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PubMed1979

Decrease in vital capacity in PCB-exposed workers in a capacitor manufacturing facility.

Pulmonary function was evaluated in 243 workers exposed to PCB in the manufacture of capacitors. Mean employment was greater than 15 years. Thirty-four of the workers (14%) were found to have a reduced Forced Vital Capacity (FVC less than 80% of Morris' predicted). Of the 34 with reduced FVC, 27 (80%) demonstrated a restrictive pattern of impairment (FEV1/FVC greater than 0.7). Only one of these 27 workers had an abnormal chest roentgenogram (greater than or equal to 1/0 by ILO UC Classification of Radiographs of Pneumoconioses). These findings are of interest in view of recent experimental data indicating the accumulation of PCBs and PCB metabolites in lung tissue (Brandt and Jansson). Restrictive spirometric impairment with no radiographic change is unusual in occupational exposure.

Adult↗
PubMed2001

Tracheal intubation without muscle relaxant--a technique using sevoflurane vital capacity induction and alfentanil.

This randomized controlled study examined intubating conditions and haemodynamic changes following sevoflurane nitrous oxide induction in four groups: three different doses of alfentanil compared with low-dose alfentanil and suxamethonium. All patients received atropine 0.3 mg i.v. before induction of anaesthesia with vital capacity breaths of sevoflurane 8% (more than 7% in the inspiratory gas) in 60% nitrous oxide and oxygen. Patients were allocated randomly to four groups of intravenous supplements: group SA20, alfentanil 20 microg x kg(-1); group SA25, alfentanil 25 microg x kg(-1); group SA30, alfentanil 30 microg x kg(-1); group SSA, alfentanil 10 microg x kg(-1) and suxamethonium 1 mg x kg(-1). Orotracheal intubation and assessment of intubating conditions was performed by one of the investigators who was blinded to the subject's group. Intubating conditions were satisfactory or excellent in 83%, 80%, 92% and 96% of patients in groups SA20, SA25, SA30 and SSA respectively. These differences were not statistically significant. The increase in heart rate associated with laryngoscopy and tracheal intubation was effectively attenuated in all groups. Mean arterial pressure decreased significantly and similarly after induction in all groups. Two minutes after intubation the mean arterial pressure was increased significantly (P<0.05) compared to the post-induction value in group SSA. The intubating conditions obtained with sevoflurane plus alfentanil 30 microg x kg(-1) were comparable to those provided by the sevoflurane, suxamethonium and alfentanil 10 microg x kg(-1) combination.

Adolescent↗
PubMed2004

The prognostic value of pre-operative predicted forced vital capacity in corrective spinal surgery for Duchenne's muscular dystrophy.

The majority of patients with Duchenne's muscular dystrophy require corrective spinal surgery for scoliosis to maintain seated balance and to slow the progression of respiratory compromise, thereby facilitating nursing and enhancing their quality of life. Traditionally patients with a pre-operative forced vital capacity (PFVC) of 30% or below predicted have been denied this surgery as it was thought that the incidence of postoperative complications was unacceptably high. We present data collected prospectively from 45 consecutive operations undertaken in our unit. These cases indicate that there is no clinically significant difference in operative and postoperative outcomes between patients with PFVC > 30% and < or =30%. However, the routine postoperative use of mask ventilation to facilitate early tracheal extubation is vital.

Adolescent↗
PubMed1999

Methacholine-induced fall in forced vital capacity as a marker of asthma severity.

