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PubMed1994

Changes in residual volume during induced bronchoconstriction in healthy and asthmatic subjects.

The increase of residual volume (RV) was investigated during acute bronchoconstriction induced in healthy subjects by methacholine (MCh) (Group 1, n = 13) and in asthmatics by MCh (Group 2, n = 21), or housemite dust (Group 3, n = 11) during early and late airway responses (EAR and LAR), or a series of deep breaths (Group 4, n = 7). In all subjects the difference between residual volume after partial (RVp) and maximal maneuver (RV), expressed as a percentage of control FVC, increased during bronchoconstriction and was correlated with the percent increase of maximal to partial flow ratio at 50% of control FVC (M/P50) (r = 0.854, p < 0.0001). At comparable reduction of partial expiratory flow at 50% of control FVC (VP50), the decreases of FEV1 and FVC were less in healthy than asthmatic subjects, whereas the change of FEV1/FVC was similar in all groups, reflecting similar change in slope of flow-volume curves. The increase of RVp was similar in all groups (range: 15 to 19%), but the increase of RV was 6 +/- 1% (SEM) in healthy subjects and significantly greater (range: 11.1 to 13.3%) in all groups of asthmatics (p < 0.02, analysis of variance [ANOVA]). The effect of deep inhalation (DI) on the airway caliber as assessed by the increase of M/P50 was higher in normal subjects than in all groups of asthmatics (p < 0.0001). A negative correlation was found between the increases of RV and M/P50 in all groups (r = -0.358, p < 0.01), suggesting that healthy subjects had a limited increase of RV because of a marked bronchodilator effect of DI.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

Canister tip orientation and residual volume have significant impact on the dose of benzocaine delivered by Hurricaine spray.

Delivered quantities of 20% benzocaine spray (Hurricaine; Beutlich L.P. Pharmaceuticals, Waukegan, IL) are estimated by counting the number of sprays or the spraying time. Because Hurricaine spray supplies a continuous (albeit nonmetered) stream of benzocaine, neither method addresses delivered dose. We hypothesized that dose per time is a function of canister content and orientation. Thirty full canisters of Hurricaine were placed into three equal orientations (upright, inverted, or horizontal). Extrapolating from a full canister, four different estimates of benzocaine residual volume were determined before spraying out the contents (80%, 60%, 40%, and 20% full). Each canister was then sprayed for 10-s intervals, and the quantity delivered was calculated and compared statistically. Upright canisters 100% full emitted more benzocaine than canisters with residual volume 20% full (190 +/- 10 vs 172 +/- 10 mg/s). Inverted canisters emitted significantly less benzocaine from 100% full to residual volume 20% full (188 +/- 14 vs 70 +/- 10 mg/s). Oriented horizontally, two full canisters emitted <76 mg/s benzocaine, contrasted with the remaining eight in that group (186 +/- 20 mg/s). We conclude that the benzocaine (Hurricaine) sprayed in milligrams per second depends on canister content and orientation. When residual volumes diminish, there is a reduction in spraying volume per time. This diminution occurs progressively from larger to smaller residual volumes with canisters oriented horizontally, inverted, or upright. Arbitrary documentation of spraying time bears no relationship to dose delivered. Perhaps affixing an atomization device to a graduated syringe filled with benzocaine will help increase accuracy and precision in dosing.

Anesthesia, Local↗
PubMed1981

Endotracheal tube cuff residual volume and lateral wall pressure in a model trachea.

