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PubMed1995

The significance of an across-shift decrease in vital capacity--a re-analysis of a study on subjects exposed to diesel exhaust.

Occupational exposure to diesel exhaust may develop acute as well as chronic lung function impairment. In this study, data from an earlier study on a group of subjects working at tunnel construction site were analyzed. The aim of the analysis was to examine the significance of an across-shift decrease in vital capacity with concern to other lung physiological measurements. There were no statistically significant differences, either in the average age, time of employment, vital capacity before a working shift after two days of no exposure, or the distributions of smoking habits and respiratory symptoms, between the eight workers who had an across-shift decrease in vital capacity and the five workers who had not. Subjects with an across-shift decrease in vital capacity had a significantly greater across-shift decrease in residual volume and total lung capacity than subjects without an across-shift decrease in vital capacity. The pathophysiological mechanisms for this across-shift decrease in residual volume is not fully understood. However, an altered defence mechanism in the lung may play a role for a prolonged retention time for the particles in the inhaled diesel exhaust, resulting in the across-shift decrease in residual volume. The results thus suggest that measurements of across-shift vital capacity is of importance in identifying susceptible subjects with occupational exposure to diesel exhaust.

Adult↗
PubMed1998

Use of a vital capacity maneuver to prevent atelectasis after cardiopulmonary bypass: an experimental study.

BACKGROUND: Respiratory failure secondary to cardiopulmonary bypass (CPB) remains a major complication after cardiac surgery. The authors previously found that the increase in intrapulmonary shunt was well correlated with the amount of atelectasis. They tested the hypothesis that post-CPB atelectasis can be prevented by a vital capacity maneuver (VCM) performed before termination of the bypass. METHODS: Eighteen pigs received standard hypothermic CPB (no ventilation during bypass). The VCM was performed in two groups and consisted of inflating the lungs during 15 s to 40 cmH2O at the end of the bypass. In one group, the inspired oxygen fraction (FIO2) was then increased to 1.0. In the second group, the FIO2 was left at 0.4. In the third group, no VCM was performed (control group). Ventilation-perfusion distribution was measured with the inert gas technique and atelectasis by computed tomographic scanning. RESULTS: Intrapulmonary shunt increased after bypass in the control group (from 4.9 +/- 4% to 20.8 +/- 11.7%; P < 0.05) and was also increased in the vital capacity group ventilated with 100% oxygen (from 2.2 +/- 1.3% to 6.9 +/- 2.9%; P < 0.01) but was unaffected in the vital capacity group ventilated with 40% oxygen. The control pigs showed extensive atelectasis (21.3 +/- 15.8% of total lung area), which was significantly larger (P < 0.01) than the proportion of atelectasis found in the two vital capacity groups (5.7 +/- 5.7% for the vital capacity group ventilated with 100% oxygen and 2.3 +/- 2.1% for the vital capacity group ventilated with 40% oxygen. CONCLUSION: In this pig model, postcardiopulmonary bypass atelectasis was effectively prevented by a VCM.

Animals↗
PubMed1981

Pattern of diaphragmatic activity during forced expiratory vital capacity.

We measured transdiaphragmatic pressure (Pdi) during forced expiratory vital capacity (FVC) maneuvers in 13 normal subjects and electromyographic activity of the diaphragm (edi) in 8 of these subjects. In all subjects, Pdi increased at the initiation of the FVC. In most, this increase lasted 30--50 ms and reached levels well above the Pdi observed at total lung capacity (TLC). After the initial transient increase, approximately half of the subjects demonstrated a substantial fall in Pdi to values near the relaxation level in the mid-vital capacity (VC) volume range, while half showed a second large increase in Pdi in this volume range. Seven of eight subjects tested showed a rapid decrease in Edi at the onset of the FVC, reaching a minimum in 30--50 ms. After this initial transient decrease, Edi increased in six subjects in the mid-VC volume range, in association with secondary rises in Pdi. In two subjects, Edi remained low throughout the remainder of the FVC, and Pdi in the mid VC range was generally lower. These results are consistent with the conclusion that the diaphragm is neither electromyographically silent nor mechanically unimportant during the FVC. Changes in abdominothoracic configuration, superimposed upon "antagonistic" activity of the diaphragm, result in substantial reductions in pleural (esophageal) pressure that may influence regional lung emptying during the FVC.

Abdominal Muscles↗
PubMed2000

Single vital capacity breath for preoxygenation.

