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PubMed1995

A comparison of vital capacity breath and tidal breathing techniques for induction of anaesthesia with high sevoflurane concentrations in nitrous oxide and oxygen.

Vital capacity breath and tidal breathing techniques were compared for induction of anaesthesia with 7.5% sevoflurane in nitrous oxide, and oxygen. Thirty five subjects were randomly assigned to a vital capacity breath group (19) or to a tidal breathing group (16). The mean time for induction was faster with vital capacity breath (41 s) than with tidal breathing (52 s, p < 0.05). Some involuntary movements were seen in the tidal breathing group but none in the vital capacity breath group. Coughing was seen in a quarter of the subjects in the tidal breathing group and in one subject of the vital capacity breath group. The vital capacity group showed excellent characteristics: rapid, and pleasant induction without premedication. We conclude that the vital capacity breath technique is necessary for the inhalation induction of anaesthesia; it provides enough overpressure to allow the subject to pass reliably and rapidly through the initial stages of excitement.

Adult↗
PubMed2006

Inhalation induction using sevoflurane in children: the single-breath vital capacity technique compared to the tidal volume technique*.

The single-breath vital capacity technique is suitable for inhalation induction of anaesthesia, using sevoflurane in children aged > 5 years. The purpose of this randomised trial was to compare the single breath vital capacity technique with the conventional tidal volume technique. Seventy- three ASA 1 or 2 children were instructed during the pre-operative visit in the vital capacity technique. The main criterion measured was time to loss of the eyelash reflex. Induction was performed using a circle-absorber breathing circuit primed with sevoflurane 7% in 50% nitrous oxide/oxygen with 6 l.min(-1) fresh gas flow. Time required for induction, haemodynamic changes, airway tolerance and side-effects were recorded. The children's opinion on the technique used was scored using a visual analogue scale (0-100) and a Smiley scale (0-10). The time to loss of the eyelash reflex was found to be reduced in the vital capacity group compared to the tidal volume group. The time to central myosis, to achieve bispectral index values 60 and 40, haemodynamic changes, respiratory events and side-effect incidences were similar in both groups. However, we found that the vital capacity technique was preferred by the children to the tidal volume technique.

Anesthesia, Inhalation↗
PubMed2005

Single-breath vital capacity rapid inhalation induction with sevoflurane: feasibility in children.

BACKGROUND: Single-breath vital capacity technique is currently administered for inhalation induction of anesthesia with sevoflurane in adults. Because sevoflurane is used in children, the aim of this open nonrandomized trial was to explore the feasibility and acceptance of this technique in midazolam premedicated patients aged from 4 to 15 years old. METHODS: A pediatric population (n = 118) was instructed in the vital capacity technique after their arrival in the induction room in a standardized and playful manner. Induction was performed with a circle-absorber breathing circuit, primed with sevoflurane 7% in 100% O2. Success of the single-breath vital capacity, delay of induction, hemodynamic and airway tolerance, acceptance by the children and side effects were analyzed. A multivariate logistic regression model was used to identify independent risk factors associated with the failure of the vital capacity technique. RESULTS: Single-breath vital capacity technique was achieved by 57% of the children. The success rate highly correlated with age and ranged from 10% in 4-5 years old to 75% at 11 years and 95% by 14 years. Other factors for success were cooperation and understanding. The need for more than two explanations of the technique was predictive of failure. Delays in the loss of the eyelash reflex and central pupil myosis were obtained in 34 s (18-50) and 242 s (145-278), respectively [median (interquartile ranges)]. Hemodynamic tolerance was good with few airway complications. CONCLUSION: Rapid anesthesia induction using a single-breath technique with 7% sevoflurane is effective and well tolerated in children, particularly in those above 9 years of age, and in fact, success rate was markedly lower in the young age groups.

Adjuvants, Anesthesia↗
PubMed1985

Detection of ventilation unevenness by nitrogen washout and forced vital capacity manoeuvres: its limits and reliability.