The dose of methacholine causing a 20% fall in forced expiratory volume in 1 sec (FEV1) from baseline (PD20) has been used as an index of asthma severity. The aim of this study was to determine if the percentage fall in forced vital capacity (FVC) from baseline at the PD20 (dFVC%) is an independent marker of asthma severity. We first retrospectively studied the dFVC% and PD20 obtained from 149 consecutive newly diagnosed asthmatics with a positive methacholine-challenge test (MCT). We then performed MCT on 20 normal subjects and 35 stable asthmatics. The 'milder' asthmatics (n = 20) and 'more severe' asthmatics (n = 15) were on regular inhaled corticosteroids: 200 micrograms or less and 800 micrograms or more daily, respectively. A dosimeter technique was used, and normal subjects were given a cumulative dose of 2400 micrograms. The PD20 and dFVC% were calculated using log-linear interpolation of the last two points. Student's unpaired t-tests and linear regression analyses were used for comparison and correlation of results. There was no significant correlation between dFVC% and PD20 among the 149 newly diagnosed asthmatics (r = 0.1), or among the 35 known stable asthmatics (r = 0.008). The more severe asthmatics had a larger dFVC% compared with the milder asthmatics (15.8% vs. 9.6%; P = 0.0005). In addition, inhaled corticosteroid usage correlated better with dFVC% (r = 0.56) than with PD20 (r = 0.36). The normal subjects had a mean fall in FVC of only 4.8%. The percentage fall in FVC at PD20 (dFVC%) may be a useful index of asthma severity which is independent of PD20. This index is potentially complementary to the PD20 in the assessment of asthma severity.

Adrenal Cortex Hormones↗
PubMed1998

The influence of the transposed stomach through the posterior mediastinum on the respiratory forced expiratory volume and forced vital capacity in patients with resected esophageal cancer.

Although the use of the posterior mediastinum and the stomach as a reconstruction option after esophagectomy has large acceptance all over the world, there are concerns about the potential respiratory impairment it could cause. We prospectively studied 35 patients regarding the forced expiratory volume and vital capacity. The patients were studied preoperatively and between the 45th and 60th postoperative days. The value of both parameters decreased, although they were still within normal clinical ranges. We concluded that this type of reconstruction does not harm the patients regarding the respiratory flow rates.

Adenocarcinoma↗
PubMed1999

Reliability of thoracic gas volume derived from mechanical impedance at different levels of the vital capacity.

BACKGROUND: Thoracic gas volume (TGV) may be estimated during spontaneous breathing by measuring simultaneously respiratory impedance (Zrs) and alveolar gas compression (Vpl) at several oscillation frequencies [Peslin and Duvivier: J Appl Physiol 1998;84:862-867]. OBJECTIVE: The aim of the study was to test the validity of that approach at different levels of the vital capacity (VC). METHODS: We measured Zrs and Vpl at frequencies ranging from 6 to 29 Hz in 10 healthy subjects rebreathing BTPS gas in a constant volume body plethysmograph. In a first series, the subjects were asked to breathe voluntarily at different levels of the VC and oscillation TGV (TGVos) was compared to standard plethysmographic TGV (TGVst) assessed immediately after TGVos measurements. In a second series, the subjects were asked to change stepwise their lung volume in the middle of the forced oscillation recording, and the changes in TGVos (DeltaTGVos) were compared to the changes in lung volume (DeltaV) computed from the integrated flow signal. RESULTS: In most subjects TGVos and TGVst were highly correlated and the slopes of the relationships did not differ significantly from unity. DeltaTGVos and DeltaV were also highly correlated both in individuals and in the group (r = 0.97), and their signless differences averaged 0.23 +/- 0.20 liter. CONCLUSION: We conclude that forced oscillation estimates of TGV are reliable in healthy subjects over a large part of the VC.

Adult↗
PubMed1977

The First Second Timed vital capacity and the course of obstructive lung diseases.

Previous work has shown that with increasing airway obstruction in chronic obstructive pulmonary disease, the decrement in the maximum midexpiratory flow (MMEF) is exponential. Therefore, with severe obstructive disease the decrease in the MMEF as the disease progresses is difficult to discern. This work points out that the fall in first second timed vital capacity (FEV1/FVC x 100) is linear through the course of the disease and, therefore, the decrement, in absolute terms, continues unaltered regardless of how severe the obstruction becomes. It is suggested that the FEV1/FVC x 100 might be more useful in monitoring the course of severe disease than the MMEF. However, it is stressed that both measurements are useful for large groups, but may not be useful in individual cases.