PURPOSE: The report investigates, in awake patients before induction of anesthesia, the effect of preoxygenation by the single vital capacity breath technique following forced exhalation on the mean arterial PO2 (PaO2). METHODS: In 10 adult patients undergoing elective surgery, the mean PaO2 values achieved 30 sec after preoxygenation by the single vital capacity breath technique was compared with the mean PaO2 values achieved by preoxygenation by the traditional tidal volume breathing for three minutes. Each patient served as her/his own control. RESULTS: The mean PaO2 following the single vital capacity breath technique was higher (295 +/- 67 mmHg) than that achieved by the traditional tidal volume breathing technique at 30 sec and 60 sec, and was not significantly different from that achieved by the traditional technique after three minutes (307 +/- 70 mmHg). CONCLUSION: The single vital capacity breath technique following forced exhalation can rapidly provide adequate preoxygenation within 30 sec.

Aged↗
PubMed1990

Donor selection for single and double lung transplantation. Chest size matching and other factors influencing posttransplantation vital capacity.

In six single lung transplant (SLT) and six double lung transplant (DLT) recipients, the relationships of the recipient's posttransplantation vital capacity (posttx VCR) to the recipient's predicted normal vital capacity (pred VCR) and the donor's predicted normal vital capacity (pred VCD) were investigated. After left SLT the left posttx VCR was correlated with the left predicted VCD (r = 0.83; p less than 0.05); however, no correlation was found between these after DLT. In contrast, there was a tendency toward correlation between the posttx VCR and the predicted VCR after DLT (r = 0.75; p less than 0.1), but no such trend was apparent after SLT. These results suggest that posttx VCR depends primarily on predicted VCD after SLT and on pred VCR after DLT. Therefore, in donor-recipient size matching for lung transplantation a donor with a pred VCD greater than the pred VCR should be chosen for a left SLT recipient, whereas a donor with a pred VCD near the pred VCR would be suitable for a DLT recipient.

Adult↗
PubMed1997

Vital capacities in acute and chronic airway obstruction: dependence on flow and volume histories.

The aim of this study was to investigate whether measurements of vital capacity (VC) are affected by the direction of the manoeuvre (inspiratory vs expiratory) and by the rate of expiratory flow. The study was performed on 25 individuals with chronic airway obstruction (CAO) and a forced expiratory volume in one second (FEV1) (expressed in standardized residuals (SR)) of -2.0+/-1.4 SD (CAO group), and 10 asthmatic subjects with methacholine (MCh)-induced bronchoconstriction (FEV1 -23+/-1.02 SR) (MCh group). VCs were measured during fast inspiration following both slow (FIVCse) and forced (FIVCfe) expiration from end-tidal inspiration to residual volume (RV), and during slow (EVC) or forced (FVC) expiration from total lung capacity (TLC). In the CAO group, FVC was the smallest volume (3.75+/-1.03 L) and significantly different from the other three estimates of VC; FIVCse (4.03+/-0.91 L) was the largest volume and significantly different from FVC and FIVCfe (3.83+/-0.98 L). In the MCh group, FVC (4.16+/-0.94 L) and EVC (4.19+/-0.89 L) were the largest volumes, although only the difference between FVC and FIVCfe (3.76+/-0.81 L) reached statistical significance. These data suggest that both flow and volume histories contribute to decreased vital capacities during bronchoconstriction. However, whereas increasing expiratory flow always tends to decrease vital capacity, the volume history of full inflation has different effects in chronic and acute bronchoconstriction, probably due to different effects on airway calibre. These results stress the importance of using standardized manoeuvres in order to obtain comparable values of vital capacity.

Acute Disease↗
PubMed1996

[Effects of pulmonary rehabilitation on vital capacity in patients with chronic pulmonary emphysema].

To evaluate the effects of pulmonary rehabilitation on pulmonary function, 15 patients with chronic pulmonary emphysema underwent pulmonary rehabilitation for six weeks as inpatients. Pulmonary rehabilitation consisted of relaxation techniques, breathing retraining, thoracic massage, physical exercise, and walking. In 8 of the 15 patients vital capacity increased by more than 200 ml (over 10%), and in 7 of the 15 patients the load of maximal exercise increased by more than 5 watts (over 10%). Increases in vital capacity were not associated with increases in maximal exercise load. The percent change in vital capacity associated with pulmonary rehabilitation correlated significantly with the percent change in tidal volume and the percent change in expiratory minute ventilation at the maximal load. The percent change in tidal volume at the maximal load correlated significantly with the percent change in maximum oxygen uptake. We attribute the increase in vital capacity to an improvement in thoracic cage movement. These findings suggest that pulmonary rehabilitation can increase vital capacity in some patients with chronic pulmonary emphysema, and that such an increase is not directly connected to increases in exercise capacity.