The authors constructed a D-shaped tracheal model with an elastic posterior wall, thus simulating normal tracheal anatomy more closely than previous models. The performance of 9-10 tracheal tube cuffs, of 2-3 different tube sizes (7.0-10.0 mm, ID), from six different manufacturers were tested in the model. Cuff residual volumes ranged from 1.78 to 27.35 ml. Cuff pressure and lateral wall pressures exerted by the cuff on the model were measured at the time a seal was achieved which just prevented leakage of water past the cuff. When a seal was achieved with a volume of air in the cuff less than cuff residual volume, wall pressure tended to be low (less than 35 torr) and cuff pressure closely approximated wall pressure. There was no relationship between cuff brands in the wall pressure required to effect a seal in the model. The authors conclude that intratracheal tubes should have cuffs with large residual volumes. This would permit some latitude in tube size selection while ensuring that a seal could be achieved before the cuff is inflated to its residual volume.

Humans↗
PubMed2006

Post-void residual volume in labor: a prospective study comparing parturients with and without epidural analgesia.

BACKGROUND: This prospective, non-randomized study compared post-void residual volume in laboring and postpartum women with or without epidural analgesia. METHODS: The study was conducted over 1 year with institutional review board approval. Parturients were recruited in early labor and self-selected to either the study (with epidural) or control (without epidural) group. Post-void residual volume was compared between groups, using transabdominal ultrasound during labor, and on postpartum day 1 and 2. Main outcome measure was intrapartum residual bladder volume. RESULTS: Thirty patients were recruited to each group. During labor, residual bladder volume was significantly larger in the epidural group compared with the non-epidural group [median (range)] 240 (12-640), ml vs. 45 (13-250) ml, respectively, P < 0.001], but was similar on postpartum day 1 and 2. Twenty-five (83%) women with epidural analgesia required bladder catheterization during labor vs. one (3.3%) without (P < 0.0001). CONCLUSION: The greater post-void residual volume and increased inability to void in parturients with epidurals suggests that epidural analgesia plays a role in intrapartum urinary retention.

Anesthesia, Epidural↗
PubMed1984

[Functional differentiation of residual volume changes and problems of evaluation from the physiopathologic viewpoint].

The ascertainment of the residual volume is a very important method for pulmonary emphysema diagnosis. But there are problems of estimation on the basis of this residual volume. The usual relation (RV/TLC) greater than 0,35 as measure for an emphysema will be considered critically. In this way functional relations will be given which allow a more secure emphysema diagnosis. They use as measure comparisons between RV and fit reference volumes, such as normal values of RV, VC or TLC. These equations make it possible to differentiate between structural and functional disturbances.

Adolescent↗
PubMed1998

Diagnostic role of residual volume in paediatric patients with chronic symptoms of the lower airways.

In bronchial asthma, measurement of absolute lung volumes may reveal lung dysfunction more readily than forced expiratory spirometry. Sixty-one children (aged 4-16 years) with mild to moderate bronchial asthma and 35 children (aged 7-16 years) with other symptoms of the lower airways (OSLA) were studied, and the plethysmographic results were compared with data obtained from 36 healthy volunteers aged 6-16 years. In the first test session, repeatability of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), residual volume (RV), functional residual capacity (FRC) and total lung capacity (TLC) were good. Control subjects were also tested the next day, and intra-subject variability of repeat pulmonary function testing was in the normal range. The FEV1/FVC ratio was significantly higher in control subjects than in patients with asthma or OSLA, but only the decrease in RV after bronchodilator challenge separated patients with asthma from patients with OSLA. Changes in FEV1 and RV after bronchodilator challenge had a significant, although low, inverse correlation. An increase of > or = 5% in FEV1 had a positive predictive value of 44% and a negative predictive value of 68% for the clinical diagnosis of bronchial asthma; for a decrease of > or = 24% in RV, the figures were 86% and 71% respectively. The support of baseline absolute lung volumes on clinical decision-making is not necessarily great. Bronchodilator response, particularly in RV, is more pertinent and may enhance the detection of reversible lung dysfunction.

Adolescent↗
PubMed2004

Intrathecal baclofen withdrawal syndrome caused by low residual volume in the pump reservoir: a report of 2 cases.

