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PubMed1985

Distribution of forced expiratory volume in one second and forced vital capacity in healthy, white, adult never-smokers in six U.S. cities.

As part of a longitudinal study of the respiratory health effects of air pollution, we measured the lung function of 2,454 white adults 25 to 74 yr of age who had never smoked and who reported no respiratory symptoms. These measurements were analyzed to develop a simple model for the cross-sectional dependence of pulmonary function on height, sex, and age. Both forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) can be effectively standardized for body size by dividing each pulmonary function measurement by the square of the standing height (HT2). The age-specific distribution of these standardized measurements is approximately Gaussian, with variance that is independent of age. Plots of FEV1/HT2 and FVC/HT2 against age showed a nonlinear relationship consistent with an increase in the rate of pulmonary function loss with age. On the basis of these graphic analyses, both pulmonary function measurements were fitted to a four-parameter normative model including sex and linear and quadratic terms in age as dependent variables. This model gave predictions that were very close to those from more complicated models currently in use. Predicted percentile levels were calculated for each sex and age, and shown to describe the observations well. The estimated annual change in height-standardized lung function based on the cross-sectional model was compared with the observed change between the first and second examinations of these adults 3 yr later. The observed changes were close to predicted values, except for subjects younger than 35 yr of age at their first examination. The observed change was larger for men than for women. Such simple longitudinal comparisons are subject to selection bias. In this study, subjects in the lowest quartile of FEV1/HT2 for their age and sex at the first examination had a lower probability of providing a lung function measurement 3 yr later.

Adult↗
PubMed2002

[Vital capacity rapid inhalation induction (VCRII) technique with sevoflurane for a rheumatoid patient with difficult airway].

Successful airway management in an adult female patient with limited cervical extension and a subluxation of bilateral jaw joints caused by rheumatoid arthritis was reported. We planned to reduce the intensity of pain in her right hand through neurolysis of the ulnar nerve in her right elbow joint. Right axillary nerve blockade with 1% lidocaine 10 ml and 0.25% bupivacaine 10 ml, was employed unsuccessfully to achieve adequate anesthetic effect. Anesthesia was administered using a vital capacity rapid inhalation induction (VCRII) technique with 5% sevoflurane in the oxygen. When the patient lost consciousness, a size 3 laryngeal mask airway (LMA) was inserted under spontaneous breathing on the first trial. There was very little hemodynamic change during the insertion of the LMA. Anesthesia was maintained with sevoflurane 1.5-2.0% in oxygen under spontaneous breathing. Emergence from anesthesia was rapid and no signs of upper airway obstruction were observed after the removal of the LMA. The use of the LMA with VCRII technique and anesthetic maintenance using sevoflurane, are likely to be an optional technique of airway management in patients with problematic airway.

Anesthesia, Inhalation↗
PubMed1995

Effects within the week on forced vital capacity are correlated with long term changes in pulmonary function: reanalysis of studies on car painters exposed to isocyanate.

OBJECTIVES: To examine if car painters who work with polyurethane paints that contain hexamethylenediisocyanate (HDI) and hexamethylenediisocyanate biuret trimer (HDI-BT) develop acute as well as chronic impairment of lung function. METHODS: In this study data were reanalysed from two earlier studies on a group of car painters to see if a decrease in lung function within the week is a marker of vulnerability in those workers. Data on changes in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) within the week were available for 20 car painters who were also examined six years later. RESULTS: 10 men showed a decline in FVC within the week. There were no significant differences in age, duration of employment, exposures during the follow up period, or smoking between car painters who had decline in lung function within the week and car painters who had not. A significant correlation was found between the change in FVC within the week and the long term (six year) change in FVC, standardised for the effects of aging and smoking, and adjusted for the number of peak exposures. CONCLUSIONS: The results suggest that the decrease in FVC within the week might serve as a guide to identify car painters at risk of a further decrement in lung function above the effects of aging, smoking, and exposure.

Adult↗
PubMed1998

Vital capacity and tidal volume preoxygenation with a mouthpiece.