Aged↗
PubMed1975

Bronchoconstriction induced by repeated forced vital capacity manoeuvres.

An asthmatic atopic patient who developed bronchoconstriction during repeated forced vital capacity manoeuvres and after exercise is reported. Since increases in total airway and upper segment resistances and drop in FEV1 and Vmax 50 were induced, it is considered that bronchoconstriction involved most of the airways. Partial prevention of this effect could be demonstrated after inhalation of an adrenergic bronchidilator or disodium cromoglycate. Atropine completely prevented the flow response but did not alter the total airway resistance increase. Bronchoconstriction is interpreted as partially related to mast cell disruption and cholinergically mediated stimuli.

Adolescent↗
PubMed1988

Forced vital capacity and the risk of hypertension. The Normative Aging Study.

This report describes the development of hypertension among 1,270 males (aged 23-80 years at the time of entry into the study) observed prospectively for 10 years who had a baseline blood pressure of less than 140/90 mmHg and who underwent baseline spirometry. Subjects were participants in the Normative Aging Study, a longitudinal study on aging initiated in 1961 at the Veterans Administration Outpatient Clinic in Boston, Massachusetts. Blood pressures were taken at five- and 10-year follow-up examinations. The age-adjusted incidence of hypertension during the follow-up period was found to be inversely related to forced vital capacity. Multiple logistic regression was employed to assess the relation of forced vital capacity to the subsequent development of hypertension after controlling for baseline levels of age, weight, cigarettes smoked per day, and systolic and diastolic blood pressures. Forced vital capacity was a statistically significant and negative predictor, indicating that lower values of forced vital capacity were associated with the subsequent development of hypertension. This was consistently found in several logistic regression analyses with a standardized odds ratio associated with forced vital capacity of approximately 0.7. Although the physiologic mechanism for this association is unknown, these findings may have importance in identifying subjects at risk and may also provide insight into disease pathogenesis.

Adult↗
PubMed2002

Intrapulmonary shunt after cardiopulmonary bypass: the use of vital capacity maneuvers versus off-pump coronary artery bypass grafting.

OBJECTIVES: It has been proved in human subjects and animals that atelectasis is a major cause of intrapulmonary shunting and hypoxemia after cardiopulmonary bypass. Animal studies suggest that shunting can be prevented entirely by a total vital capacity maneuver performed before termination of bypass. This study aimed to test this theory in human subjects and to evaluate possible advantages of off-pump coronary artery bypass grafting. METHODS: Twenty-four patients scheduled for coronary artery bypass grafting were randomly assigned to receive no total vital capacity maneuver (control group, n = 12) or standard total vital capacity maneuvers (TVCM group, n = 12). Additionally, 12 consecutive patients undergoing off-pump coronary artery bypass grafting (off-pump group) were studied. Systemic and central hemodynamics, the pattern of breathing, and ventilatory mechanics were evaluated after induction of anesthesia, after sternotomy, after cardiopulmonary bypass and skin closure, and 4 hours after extubation. RESULTS: The use of total vital capacity maneuvers reduced (P <.05) intrapulmonary shunting after termination of cardiopulmonary bypass. However, shunting increased (P <.05) in all groups (control group, 8.2% +/- 3.3% vs 25.6% +/- 8.1%; TVCM group, 8.7% +/- 3.4% vs 24.4% +/- 8.5%; and off-pump group, 7.8% +/- 2.8% vs 14.0% +/- 5.3%) after extubation, but the increase was significantly (P <.05) less pronounced in the off-pump group. Furthermore, pulmonary compliance decreased (P <.05) in all groups except the off-pump group after extubation. Duration of hospital and intensive care unit stay was significantly shorter (P <.05) in the off-pump group than in the other groups. CONCLUSION: The development of intrapulmonary shunting and hypoxemia after coronary artery bypass grafting can be substantially reduced by performance of total vital capacity maneuvers while patients are mechanically ventilated. However, off-pump coronary artery bypass surgery is superior in preventing shunting and hypoxemia after bypass grafting in the immediate and early postoperative periods, probably leading to substantially shorter intensive care unit and hospital stays.

Aged↗
PubMed1982

Computer analysis of slow vital capacity spirograms.