We investigated the behaviour of several indices of ventilation unevenness in a sample of 234 normal subjects aged between 20 and 80 years, divided into 12 classes of 5 years each. The aim of the present study was to find out whether it is possible to predict a reliable value for each of these indices as a function of age, height and TLC. For each index a large dispersion of experimental points and a high unexplained variance was found, so that it does not seem worthwhile predicting its value as a function of age, height and TLC. We concluded that there is no reason to employ these indices to detect the beginning of a lung function impairment.

Adult↗
PubMed1987

Mechanism of the postural dependence of vital capacity in tetraplegic subjects.

It is well established that unlike normal subjects patients with cervical cord transection have an increase in VC when changing from the seated to the supine posture. To investigate the mechanism of this paradoxical increase, we measured static lung volumes in both the seated and supine posture in 14 consecutive patients with tetraplegia (C4-C7) and in 4 patients with paraplegia (Th4-Th7). The increase in VC in the supine compared with the seated posture was (mean +/- SE) 0.41 +/- 0.07 L (16.0% of the seated value) in the tetraplegic subjects and 0.40 +/- 0.01 L (11.2% of the seated value) in the paraplegic subjects (p less than 0.001). However, TLC in all subjects was 0.28 +/- 0.05 L smaller in the supine posture (p less than 0.001), thus indicating that the larger VC in this posture is related to a reduction in residual volume (RV) rather than to an increased mechanical advantage of the diaphragm. The reduction in RV in the supine posture was consistent, averaging 0.72 +/- 0.06 L (29.1% of the seated value) in the tetraplegic subjects and 0.62 +/- 0.21 L (37.6 percent of the seated value) in the paraplegic subjects (p less than 0.001). Inflating blood pressure cuffs at the bases of the legs prior to the assumption of the supine posture diminished the reduction in RV with recumbency by only 0.10 +/- 0.02 L. In contrast, the postural dependence of RV was abolished when the abdomen was tightly supported by elastic straps and maintained constant in configuration during postural changes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2006

Contribution of the diaphragmaticus muscle to vital capacity in fasting and post-prandial American alligators (Alligator mississippiensis).

The importance of the diaphragmaticus muscle to vital capacity was investigated in juvenile American alligators by transection of this muscle. In both fasting and post-prandial animals a pneumotach was used to study vital capacity that was stimulated by either a hypercapnic-anoxic gas mixture or a hypercapnic-normoxic gas mixture in two types of control groups of animals (a shamoperated group and a group receiving no treatment) and in the experimental (transected) group. Transection did not significantly reduce vital capacity or affect time of inspiration or expiration in fasted animals. For both the experimental and control groups vital capacity was greatly reduced in post-prandial animals compared to the fasting state. Furthermore, alligators with a transected diaphragmaticus muscle showed a 16-18% greater drop in vital capacity in the post-prandial state than did alligators with an intact diaphragmaticus muscle. The post-prandial decrease in vital capacity for alligators with a transected diaphragmaticus occurred concomitantly with a significant increase in time to inspire and a decrease in maximum rate of inspiration when compared to control animals. The results from this study suggest that the diaphragmaticus muscle plays an important role in enabling large volumes of oxygen to be taken into the lungs in the post-prandial state.

Alligators and Crocodiles↗
PubMed1978

Effects of respiratory exercises on the vital capacity and forced expiratory volume in children with cerebral palsy.

The purpose of this study was to determine if breathing exercises can increase the vital capacity in children with cerebral palsy. Ten children with spastic cerebral palsy, five in the experimental group and five in the control group, were the subjects for the study. A spirometer was used to measure vital capacity and the forced expiratory volume before and after the children performed a breathing exercise program. The pretest values for all 10 youngsters indicated a vital capacity lower than the normal predicted values. The breathing exercises selected emphasized strengthening of the muscles of inspiration and the muscles of expiration. In the breathing exercise program, the physical therapists also attempted to follow the Bobath treatment approach by inhibiting the abnormal breathing patterns and by teaching the child proper ways of breathing control. The results seem to indicate that a breathing exercise program can increase the vital capacity in youngsters with cerebral palsy. The vital capacity of the experimental group was increased by 0.46 liters after exercising for five to seven minutes each day for a period of eight weeks. The mean increase of the vital capacity was 31 percent over the pretest values. The control group showed no change in vital capacity. The pretest and posttest forced expiratory volumes of both groups were within normal limits.

