 5.3 pre-bronchodilator; 0.4%, 95% CI ,5.1, 5.9 post-bronchodilator). Trends in health services utilization were noted. Conclusions: Nurse-run asthma clinics based in general practice and usual medical care were similar in their effects on quality of life and lung function in adults. These findings cannot be generalized to hospital outpatients and other clinics that manage more severe asthmatic patients. [source] Exhaled air temperature in asthma: methods and relationship with markers of diseaseCLINICAL & EXPERIMENTAL ALLERGY, Issue 3 2007G. L. Piacentini Summary Background Exhaled breath temperature has been proposed as a surrogate marker for the evaluation of airway inflammation in asthmatic patients. Objective The aim of the present study was to extend the investigation of exhaled air temperature as a means for the evaluation of airway inflammation using a professionally developed instrument. Methods Fifty-seven children, 41 allergic mild asthmatics and 16 healthy controls have been evaluated. They underwent exhaled air temperature and lung function measurement. The asthmatic children also underwent exhaled nitric oxide measurement, and hypertonic saline sputum induction for the evaluation of eosinophil (EOS) percentage. Results The level of exhaled temperature was significantly higher in asthmatics than in controls, being 30.18±0.14°C vs. 27.47±0.24°C (P<0.001). In asthmatic children, a positive relationship was observed between exhaled air temperature and both exhaled nitric oxide (r=0.39; P=0.01) and EOS percentage in samples from induced sputum (,=0.53; P=0.04). Conclusion The data from the present study support the hypotheses that exhaled breath temperature is related to the degree of airway inflammation in asthma. [source] Investigation into the nutritional status, dietary intake and smoking habits of patients with chronic obstructive pulmonary diseaseJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 1 2004W. J. Cochrane Abstract Background and aims Weight loss and reduced fat-free mass are prevalent amongst patients with chronic obstructive pulmonary disease (COPD). However, the causes of this weight loss are not clear. The aims of this study are to investigate the factors affecting body weight and dietary intake in a group of outpatients with COPD, and to investigate any differences between adequately nourished and malnourished patients. Methods In 103 stable outpatients, nutritional status was assessed using Body Mass Index (BMI) and upper arm anthropometry. Lung function, smoking status, exercise tolerance, dietary intake, dietary problems and health-related quality of life were assessed. Patients were classed as either adequately nourished or malnourished. Results Twenty-three per cent of subjects were classed as malnourished. The malnourished subjects had lower lung function measurements, suffered more dietary problems and had lower nutritional intake compared with the adequately nourished subjects. They also had poorer fatigue scores. In linear regression analysis, the factors that had the most effect on BMI were a low transfer factor, presence of early satiety, and being a current smoker. Conclusion Important differences were found between adequately nourished and malnourished subjects. These differences move us closer to understanding how best to screen and treat this group of patients. [source] Annual assessment spirometry, plethysmography, and gas transfer in cystic fibrosis: Do they predict death or transplantationPEDIATRIC PULMONOLOGY, Issue 10 2008FRCPCH, Mark Rosenthal MD Abstract Aim The long- and short-term prognostic value of pediatric spirometry, plethysmography, and gas transfer measurements in cystic fibrosis (CF) were assessed. Methods Two hundred ninety-eight children with CF and ,4 annual assessment lung function measurements at a single institution were analyzed in mid childhood. Long-term outcome was death or lung transplantation (D/T) before 2007. Short-term outcome was forced expired volume in one second (FEV1) z -score 1 year after the previous lung function measurements. Results 26/298 had a D/T outcome at median 19.5 years. A zFEV1,<,,2 aged 8 years had a positive predictive value of 67% (sensitivity 67%) for D/T in those homozygous for ,F508 but zFEV1 at older ages and all genotypes was unhelpful. The ratio of residual volume to total lung capacity z -score could also predict a few D/T individuals when zFEV1 was normal in mid childhood. Most other lung function measurements were not helpful. Matching D/T with alive groups for year of birth left prognostic utility unchanged. Only current zFEV1 could significantly predict zFEV1 1 year hence (56% variability explained, P,<,0.00001); no other lung function, gender, age or nutrition factor was significant. Conclusion The value of routine plethysmography and gas transfer measurements in CF is questionable in CF management. Detecting abnormal spirometry even at age 8 years may be too late to affect long-term outcome. Pediatr Pulmonol. 