We have developed a digital computer program which evaluates the vital capacity and its subdivisions, expiratory reserve volume and inspiratory capacity. The algorithm examines the multibreath spirogram, a continuous record of quiet breathing interspersed among repeated slow, large volume maneuvers. Quiet breaths are recognized by comparing features of each breath to the respective average and variation of these features for all breaths. A self-scaling, iterative procedure is used to identify those end-tidal points that most likely represent the subject's functional residual capacity. A least-squared error baseline is then fit through these points to partition the vital capacity. Twenty-three spirograms from patients with documented pulmonary disease were independently analyzed by the computer, a pulmonary function technician, and the laboratory supervisor. No practical differences were found among the results. However, the computer's values, in contrast to those of the technician, were reproducible on repeated trials and free of computational and transcriptional errors.

Computers↗
PubMedDate not supplied

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

The reliability of 33 prediction models for vital capacity was assessed in university students living in Mexico City (altitude = 2,240 m). Forced vital capacity (FVC) was predicted and measured in 83 healthy male students, 18 to 30 years old and non-smokers. Spirometric tests were performed with a 9 liter bell spirometer, according to ATS guidelines. Mean measured FVC was 5,094 +/- 555 mL (BTPS) while mean predicted FVC by the models ranged from 3,700 mL to 5,350 mL (BTPS) with a small but significative correlation between actual and reference values (r = 0.398 to 0.474, p < 0.05). The residual standard deviation showed values from 503 to 577 mL which were similar to those seen in the original population. Although 11 of the 33 models were able to predict mean observed FVC by Dunnett's test (p < 0.05), all of them showed significant bias on the regression between measured values and residuals of predicted values, i.e. intercepts (2,435 to 4,127 mL), slopes (-0.61 to -0.87) and correlations (-0.59 to -0.95) were statistically different from zero (p < 0.01). Our data remark the need to obtain appropriate reference FVC values in young Mexican males due to the questionable predictability of the models tested.

Adolescent↗
PubMed1994

Laryngeal response during forced vital capacity maneuvers in normal adult humans.

Previous investigators have reported that transient forced expiration is accompanied by abduction of the vocal cords. To further investigate the laryngeal response during voluntary forced vital capacity maneuvers, intramuscular electromyographic recordings were obtained in 25 normal adult humans from three intrinsic laryngeal muscles: the posterior cricoarytenoid (PCA), a vocal cord abductor, and the thyroarytenoid (TA) and arytenoideus (AR), both vocal cord adductors. All three muscles exhibited sustained activation throughout most of forced expiration from total lung capacity. Forced inspiration from residual volume was associated with a further increase in PCA activity and a marked decrease in adductor muscle activity. To determine the net effect of these electromyographic changes on vocal cord position, simultaneous fiberoptic recordings of vocal cord movement were obtained in five of the subjects. The angle formed by the vocal cords at the anterior commissure was used to assess glottic aperture size. Glottic angle progressively decreased from peak expiratory flow to the end of forced expiration. The angle was 56 +/- 13 degrees (SD) at peak expiratory flow, 34 +/- 4 degrees after forced expiration of 90% of the vital capacity, and 7 +/- 7 degrees at end-expiration. The results indicate that forced expiration is associated with marked activation of not only the PCA but also laryngeal adductor muscles. During forced expiration, the glottis does not decrease below its size during quiet breathing until exhalation of about 75% of forced vital capacity.

Adult↗
PubMed1983

Antishock trouser inflation and pulmonary vital capacity.

Two models of antishock trousers were studied for the effect of their inflation on the pulmonary function of 20 healthy men. Vital capacity was measured for each model at pressures of 0, 30, 60, and 100 mm Hg. The antishock suit with the abdominal compartment extending over the entire abdomen decreased the vital capacity 13.8% with inflation to a pressure of 100 mm Hg. The antishock suit with a smaller abdominal compartment, considered the standard model, decreased vital capacity only 5% at the same pressure.

Adult↗
PubMed1982

Assessment of time-volume and flow-volume components of forced vital capacity. Measurement with spirometry, body plethysmography and respiratory inductive plethysmography in nonsmokers and smokers.