Breathing Exercises↗
PubMedDate not supplied

Reliability of reference models for vital capacity in young Mexican females.

OBJECTIVE: To assess the reliability of 29 prediction models for vital capacity when these are applied as reference for young females, natives and residents in Mexico City (altitude = 2,240 m). DESIGN: Transversal, prospective and comparative study. SETTING: Metropolitan Autonomous University, Mexico. SUBJECTS: Sixty females clinically healthy, 17 to 29 years old, non-smokers. PROCEDURE: Vital capacity was predicted from 29 models and measured with a bell spirometer (Collins 9 L) according to the American Thoracic Society guidelines. Statistical comparison was done between measured and predicted values by linear regression, analysis of variance and analysis of residuals. RESULTS: Mean of measured vital capacity was 3,625 mL while mean values of predicted vital capacities varied from 2,644 mL to 3,962 mL. Actual and reference values showed a small but significative correlation (r = 0.40 to 0.49). By Dunnett's test, means from six of the 29 models showed non-significant differences (p > 0.05) with the mean of the measured vital capacity; however, all 29 models presented significative bias in the regression line between actual values and the residuals of predicted values (correlation coefficient, slope and intercept statistically different from zero, p < 0.05). CONCLUSION: Due to the large bias found, models tested in the present study have limitations to predict accurate reference values for young mexican females.

Adolescent↗
PubMed1992

Relationships between vital capacity, height and nasal airway resistance in asymptomatic volunteers.

Nasal airway resistance (NAR), vital capacity and height were measured in 76 asymptomatic volunteers aged between 18 and 71, mean age 28 +/- 1.4 years. Total NAR ranged from 0.15-0.39 Pa/cm3/s, with a mean total NAR of 0.23 +/- 0.006 Pa/cm3/s. Despite a good correlation between vital capacity and height in these subjects (r = 0.76) no relationships were found between either total NAR and vital capacity or total NAR and height. Physiological NAR is not related to vital capacity or height in normal healthy individuals.

Adult↗
PubMed1979

[Normal values for vital capacity and forced expiratory capacity of the lungs in old age].

In 545 healthy men aged 71-90 years and 160 women aged 71-85 years, vital capacity and FEV1.0 in the standing position were measured using a closed spirometer system. Analysis of the results from different groups based on age and body size makes it possible to extend an already existing nomogram for prediction of normal values for vital capacity up to 90 years in men and up to 80 years in women. There is no linear relationship between age and vital capacity in men and women aged 20-90 years. The average FEV1.0 is more than 70% of the effective vital capacity in men and women aged 71-90 and 71-85 years respectively. A reduction of more than 20% in vital capacity, and a FEV1.0 below 65% of the actual vital capacity, is to be considered pathological in men and women of any age.

Age Factors↗
PubMed2001

Influence of a vital capacity maneuver on pulmonary gas exchange after cardiopulmonary bypass.

OBJECTIVE: To investigate the effect of a single, vital capacity breath (vital capacity maneuver [VCM]), administered at the end of cardiopulmonary bypass (CPB), on pulmonary gas exchange in patients undergoing coronary artery bypass graft surgery. DESIGN: Prospective, randomized, double-blind study. SETTING: University-affiliated hospital. PARTICIPANTS: Forty patients scheduled for elective coronary artery bypass graft surgery and early tracheal extubation. INTERVENTIONS: Patients were randomized to 1 of 2 groups. VCM patients received a VCM at the conclusion of CPB. Control patients received no VCM. MEASUREMENTS AND MAIN RESULTS: Intrapulmonary shunt (Q(S)/Q(T)), arterial oxygenation (PaO2), and alveolar-arterial oxygen gradients (P(A-a)O2) were measured after induction of anesthesia, CPB, intensive care unit (ICU) arrival, and extubation. The duration of postoperative intubation was recorded for each group. Q(S)/Q(T) increased significantly 30 minutes after CPB in the control group (15.7 +/- 1.8% to 27.4 +/- 2.6%; p = 0.01). In the VCM group, a small decrease in Q(S)/Q(T) occurred (16.1 +/- 2.0% to 14.9 +/- 2.0%). After ICU arrival and extubation, no significant difference in Q(S)/Q(T) existed between the 2 groups. With the exception of a higher P(A-a)O2 in the control group at induction of anesthesia, no differences in PaO2 or P(A-a)O2 were present between the 2 groups at any measurement interval. Patients who received a VCM were extubated earlier than the control group (6.5 +/- 2.1 hours v 9.4 +/- 4.2 hours; p = 0.01). CONCLUSION: The use of a VCM prevented an increase in Q(S)/Q(T) from occurring in the operating room. Although a VCM did not influence pulmonary gas exchange in the ICU, its application in the operating room appears to exert a beneficial effect on tracheal extubation times after cardiac surgery.