We have measured oxygen wash-in in 20 volunteers undergoing preoxygenation with a face mask, mouthpiece alone and a mouthpiece with a noseclip, in a crossover study. Tidal volume breathing and maximal deep breath techniques were studied with each type of equipment. When tidal volume breathing was used, the face mask and mouthpiece with noseclip were comparable, but the mouthpiece alone achieved a lower end-expiratory oxygen concentration than the two other methods after 3 min (P < 0.001 and P < 0.01), and after 5 min (P < 0.05 in each case). Conversely, during preoxygenation with vital capacity breaths, the mouthpiece and mouthpiece with noseclip were comparable, and both were more effective than the face mask (P < 0.001). In a second study, 20 patients who had undergone preoxygenation before induction of anaesthesia were asked later if they would have preferred the face mask or mouthpiece for this procedure. Significantly more patients (14 of 18 who expressed a preference) favoured the mouthpiece (P < 0.05; confidence limits 0.56-0.92).

Cross-Over Studies↗
PubMed2006

Sources of variation in forced expiratory volume in one second and forced vital capacity.

Published prediction equations for lung function differ considerably, but the components of population variation responsible for the differences are unknown. Data were analysed for 6,323 never-smoking adults who did not report wheeze or asthma, from 42 centres participating in the European Community Respiratory Health Survey. Means and components of variance were estimated for males and females aged 20-24 yrs, and the relationships with age and height were examined in those aged 25-44 yrs. Mean lung function for those aged 20-24 yrs differed between centres, but variation could not be wholly attributed to differences in population or equipment. The maximum difference in means by equipment type was 101 mL for FVC in males. Equipment differences were not statistically significant adjusted for country, but differences in mean forced expiratory volume in one second and forced vital capacity by country, adjusted for instrument, were statistically significant in males. Differences between centres in relation to age and height had less influence on predicted values. In conclusion, there are unexplained differences in lung function between ethnically similar nonsmoking symptom-free populations. Neither national reference curves nor those based on the same ethnic group can be guaranteed to give accurate norms of lung health.

Adult↗
PubMedDate not supplied

Reference values for vital capacity and flow-volume curves from a general population study.

A longitudinal epidemiological respiratory study has been started in the North of Italy to investigate the natural history of obstructive airways disease and the long-term effect of SO2 exposure. The first cross-sectional study was completed in this unpolluted area before the activation of a thermoelectric power plant (500 tons of SO2 produced daily). Follow-up surveys are planned after pollution emission starts for a period of ten years. A sample (n = 3289) representative of the general population was drawn from the villages of the area according to the different risks of pollution exposure. Subjects completed questionnaires and performed lung function tests, including forced expiratory (FVC) manoeuvres. For 801 'normal' subjects, prediction equations have been derived in age/sex groups for slow vital capacity (VC) and variables from the FVC manoeuvre. Comparisons with predictions of other studies are reported. Differences among FVC predictions were found, indicating that the use of different criteria for determination of the FVC manoeuvre end-point can affect results. In 'normals' VC was higher than FVC in older subjects. The difference between VC and FVC may be hypothesized as an epidemiological indication of the ageing effect on the mechanical properties of the ventilatory system.

Adolescent↗
PubMed1998

Effects of a movement and swimming program on vital capacity and water orientation skills of children with cerebral palsy.

Swimming and aquatic exercise are known for their effects on respiration in normal and asthmatic people. The purpose of the present study was to evaluate the effect of a 6-month movement and swimming program on the respiratory function and water orientation skills of children with cerebral palsy (CP). Forty-six kindergarten children aged 5 to 7 years were assigned either to a treatment or control group. The intervention program consisted of swimming sessions twice weekly and sessions of group physical activity in a gym once weekly, each session lasting 30 minutes, for a period of 6 months. Children in the control group were treated (30 minutes, 4 days per week) with Bobath physical therapy. The children in the treatment and control groups had comparable disability types, age, and anthropometric measurements. A 2 x 2 (group x test period) repeated measures ANOVA design confirmed a significant effect of interaction of time with group. The results also confirmed that children with CP have reduced lung function compared with normative data for children in the same age category. The treatment program improved baseline vital capacity results by 65%, while children in the control group improved by only 23%. The movement and swimming exercise program had a better effect than a physical therapy routine implemented in a previous study, consisting of respiratory exercise alone.

Analysis of Variance↗
PubMed2004

How to predict forced vital capacity after living-donor lobar-lung transplantation.