Intrathecal baclofen (ITB) is an effective treatment for spasticity caused by spinal or cerebral pathologies. Severe withdrawal symptoms can result, however, if ITB is abruptly withdrawn as a result of equipment malfunctions or human error. We describe 2 cases of severe ITB withdrawal syndrome. In the first case, the symptoms appeared 5 months after pump placement, when residual volume was 2.0 mL; in the second case, symptoms appeared 2 months after the replacement of a new pump, when residual volume was 0.9 mL. In both cases, there was no evidence of system malfunction or human error. The syndrome occurred from up to 72 hours before the scheduled refilling procedure, and the residual volume in the Medtronic SynchroMed EL pump reservoir was either at, or significantly lower than, the recommended 2 mL. These cases suggest that the SynchroMed EL pump reservoir should be refilled, to avoid potentially serious consequences, when the residual volume is not lower than 3 mL by programming the alarm to sound at a volume larger than the recommended 2 mL.

Adult↗
PubMed1980

Lung mechanics in subjects showing increased residual volume without bronchial obstruction.

Fourteen subjects showing an increase of residual volume (RV) without any clinical or functional signs of bronchial obstruction were studied. Maximum expiratory flow volume (MEFV) curves were obtained with a pressure-corrected volume plethysmograph. Static pressure-volume curves were obtained by stepwise interruption of a slow expiration from total lung capacity (TLC) to RV. Static compliance was measured by the slope of pressure-volume curve between functional residual capacity (FRC) and FRC+20% of TLC. Maximum flow static recoil (MFSR) curves were constructed by plotting MEF obtained from MEFV curves against elastic pressure (Pst) obtained from pressure-volume curves at the same lung volumes. Most patients demonstrated a decrease of MEF 50% and 25% of VC. From the MFSR curves it was clear that this reduction was not the result of increased airways resistance, but rather of loss of elastic recoil. Most patients showed a significant decrease of Pst at different volumes and changes seem likely to be evidence of emphysema.

Adult↗
PubMedDate not supplied

[False postvoid residual volume diagnosed by videourodynamics].

We present a case report of a young male patient, with a bilateral vesico renal reflux. The urodynamic study findings suggested the possibility of a non-neurogenic bladder-external spincter dissinergya producing a valuable residual volume. After biofeedback treatment, the dissinergia disappeaed, but residual volume persisted. The videourodynamic assessment allowed us the accurate diagnosis of a false residual volume, produced by the voiding of the refluxed urine from the ureters into the bladder.

Adolescent↗
PubMed1984

Body composition by hydrostatic weighing at total lung capacity and residual volume.

Body density and percent fat were determined by hydro-static weighing (HW) at residual volume (RV), total lung capacity measured on land (TLCL), and total lung capacity measured in water (TLCW) in 50 male and 50 female subjects. Residual volume was measured on land by using the helium dilution method. Vital capacity was measured both on land and with the subject submerged to the neck in water. Total lung capacity was reduced during water submersion by 6.7 and 5.1% in males and females, respectively. Body density was 1.0588 +/- 0.0215, 1.0581 +/- 0.0207, and 1.0634 +/- 0.0214 for males, and 1.0246 +/- 0.0219, 1.0242 +/- 0.0233, and 1.0276 +/- 0.0238 for females at RV, TLCW, and TLCL, respectively. Percent fat was 17.7 +/- 9.7, 18.0 +/- 9.3, and 15.7 +/- 9.5 for males, and 33.4 +/- 10.3, 33.5 +/- 10.8, and 32.0 +/- 11.0 for females at RV, TLCW, and TLCL, respectively. Body density and percent fat were similar when measured by HW at RV and by HW at TLCW. Body density and percent fat measured by HW at TLCL were different than when measured by HW at RV (P less than 0.001). The subjects, using a modified 10-point Borg Scale, rated the HW procedure easier to perform at TLC than at RV (P less than 0.001). The results of this study indicate that measurement of body density and percent fat by HW at TLCW and HW at RV are similar, but if measured by HW at TLCL, body density is overestimated and percent fat is underestimated.