The purpose of this investigation was to assess the effectiveness of the time-volume and flow-volume components of the forced vital capacity measured by simultaneous spirometry, respiratory inductive plethysmography, and body plethysmography in detecting small airway disease. Spirometry measured the exit of gas from the lungs, whereas body plethysmography measured both the exit of gas and alveolar gas compression. Respiratory inductive plethysmography, which reflected change in thoracic volume, provided semi-quantitative data f both gas exit and alveolar gas compression which generally lay between spirometry and body plethysmography. In nine nonsmokers and 12 smokers (six with small airway disease as defined by abnormal closing volumes and alveolar uniformity), analysis of forced vital capacity revealed that the only test which differentiated nonsmokers from smokers was the higher spirometric estimation of maximum expiratory flow measured at 25 percent VC in nonsmokers. Combining flow measure at the mouth with volume referenced to change in alveolar gas volume as measured by body or respiratory inductive plethysmography did not differentiate nonsmokers from smokers. Moment analysis performed of forced vital capacity with all of the three devices did not distinguish nonsmokers from smokers. The data in this study and a review of other investigations indicate that the time-volume and flow-volume components of the forced vital capacity on air breathing are not very sensitive in detecting early lung disease in smokers.

Adolescent↗
PubMed1991

The effect of an exercise program on vital capacity and rib mobility in patients with idiopathic scoliosis.

All 813 patients with idiopathic scoliosis who completed their first Schroth physiotherapeutic rehabilitation program at the Katharina Schroth Hospital between 1984 and 1987 were reviewed. The patients were divided into four age groups. In Group I (10-13 years, N = 278), vital capacity in patients treated for the first time improved by 18.94% (445 ml). In Group II (14-17 years, N = 264), the average increase in vital capacity after initial treatment was 16.33% (497 ml). In Groups III (18-24 years, N = 123) and IV (greater than 24 years, N = 148), the corresponding increases were 15.11% (501) and 13.77% (394 ml), respectively. In the 256 patients receiving repeat treatment, the increases in vital capacity in the respective age groups amounted to just more than half those in the patients treated for the first time. The average increase in chest expansion was more than 20% in all groups at all measuring points. These findings show that a course of inpatient treatment by the Schroth method can lead to an increase in vital capacity and chest expansion so that, even in adult scoliosis patients, effective treatment of the associated restrictive ventilatory disorder is possible.

Adolescent↗
PubMed1989

[Effects of aging on respiratory function: with special reference to timed vital capacity].

In order to study the effects of aging on the respiratory function, the examinations were made on the forced vital capacity (FVC), % forced vital capacity (%FVC), peak expiratory flow (PF), and forced expiratory volume in 1 second (FEV1.0%). A total of 427 healthy male ranging in age from 22 to 59 years served as the subjects of the present study. The following were the results of this investigations. 1. The results of the measured values for FVC, %FVC, PF and FEV1.0% by age group showed a decrease in accordance with becoming older, thus showing a negative correlation with aging. 2. The major component analysis and the discriminant analysis were made for each of the above measurement items and the discriminant function Z was obtained by the following formula: Z = 0.177 x (age) + 0.0001 x (FVC) - 0.006 x (% FVC) - 0.009 x (FEV1.0%) - 0.023 x (PF) - 5.238. The discriminant border value Z was 0.244, which divided the subjects into two groups; the young (22-37 years of age, N = 245) and the middle aged (38-59 years of age, N = 182). 3. Some discriminant features were also observed within the middle-aged group between the younger (38-49 years of age) and the older (50-59 years of age) sub-groups. In evaluating the effects of aging on the respiratory function, three age-groups rather than two (young and middle-aged) maybe useful in many respects. 4. With the young group, there observed no correlations between the aged and each of the measurement items.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Foot and hand length for prediction of vital capacity in scoliotic children.

Expected values of vital capacity (VC) and other lung function variables in children are usually predicted from regression equations of the index test on stature. In children with scoliosis, arm span or an "uncoiled" stature derived from the observed stature and the degree of spinal angulation have been used to predict expected values. Stature and hand and foot length were measured and all three anthropometric indices were used as independent variables for the prediction of VC in 489 normal children and adolescents (aged 4-18 years). VC was highly correlated with stature for boys and girls with regression coefficients of 0.93 and 0.91, respectively. For foot length, corresponding coefficients were 0.90 and 0.83, and for hand length 0.90 and 0.80. In 14 scoliotic children, aged 5.9-18.4 years, a close agreement was found for predictions of VC from arm span, uncoiled stature and hand and foot length. When accurate measurements of stature cannot be made, hand or foot length can be used to predict expected VC. This approach may be an alternative to the use of arm span or uncoiled stature to predict VC in children with scoliosis.

Adolescent↗