BACKGROUND: Living-donor lobar-lung transplantation (LDLLT) has evolved from a rarely performed experimental procedure to an accepted therapy for selected patients who are unlikely to survive the long wait for cadaveric lungs. However, a convincing study has not been performed that shows the effects of small grafts and of pre-operative variables in predicting functional outcome of recipients after LDLLT. METHODS: From October 1998 to March 2002, 2 male and 11 female patients underwent LDLLT. Mean age was 27.3 years (range, 8-53 years). Diagnoses included primary pulmonary hypertension (n = 5), idiopathic interstitial pneumonia (n = 2), bronchiolitis obliterans (n = 2), bronchiectasis (n = 2), lymphangioleiomyomatosis (n = 1), and cystic fibrosis (n = 1). Donors included 12 men and 14 women with a mean age of 40 years. Given that the right lower lobe consists of 5 segments, the left lower lobe of 4, and the whole lung of 19, we estimated the graft forced vital capacity (FVC) based on the donor's measured FVC and compared this with the recipient's FVC measured after LDLLT. RESULTS: Currently, all patients are alive, with a mean follow-up of 22.2 months (range, 10-51 months). The recipients' FVC measured at 6 months (1,813 +/- 86 ml) correlated well with the graft FVC (1,803 +/- 70 ml), estimated based on the donors' measured FVC (r = 0.802, p = 0.00098). CONCLUSIONS: Recipient FVC after LDLLT can be predicted by measuring donor FVC before surgery regardless of the diagnosis of the recipient.

Adolescent↗
PubMed2001

Use of forced inspiratory vital capacity to identify bronchodilator reversibility in obstructive lung disease.

The objective of this study was to assess the utility of forced inspiratory vital capacity (FIVC) to identify bronchodilator reversibility (BDR) for patients with obstructive lung disease (OLD) in relation to customary BDR criteria as defined by the American Thoracic Society (ATS). Concurrent data analysis was used in an academic medical center setting. Two hundred patients with OLD (including chronic obstructive lung disease and asthma) undergoing testing at the Pulmonary Function Laboratory at Cedars-Sinai Medical Center from January 1995 to December 1996 were identified. These 200 patients were categorized into four grades of obstruction by ATS-defined forced expiratory volume in 1 sec (FEV1) criteria (severe, moderately severe, moderate, and mild). Each of these groups was further subdivided into equal subgroups according to the presence (+) or absence (-) of BDR. Inspiratory flow-volume loops and FIVC were analyzed for each of these subgroups. Of the patients exhibiting BDR on the forced expiratory maneuver (FEM), FIVC correctly identified 53% of the cases. For patients not exhibiting BDR on FEM, FIVC identified an additional 12 cases. In 72% of cases, the maximal FIVC was not obtained from the maximal FEM flow-volume loop. FIVC inspection of the data (which were already available from standard spirometric testing) identified a subgroup of OLD patients with BDR not appreciated by FEV1 or FVC criteria, which may respond to bronchodilator therapy. The maximal FIVC value should be obtained by manual inspection to identify the best inspiratory flow-volume loop.

Adult↗
PubMed2003

Difference in the impairment of vital capacity and 6-minute walking after a lobectomy performed by thoracoscopic surgery, an anterior limited thoracotomy, an anteroaxillary thoracotomy, and a posterolateral thoracotomy.

PURPOSE: Postoperative vital capacity (VC) and the 6-min walking (6MW) test were used to compare the differences in impairment of the pulmonary function and walking capacity in patients undergoing a lobectomy by video-assisted thoracoscopic surgery (VATS), an anterior limited thoracotomy (ALT), an anteroaxillary thoracotomy (AAT), or a posterolateral thoracotomy without muscle sparing (PLT). METHODS: The study was a retrospective analysis. Lung cancer patients who underwent a lobectomy by VATS, ALT, AAT, or PLT (28 in each group) were matched by sex and age (+/-5 years). VC was measured before surgery and at 1, 2, 4, 12, and 24 weeks after surgery. The distance covered during the 6MW test (6MWD) was measured before surgery and in a postoperative test 1 week after surgery. RESULTS: Compared with the VATS, ALT, and AAT groups, PLT patients showed a significant impairment of VC from 1 to 24 weeks after surgery ( P < 0.05-0.001) and also a significant impairment of 6MWD 1 week after surgery ( P < 0.01-0.001). The AAT group showed a significant impairment of 6MWD 1 week after surgery compared with the VATS and ALT groups ( P < 0.001 and P < 0.05, respectively). There was no significant difference in the impairment of either VC or 6MWD between VATS and ALT. CONCLUSIONS: The PLT without a muscle sparing procedure therefore cannot be recommended for general lung cancer surgery because of the impairment of both walking capacity and pulmonary function which continues long after surgery. VATS and ALT are better procedures than AAT regarding the recovery of walking capacity early after surgery. VATS and ALT are similar to each other regarding the impairment of pulmonary function and walking capacity after surgery.

Aged↗