Adult↗
PubMed1993

Evidence supporting the superiority of intraperitoneal cisplatin compared to intraperitoneal carboplatin for salvage therapy of small-volume residual ovarian cancer.

PURPOSE: To examine the relative efficacy of cisplatin-based intraperitoneal (IP) therapy versus carboplatin-based IP therapy as salvage treatment of small-volume residual ovarian cancer. PATIENTS AND METHODS: We retrospectively examined the surgically defined response rates of patients with ovarian cancer treated at the Memorial Sloan-Kettering Cancer Center on four organoplatinum-based salvage IP trials (cisplatin/etoposide, cisplatin/cytarabine, carboplatin/etoposide, carboplatin/etoposide + recombinant human erythropoietin). Additional criteria for inclusion in this analysis were: (a) small-volume residual disease (microscopic disease only or largest residual tumor mass < or = 0.5 cm) when IP therapy was initiated; (b) prior response to organoplatinum-based systemic therapy; (c) laparotomy evaluation for response to the IP salvage program. RESULTS: The surgically documented complete response rate for patients with microscopic disease treated with cisplatin-based or carboplatin-based therapy was 46% (6/13) versus 38% (6/16), respectively (P > 0.25). In contrast, the surgically documented overall and complete response rates for patients with small-volume macroscopic disease treated with cisplatin or carboplatin were 71% (12/17) versus 32% (6/19) (P < 0.05, chi 2 test with Yates' correction), and 41% (6/17) versus 11% (2/19) (p < 0.1), respectively. CONCLUSION: In agreement with experimental data demonstrating that the concentration of platinum within tumor is higher following equimolar doses of cisplatin, compared to carboplatin, we have observed, in this retrospective analysis, a higher surgically documented response rate for patients with small-volume residual macroscopic ovarian cancer receiving salvage cisplatin-based IP therapy. While a randomized trial will be required to definitively address the question of the relative effectiveness of the two commercially available organoplatinum agents for IP treatment of ovarian cancer, our data suggest that cisplatin is the superior agent for regional therapy in this disease.

Carboplatin↗
PubMed2000

How the measurement of residual volume developed after Davy (1800).

H. Davy measured the residual volume of his own lungs in 1800, by inhaling a hydrogen mixture contained in a mercurial air holder. Using the same principle, Nestor Grehant determined the functional residual capacity, and the volume of the dead space, in 1864. Both used a forced breathing method, that was substituted by a prolonged dilution method by D.D. Van Slyke and C.A.L. Binger in 1923. It was in 1941 that G.R. Meneely and M.L. Kaltreider replaced hydrogen with helium. The open circuit nitrogen washout method was proposed by R.E. Darling, A. Cournand and D.W. Richards in 1940, and the body plethysmograph by A.B. DuBois et al. in 1956. So the three methods, still in common use today for measuring the static lung volumes, had been described by the mid-1950s.

History, 19th Century↗
PubMed1990

A comparison of the effects of measured, predicted, estimated and constant residual volumes on the body density of male athletes.

The aim of this study was to use the measured residual volume (RV) of male athletes (n = 207) as a criterion and assess the error in their RV, body density (BD) and relative body fat (%BF) associated with using RVs predicted from regression equations, RVs estimated from vital capacity (VC) and an assumed constant RV of 1300 ml. The ventilated residual volume (RV) was determined both before and after the underwater weighing by helium dilution with the subject immersed to neck level. The mean of the absolute differences Idl and SEE between the 2 RV trials were 66 and 89 ml, respectively. These increased to values ranging 195-747 and 259-308 ml, respectively, when the means of the 2 RV trials for each subject were compared with the RVs predicted via regression equations, estimated from the VC and assumed to be a constant of 1300 ml. A similar trend emerged with variation of only the RV in the BD formula for each subject. The 2 RV trials resulted in a Idl and SEE of .00109 (.5% BF) and .00145 g.cm-3 (.6% BF), respectively, but these increased to values ranging .00306 (1.3% BF)-.01207 (5.1% BF) and .00394 (1.7% BF)-.00441 g.cm-3 (1.9% BF), respectively, for predicted, estimated and assumed constant RVs. In all cases the lowest Idl and SEE were associated with the RVs predicted by a multiple regression equation (R = .616; SEE = 259 ml) which was generated on our sample.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMedDate not supplied