Aged↗
PubMedDate not supplied

Lung functions with spirometry: an Indian perspective--II: on the vital capacity of Indians.

Spirometry has been used in India since 1929 to evaluate vital capacity. The mean value for this parameter has changed slightly for the better over about eight decades. It is currently recorded at about 21.8 ml/cm height for males and about 18 ml/cm height for females, the difference between the two sexes being statistically significant throughout the period studied. The vital capacity reaches its peak at about 30 years of age in both Indian men and women and declines there after. There is no significant statistical difference in the vital capacities of subjects from different regions of India. Composite regressions have been generated for use as reference equations for estimating. Vital capacity of Indians is lower than that of Caucasians, but the age related decline is much greater for Caucasians.

Age Factors↗
PubMedDate not supplied

Reconstructive spine surgery in pediatric patients with major loss in vital capacity.

Thirty-two pediatric patients with severe restrictive lung disease identified with vital capacities < 40% of predicted, who had undergone major reconstructive spine surgery, were reviewed. There were 18 boys and 14 girls, the mean age was 13 years (range, 7-17), and the mean vital capacity was 31% of predicted (range, 16-39%). Fifty-four procedures were performed, 13 posterior only, one of which was staged, and 19 anterior and posterior procedures, of which 15 were staged and four were sequential. The incidence of pulmonary complications (pneumonia, reintubation, pneumothorax, respiratory arrest, or the need for tracheostomy) was 19% (six patients), and only three patients required tracheostomy. The surgical and perioperative mortality rate was zero. Patients who had a thoracotomy or a thoracoabdominal approach had a significantly higher number of pulmonary complications. The use of preoperative decreased vital capacity as a measure of inoperability excludes the young patient most in need of surgical intervention. With improved preoperative, intraoperative, and postoperative techniques, careful monitoring, and the cooperation of pediatric pulmonologists and intensivists, reconstructive spine surgery can be performed in the pediatric patient with severe decreased vital capacity with very acceptable morbidity and mortality.

Adolescent↗
PubMed1980

Dysanapsis in normal lungs assessed by the relationship between maximal flow, static recoil, and vital capacity.

To quantify the degree of association, if any, between lung size and airway size in humans, the ratio of a measurement known to be sensitive to airway size (maximal expiratory flow divided by static recoil pressure at 50% of vital capacity) to one sensitive to lung size (vital capacity) was examined. If lung and airway size changed together, this ratio would be the same for large and small lungs, i.e., for persons with large and small vital capacities. If lung and airway size were independent, then, on average, the ratio would vary as (vital capacity)-1. Data for 21 men 20 to 50 yr of age showed that the ratio to decreased approximately as (vital capacity)-4/3. This is consistent with independence of airway diameter but dependence of airway length on lung size. Data for each of 7 females of comparable age fell below the adult male (smaller ratios at a given size), as did data for 5 boys less than 20 yr of age. These results suggest that women and boys have airways that are smaller relative to lung size than are those of men and that these sex differences develop late in the growth period.

Adult↗
PubMed2005

Spirometer-dependence of vital capacity in ALS: validation of a portable device in 52 patients.