2008; 43:945,952. © 2008 Wiley-Liss, Inc. [source] Guidelines for mechanical lung function measurements in psychophysiologyPSYCHOPHYSIOLOGY, Issue 5 2002Thomas Ritz Studies in psychophysiology and behavioral medicine have uncovered associations among psychological processes, behavior, and lung function. However, methodological issues specific to the measurement of mechanical lung function have rarely been discussed. This report presents an overview of the physiology, techniques, and experimental methods of mechanical lung function measurements relevant to this research context. Techniques to measure lung volumes, airflow, airway resistance, respiratory resistance, and airflow perception are introduced and discussed. Confounding factors such as ventilation, medication, environmental factors, physical activity, and instructional and experimenter effects are outlined, and issues specific to children and clinical groups are discussed. Recommendations are presented to increase the degree of standardization in the research application and publication of mechanical lung function measurements in psychophysiology. [source] Identifying problematic severe asthma in the individual child , does lung function matter?,ACTA PAEDIATRICA, Issue 3 2010AM Lang Abstract Aim:, Measures of lung function (usually FEV1 <80% predicted) are used to classify asthma severity in both adults and children, despite evidence that lung function impairment is less pronounced in the paediatric asthma population. The present study assesses the relevance of lung function measurements as discriminators of severe childhood asthma. Methods:, Fifty-one school-aged children with problematic severe asthma, 37 mild-to-moderate asthmatics and 29 healthy controls underwent a comprehensive clinical work-up. Problematic severe asthma was defined in patients exhibiting poor asthma control despite high-dose inhaled corticosteroid treatment and at least one other asthma controller drug. Mild-to-moderate asthmatic children used low-dose inhaled steroids and reported minimal asthma symptoms. Results:, Baseline FEV1 values were significantly reduced in children with problematic severe asthma, yet FEV1 <80% predicted showed a low sensitivity (41%) for discriminating severe vs. mild-to-moderate asthma. Receiver-operated characteristic analysis estimated the optimal cut-off of FEV1 to be 90% predicted in this population (sensitivity 61%, specificity 83%). Baseline FEV1/FVC and FEF25,75 values were not superior to FEV1 in discriminating problematic severe asthma, and neither exhaled nitric oxide levels nor bronchial hyperresponsiveness differentiated between the two asthmatic study populations. Conclusion:, Spirometric measurements are insensitive discriminators of problematic severe asthma in childhood. [source] Increased occurrence of asthma and allergy: critical appraisal of studies using allergic sensitization, bronchial hyper-responsiveness and lung function measurementsCLINICAL & EXPERIMENTAL ALLERGY, Issue 10 2001M. H. Wieringa Background Many studies have reported an increase in the occurrence of asthma and respiratory allergies in recent decades, but this increase is mostly based on studies using rather subjective measurements of asthma and allergies, such as questionnaires and doctor's diagnosis. None of the reviews specifically focused on studies using more ,objective' measurements, such as sensitization (specific IgE or skin prick testing (SPT)), bronchial hyper-responsiveness (BHR) or lung function (LF). Objective To review articles studying a time trend of occurrence of these ,more objective' measurements. Methods A MEDLINE-search (1966,February 2000) was performed. The following criteria were used: population-based, using IgE, SPT, BHR or LF measurements in the same age-group at least twice, with at least 2 years between and using similar methods. Results The MEDLINE-search resulted in only 16 articles, performed in 13 populations in seven different countries. Nine articles used the same objective measurements twice in the whole population. Three of these reported a non-significant increase or decrease. The other six articles found a significant increase in at least one objective measurement and of these only three reported a consistent significant increase. Conclusions The increase in the occurrence of reported asthma and allergy is supported by only a few articles confirming these results with ,more objective measurements'. [source] Survey of neonatal respiratory support strategiesACTA PAEDIATRICA, Issue 8 2007Atul Sharma Abstract Aim: To survey current practice regarding neonatal respiratory support strategies to determine whether it reflected evidence from randomised trials. Methods: A questionnaire (in Supplementary Material online) survey of all U.K. neonatal units was undertaken to determine what modes of ventilation, types of endotracheal tube, lung function monitoring and oxygen saturation levels were used. Results: There was an 80% response rate. Most (73%) units used in prematurely born infants (in the first 24 h) the intermittent positive pressure ventilation, and other respiratory modes included: CPAP (2%), triggered ventilation with or without volume guarantee (22%) and high frequency oscillation (2%). Only 15% of units used assist control mode for weaning; the preferred weaning mode was synchronous intermittent mandatory ventilation (73%). Few units used shouldered endotracheal tubes (3%) or lung function measurements (25%) to aid choice of ventilator settings. Oxygen saturation levels from 80% to 98% were used, levels greater or equal to 95% were used by 11% of units for infants with acute respiratory disease but by 34% of units for BPD infants (p < 0.001). Conclusion: Many practitioners do not base their choice of neonatal respiratory support strategies on the results of large randomised trials; more effective methods are required to ensure evidence-based practice. [source] | ||||||||||