Forced Expiratory Volume↗
PubMed2004

[Association between the forced midexpiratory flow/forced vital capacity ratio and bronchial hyperresponsiveness].

OBJECTIVE: A long-standing hypothesis is that a low ratio of airway caliber to lung size is associated with bronchial hyperresponsiveness (BHR). The aim of our study was to measure the association between airway caliber relative to lung size (expressed as the ratio between forced expiratory flow, midexpiratory phase, divided by forced vital capacity [FEF(25%-75%)/FVC]) and BHR measured by a methacholine challenge test, adjusting for age, height, sex, smoking history, geographic area, respiratory symptoms, and baseline forced expiratory volume in 1 second (FEV1). MATERIAL AND METHODS: We carried out a multicenter cross-sectional study of the general Spanish population in 2647 subjects from the European Community Respiratory Health Survey (ECRHS I). The ECRHS questionnaire was administered, total and specific immunoglobulin E were measured, and skin tests, spirometry, and a methacholine challenge test were performed. RESULTS: We show the relationship of the various clinical and sociodemographic variables with the 2 parameters indicative of a positive methacholine test. The lower the FEF(25%-75%)/FVC ratio was, the greater the risk of HRB, after adjustment for variables (odds ratio [OR]=0.09; 95% confidence interval [CI], 0.04-0.018 for the concentration provoking a 20% decrease in FEV1, and OR=0.06; 95% CI, 0.03-0.12 for the dose provoking a 20% decrease in FEV1). CONCLUSIONS: There is a significant association between the FEF(25%-75%)/FVC ratio and BHR after adjustment for age, atopy, smoking, geographic area, respiratory symptoms, and initial FEV1.

Adult↗
PubMed1976

Incomplete right bundle branch block and vital capacity.

Right bundle branch block (RBBB) is occasionally encountered in young persons who lack any other evidence of overt cardiac disease (Hiss and Lamb, 1962; Lancaster, Schechter, and Massing, 1972). The block may be complete or incomplete, the latter being more common. Right bundle branch block has been studied in relation to body weight, obesity, serum cholesterol and glucose levels, and blood pressure, but the results have been negative (Ostrander, 1964; Kannel et al., 1962). Data presented here suggest that incomplete RBBB is related to vital capacity.

Adult↗
PubMed1984

[So-called pocket-sized spirometry versus respiratory function tests: a comparative study of vital capacity, forced expiratory volume in 1 second and Tiffeneau's coefficient].

A simplified preoperative respiratory assessment was carried out in order to assess the reliability of a pocket-sized spirometer. 30 patients were each tested using two methods: 1) the traditional extensive laboratory lung function tests and 2) a bedside test using a pocket-sized spirometer, which measured the vital capacity (VC), the forced expiratory volume in 1 second (FEV1), the peak flow (PEF) and the ratio of FEV1 to VC. The correlation between the two series of VC and FEV1 measurements was highly significant (p less than 0.001). Therefore, these two parameters could be considered as reliable when testing was performed at the bedside. However, the sensitivity of the FEV1/VC ratio was decreased; in three of the patients, the significance of this third parameter was not the same with the two methods. Measurements of peak flow were only collected at the bedside, and a statistical comparison was not established. Analysis of this last parameter always allowed us to confirm or not an obstructive syndrome when the values of FEV1 or FEV1/VC were in disagreement. The pocket-sized spirometer would seem to be a simple and reliable means of diagnosing respiratory insufficiency, its type (obstructive or restrictive) and its seriousness.

Aged↗
PubMed1992

Does the combined ventral derotation system (VDS) followed by Harrington instrumentation improve the vital capacity in patients with idiopathic double major curve pattern scoliosis? An analysis of 33 cases and review of the literature.