Since the evaluation of vital capacity (VC) needs to be carried out every three months in patients with amyotrophic lateral sclerosis (ALS), a portable spirometer would be of value in clinical practice. Over the follow-up of 52 ALS patients, we compared the values of slow vital capacity measured by two spirometers: a reference flow-metered spirometer based on a Hans-Rudolph pneumotachograph and a portable Venturi spirometer. The objectives were to analyse the overall concordance of the measurements from the two devices and determine a discordance cut-off. The correlation between measurements was high (r = 0.936) and significant (p<10(-20)). Bland and Altman analysis showed that the measurements were concordant at a statistical risk of 5%; nevertheless, on examination of the raw differences between the measurements, two sub-populations could be identified on either side of the 56% cut-off where the means of the differences were significantly different (p<0.0001). The 56% cut-off was also statistically significant in plotting differences against the coefficient of variations of the data pairs expressed as (100 x s/mean). The differences observed between the two spirometers could be explained by technical differences between the devices as well as by an increase in variability with progression of the disease. In conclusion, this study demonstrates that a portable spirometer can be used reliably at the bedside. For values of vital capacity below the discordance cut-off of 56%, vital capacity should be determined by operators trained in pulmonary function examinations.

Amyotrophic Lateral Sclerosis↗
PubMed2005

Vital capacity as a predictor of incident type 2 diabetes: the Atherosclerosis Risk in Communities study.

OBJECTIVE: To test the hypothesis that lower vital capacity is cross-sectionally associated with features of insulin resistance and is an independent predictor of incident type 2 diabetes. RESEARCH DESIGN AND METHODS: We conducted a prospective cohort study of vital capacity as a predictor of incident type 2 diabetes using 9-year follow-up data on 11,479 middle-aged adults without diabetes at baseline from the Atherosclerosis Risk in Communities (ARIC) Study. RESULTS: Forced vital capacity (FVC) and forced expiratory volume in 1 s were measured at baseline using standard spirometry. Incident type 2 diabetes cases were ascertained during follow-up. At baseline, low FVC (% predicted) was independently associated with indicators of the insulin resistance syndrome, including higher fasting levels of glucose, insulin, and triglycerides; lower fasting HDL cholesterol; and higher systolic blood pressure. In prospective analyses, there were graded associations between low FVC (% predicted) and incidence of type 2 diabetes in men and women. These associations persisted in multivariable analyses that adjusted for age, race, adiposity, smoking, physical activity, and ARIC center. Compared with individuals in the highest quartile of FVC (% predicted), the fully adjusted hazard ratio (95% CI) of diabetes in individuals in the lowest quartile was 1.6 (1.3-2.0) in men and 1.7 (1.3-2.1) in women. These relationships were stronger in those who have never smoked. CONCLUSIONS: Lower vital capacity is an independent predictor of incident type 2 diabetes. Pulmonary factors related to vital capacity deserve attention as possible risk factors for insulin resistance and diabetes.

Arteriosclerosis↗
PubMed2006

Vital capacity and selected metabolic diseases in middle-aged Japanese men.

OBJECTIVE: To elucidate the association between vital capacity and the presence of selected metabolic diseases in middle-aged Japanese men. METHODS: A cross-sectional analysis of the associations among forced vital capacity (FVC), static vital capacity as a percentage of that predicted (%VC) and the presence of metabolic diseases was performed. RESULTS: In a univariate linear regression analysis, FVC and %VC were inversely associated with poor vegetable intake, cigarette smoking and body mass index, but not with physical activity or ethanol consumption. In a logistic regression analysis adjusted for lifestyle factors, body mass index and age, the odds ratios for the presence of metabolic disease per 0.54 L (1 SD) decrease in FVC were 1.24 (95% CI 1.03 to 1.50) for type II diabetes, 1.21 (95% CI 1.02 to 1.42) for hypertension, 1.34 (95% CI 1.11 to 1.63) for hypertriglyceridemia, 1.23 (95% CI 1.03 to 1.46) for high gamma-glutamyl transferase levels and 1.63 (95% CI 1.10 to 2.41) for an episode of cardiovascular disease. FVC did not correlate with hyperhomocysteinemia, hypercholesterolemia or high white blood cell count. Similar results were also obtained for the association between %VC and metabolic diseases. CONCLUSIONS: A decrease in FVC or %VC was associated with the presence of some metabolic diseases. The association may partly explain the reported association between low FVC and cardiovascular disease.

Alcohol Drinking↗