Influence of external resistance and minor flow variations on single breath nitrogen test and residual volume.

Inspiratory and expiratory flow are known to influence parameters obtained from the single breath nitrogen test. We assessed the influence of two different flow rates (0.3 and 0.5 1.s-1) with and without the use of an external resistor during inspiration and/or expiration on the indices of the single breath nitrogen test in eight healthy subjects. We found that when an external resistance was used during expiration residual volume was larger and the height of phase IV smaller, because the resistance interferes with complete lung emptying. When applied only during inspiration the resistance did not affect any of the measurements. The height of phase IV was greater at a flow of 0.3 1.s-1 than at 0.5 1.s-1; also residual volume was greater at the lower flow rate. The effect of flow rate can be accounted for by continuous gas exchange during the manoeuvers. The slope of the alveolar plateau and closing volume are not influenced by the resistance or by minor changes in flow rate. We conclude that for commonly used indices (slope of phase III, closing volume) the use of a resistance does not affect the results and is helpful for the subject; residual volumes are affected by both the resistance and the flow rate, but these effects are small.

Adult↗
PubMed1992

Predictive equations for total lung capacity and residual volume calculated from radiographs in a random sample of the Michigan population.

BACKGROUND: Published predicted values for total lung capacity and residual volume are often based on a small number of subjects and derive from different populations from predicted spirometric values. Equations from the only two large studies gave smaller predicted values for total lung capacity than the smaller studies. A large number of subjects have been studied from a population which has already provided predicted values for spirometry and transfer factor for carbon monoxide. METHODS: Total lung capacity was measured from standard posteroanterior and lateral chest radiographs and forced vital capacity by spirometry in a population sample of 771 subjects. Prediction equations were developed for total lung capacity (TLC), residual volume (RV) and RV/TLC in two groups--normal and total. Subjects with signs or symptoms of cardiopulmonary disease were combined with the normal subjects and equations for all subjects were also modelled. RESULTS: Prediction equations for TLC and RV in non-smoking normal men and women were square root transformations which included height and weight but not age. They included a coefficient for duration of smoking in current smokers. The predictive equation for RV/TLC included weight, age, age and duration of smoking for current smokers and ex-smokers of both sexes. For the total population the equations took the same form but the height coefficients and constants were slightly different. CONCLUSION: These population based prediction equations for TLC, RV and RV/TLC provide reference standards in a population that has provided reference standards for spirometry and single breath transfer factor for carbon monoxide.

Adult↗
PubMed2004

Correlation between withdrawal symptoms and medication pump residual volume in patients with implantable SynchroMed pumps.

OBJECTIVE: To investigate whether patients with implantable SynchroMed pumps (Medtronic, Inc., Minneapolis, MN) develop symptoms of drug withdrawal at residual medication volumes that exceed 2 ml (the alarm residual volume recommended by the manufacturer). METHODS: The data sheets of 88 patients with implantable SynchroMed pumps were retrospectively reviewed. The following parameters were analyzed: development of symptoms of drug withdrawal; drugs used in the pump; disease state; drug residual volume in the pump; intake of orally administered medications; time of development of withdrawal symptoms; drug flow volume through the pump; daily intrathecally administered drug dose; and drug concentration in the pump. RESULTS: Of 88 patients, 21 (24%) consistently developed symptoms of drug withdrawal 1 to 7 days before the drug residual volume reached a mean of 2.7 ml (range, 2.1-3.8 ml; median, 2.6 ml). Symptoms first developed 1 to 18 months after surgery. In all patients, symptoms of drug withdrawal subsided after pump refill and did not recur after the alarm volume was increased to 4 ml. Symptom development did not correlate with intake of orally administered medication, drug flow volume through the pump, intrathecally administered drug dose, drug concentration in the pump, drugs used in the pump, or disease state. CONCLUSION: Some patients develop symptoms of drug withdrawal at residual volumes that exceed 2 ml. We could not identify factors that predict this occurrence. Withdrawal symptoms did not recur when the alarm volume was increased to 4 ml.