A young, homogenous population of 33 patients with idiopathic scoliosis of double major curve pattern (DMC), a mean thoracic curve of 70.6 degrees (standard deviation [SD] = 20.6), and a mean lumbar curve of 72.9 degrees (SD = 15), had a measurement of the vital capacity (VC) at rest before and at a minimum of one year after combined ventral derotation system (VDS). This was followed by Harrington instrumentation and fusion to evaluate the effect of scoliosis, kyphosis, and their surgical correction on VC at rest. A regression analysis showed that the VC was significantly lowered before operation to 69.6% of predicted value, whereas individuals with thoracic curvatures greater than 70 degrees had a lower VC. The surgical correction of the thoracic curve of 50.8% and the lumbar curve of 68.4% was permanent in the follow-up evaluation, and the functional improvement in postoperative VC was 4.36%, statistically not very significant. The time between the two evaluations did have a significant statistical correlation with the observed improvement of the VC. The longer the interval between the two evaluations, the better the improvement of the VC. The age of the patient at the time of the first (VDS) operation influences the changes of the observed VC, significantly favoring the younger patients. The number of the functional vertebral segments included by the spinal instrumentation and fusion does not improve the VC.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Efficient inspired concentration of sevoflurane for vital capacity rapid inhalation induction (VCRII) technique.

STUDY OBJECTIVES: To evaluate the efficient inspired concentration of sevoflurane for a vital capacity rapid inhalation induction (VCRII) technique with respect to induction time, characteristics, and acceptability. DESIGN: Prospective study. SETTING: Medical college hospital. PATIENTS: 68 unpremedicated healthy adult volunteers were assigned to one of four groups in order of sequential entry of informed consent. INTERVENTIONS: 3%, 4.5%, 6%, or 7.5% concentrations of sevoflurane were administered for 5 minutes (3% and 4.5%) or 3 minutes (6% and 7.5%) using a single breath technique. MEASUREMENTS AND MAIN RESULTS: The mean induction time required with 3%, 4.5%, 6%, or 7.5% sevoflurane was 120 +/- 26 sec, 79 +/- 18 sec, 52 +/- 15 sec, or 47 +/- 17 seconds, respectively. Each induction time was significantly different from the others (p < 0.05) except for that between 6% and 7.5%. There appeared to be a direct inverse relationship between the mean induction time and the logarithm of inspired concentration of sevoflurane, but this relationship did not extend beyond concentrations above 6%. Blood pressure decreased by approximately 18% from baseline at the end of inhalation of the drug, and heart rate remained constant in all groups. Except of one subject in the 7.5% group, no coughing was observed and laryngospasm, breath-holding, and secretions were not seen in any subjects. Slight limb movement was observed in a few subjects in each group. All subjects except one in the 3% group would accept undergoing a similar procedure again. CONCLUSION: Sevoflurane 6% can be recommended for VCRII, but increasing the concentration higher than this does not markedly shorten the induction time and thus seems to add little benefit.

Adult↗
PubMed1991

Electroencephalographic changes during vital capacity breath induction with halothane.

We investigated the EEG responses in 17 patients during induction of anaesthesia with vital capacity breaths of 4% halothane. The control alpha activity changed to a low voltage, 5-25 muV, fast, 20-28 Hz activity at the time of loss of consciousness at 78 (SD 27) s and typical spindle bursts (20-75 muV, 12-15 Hz) developed at 223 (51) s. All patients remained haemodynamically stable. This sequence of EEG changes was similar to that observed during induction with the conventional method of normal tidal volume breathing and a gradual increase of the inspired concentration of halothane.

Adult↗
PubMed1977

The volume of isoflow and increase in maximal flow at 50 percent of forced vital capacity during helium-oxygen breathing as tests of small airway dysfunction.

The purpose of this report is to review the role of helium in the early detection of obstructive pulmonary disease. The underlying physiologic mechanisms of the volume of isoflow (the volume at which flow was the same with the subject breathing air and breathing a mixture of 80 percent helium and 20 percent oxygen) and increases in maximal flow at 50 percent of vital capacity (Vmax50) after breathing helium are reviewed. These tests are able to detect physiologic abnormalities in asymptomatic subjects when the results of other tests are normal; and following cessation of smoking, abnormal results may be reversible. The volume of isoflow is increased when maximal flow is reduced because of loss of elastic recoil or increase in upstream resistance. The increase in Vmax50 after breathing helium appears to be relatively specific for the caliber of the small airways, being uninfluenced by loss of elastic recoil; it can further help to localize the major site of obstruction to either small or large airways. At present, random screening for early unsuspected disease is not warranted, and these tests remain an investigative tool.