Adult↗
PubMed1992

Salvage intraperitoneal therapy of small-volume residual ovarian cancer: impact of pretreatment finding of peritoneal carcinomatosis on the surgical complete response rate.

Second-line intraperitoneal (i.p.) therapy has been demonstrated to result in surgically defined complete responses (S-CR) in 25%-40% of patients with small-volume residual ovarian cancer (microscopic disease or largest tumor mass less than 1 cm in diameter). To evaluate the influence of the surgical finding of diffuse peritoneal carcinomatosis on the S-CR rate to salvage i.p. therapy in this patient population, we retrospectively reviewed the operative reports of 70 patients with small-volume residual ovarian cancer treated on one of three phase-2 second-line i.p. trials at the Memorial Sloan-Kettering Cancer Center. Of the 11 patients with diffuse carcinomatosis, none achieved a S-CR compared to a S-CR rate of 37% (22/59) in patients without this surgical finding (chi 2 = 6.0; P less than 0.025). However, of the 7 patients with diffuse carcinomatosis treated on a cisplatin-based i.p. program, the only 2 who had previously responded to systemic platinum also experienced a response (partial) to the i.p. cisplatin regimen. In conclusion, while the surgical finding of diffuse peritoneal carcinomatosis indicates a poor prognosis in patients with small-volume residual ovarian cancer for response to i.p. chemotherapy, patients in this clinical setting with prior evidence of platinum sensitivity may experience some benefit from an i.p. cisplatin-based treatment strategy.

Cisplatin↗
PubMed1991

Effects of famotidine on gastric pH and residual volume in pediatric surgery.

Aspiration pneumonitis is a severe complication of anesthesia. The objectives of this study were to determine if preoperative famotidine, a new histamine2-receptor antagonist, given by mouth either the evening before or the morning of elective surgery, reduced gastric residual volume and increased gastric pH in pediatric patients. Either famotidine or placebo (or both) were orally administered to 58 children (aged 2-17 years). The patients were randomly assigned to four groups: Famotidine-Famotidine, Placebo-Placebo, Placebo-Famotidine, and Famotidine-Placebo; subjects in the Famotidine-Famotidine group received two doses of famotidine (0.5 mg.kg-1 per dose), those in the Placebo-Placebo group, two doses of placebo, those in the Placebo-Famotidine and Famotidine-Placebo group, one dose of each by mouth. The Famotidine-Famotidine group received one dose of famotidine at 22:00 the evening before surgery and a second dose 60-90 min before the scheduled time of surgery. The Placebo-Placebo group received two doses of placebo at the same times as the Famotidine-Famotidine group. The Placebo-Famotidine group received a dose of placebo the night before surgery and a dose of famotidine the morning of surgery; the Famotidine-Placebo group received famotidine the night before surgery and placebo the morning of surgery. The administration of famotidine on the morning of surgery significantly increased gastric pH (4.8 vs. 1.3) in comparison with placebo, as did two doses of famotidine (6.6). Famotidine failed to reduce gastric residual volume significantly in any group. The administration of famotidine significantly reduced the number of pediatric patients considered at higher risk for aspiration pneumonitis, despite not decreasing gastric residual volume.

Administration, Oral↗