Evaluation Studies as Topic↗
PubMed2006

Determinants of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC in chronic spinal cord injury.

OBJECTIVE: To assess factors that influence pulmonary function, because respiratory system dysfunction is common in chronic spinal cord injury (SCI). DESIGN: Cross-sectional cohort study. SETTING: Veterans Affairs Boston SCI service and the community. PARTICIPANTS: Between 1994 and 2003, 339 white men with chronic SCI completed a respiratory questionnaire and underwent spirometry. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Forced expiratory volume in 1 second (FEV(1)), forced vital capacity (FVC), and FEV(1)/FVC. RESULTS: Adjusting for SCI level and completeness, FEV(1) (-21.0 mL/y; 95% confidence interval [CI], -26.3 to -15.7 mL/y) and FVC (-17.2 mL/y; 95% CI, -23.7 to -10.8 mL/y) declined with age. Lifetime cigarette use was also associated with a decrease in FEV(1) (-3.8 mL/pack-year; 95% CI, -6.5 to -1.1 mL/pack-year), and persistent wheeze and elevated body mass index were associated with a lower FEV(1)/FVC. A greater maximal inspiratory pressure (MIP) was associated with a greater FEV(1) and FVC. FEV(1) significantly decreased with injury duration (-6.1 mL/y; 95% CI, -11.7 to -0.6 mL/y), with the greatest decrement in the most neurologically impaired. The most neurologically impaired also had a greater FEV(1)/FVC, and their FEV(1) and FVC were less affected by age and smoking. CONCLUSIONS: Smoking, persistent wheeze, obesity, and MIP, in addition to SCI level and completeness, were significant determinants of pulmonary function. In SCI, FEV(1), FVC, and FEV(1)/FVC may be less sensitive to factors associated with change in airway size and not reliably detect the severity of airflow obstruction.

Adult↗
PubMed1980

Lung recoil during rapid vital capacity expirations simulated by gas compression.

Excised dog lobes were inflated to a transpulmonary pressure (PL) of about 30 cmH2O, and their airways were occluded. Then they were rapidly compressed to a volume where PL was about zero, simulating forced expiratory maneuvers. Since there was no airflow during the compression, PL was a direct measure of lung recoil. Lung volume (VL) was calculated from absolute airway pressure using Boyle's law. At ambient temperature, lung recoil pressure during compressive maneuvers simulating forced vital capacity expirations (Pdyn) was less than that during quasi-static (30 s) compressions (Pst). Typically the dynamic component (i.e., Pst--Pdyn) decreased from about 2 cmH2O near total lung capacity to no difference at the end of the compression. Cooling the lobes to 15 degrees C increased Pst-Pdyn, and warming the lobes to 37 degrees C reduced Pst-Pdyn almost to zero. We suggest that the driving force of lung recoil during expirations is adequately modeled by the quasi-static VL/PL relationship, though a small correction should be made for excised lungs at room temperature.

Airway Resistance↗
PubMed1980

Reference values for flow-volume curves during forced vital capacity breathing in male children and young adults.

127 non-smoking males aged 8-25 years were studied to obtain normal reference values for flow-volume (FV) curves. Analysis of variance (ANOVA) showed significant differences for all indices (PEF; MEF 25%, 50%, 75%; PIF; MIF 25%, 50%, 75%) in the first three age-groups (8-10, 11-13 and 14-16 years); the three last groups (17-19, 20-22 and 23-25 years) did not show any significant variation of FV curve data. Male subjects older than 16 years showed a negative correlation between maximal expiratory flow at 50% of forced vital capacity and standing height. Multiple regression equations relating FV curve indices to age and anthropometric data are calculated.

Adolescent↗