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PubMed1997

Dependence of forced vital capacity manoeuvre on time course of preceding inspiration in patients with restrictive lung disease.

In normal subjects and patients with airway obstruction, flows during a forced vital capacity (FVC) manoeuvre are higher after a fast inspiration without an end-inspiratory pause (manoeuvre 1) as compared to a slow inspiration with an end-expiratory pause of approximately 5 s (manoeuvre 2). In this study, we investigated the influence of these manoeuvres on maximal expiratory volume-time and flow-volume curves in patients with restrictive lung disease. Eleven patients with restrictive lung disease were studied. Their average (+/-SD) lung function test results were: FVC=55+/-12% predicted value, forced expiratory volume in one second (FEV1) 52+/-20% pred, FEV1/FVC 85+/-6%, total lung capacity 55+/-8% pred, and carbon monoxide transfer factor 47+/-18% pred. The patients performed the two FVC manoeuvres in random order. We compared the ensuing spirograms and maximal expiratory flow-volume curves from which peak expiratory flow, FEV1, FEV1/FVC, maximal mid-expiratory flow, and maximal flows were computed. All spirometric indices were significantly higher with manoeuvre 1 than 2. Maximal expiratory flows at the same lung volume were also significantly higher with manoeuvre 1 than 2, in all patients. Routine spirometric indices, obtained during a forced vital capacity manoeuvre depend on the time course of the preceding inspiration in patients with restrictive lung disease. Therefore, the forced vital capacity manoeuvre should be standardized if used in clinical, epidemiological and research studies.

Adult↗
PubMed1999

Sevoflurane: a comparison between vital capacity and tidal breathing techniques for the induction of anaesthesia and laryngeal mask airway placement.

Sixty unpremedicated adult day-case patients were randomly assigned to either vital capacity or tidal breathing inhalational induction techniques. End points assessed included loss of eyelash reflex, time to drop a weighted syringe, time to jaw relaxation and time to the end of laryngeal mask airway insertion. Complications occurring during the induction of anaesthesia were recorded. The data show that there is no statistical or clinical difference between the two induction techniques. Patient acceptance of both techniques was similarly high. When the time taken to prime the anaesthetic breathing system is taken into consideration, the vital capacity technique is more expensive for induction of anaesthesia. These results therefore question the need for the vital capacity induction technique with sevoflurane 8%.

Adolescent↗
PubMed1980

Postoperative thoracotomy. Effect of transcutaneous electrical nerve stimulation on forced vital capacity.

The purpose of this study was to measure the effects of transcutaneous electrical nerve stimulation on patients who had undergone thoracotomies, using the objective physiological measurement of forced vital capacity. Twenty-one patients were randomly assigned to an experimental group (n = 11) or a control group (n = 10). Each group performed three trials of forced vital capacity testing over a 20-minute period. In addition, the experimental group was given a 10-minute treatment of transcutaneous electrical nerve stimulation at the sites of greatest pain. The data indicated a statistically significant increase in forced vital capacity during the stimulation (p less than .01), suggesting that transcutaneous electrical nerve stimulation during application improves chest expansion and mobility in patients who have had thoracotomies.

Adolescent↗
PubMed2001

Vital capacity in tetraplegics twenty years and beyond.

OBJECTIVES: To observe the trends in vital capacity (VC) over time in tetraplegics 20 years and more after injury, the effects of age at injury, severity of injury and gender on this trend. METHODS: The medical records of all spinal cord injured persons admitted to a regional spinal injury center from January 1960 to December 1996 were reviewed. Fifty-seven patients had documented post-rehabilitation VC (mean 1.3+/-1.1 years) and VC at 10 (mean 11.8+/-2.69) and 20 (20.60+/-2.67) years post injury and beyond. RESULTS: The mean age at injury was 23.2+/-9.1 years. Severity of injury when classified according the system proposed by Coll et al were: Group 1: C1-4 Frankel A injury: 11.6%, Group 2: C5-8 Frankel A injury: 55.6%, Group 3: C2-8 Frankel B and C: 29.8% and Group 4: C2-8 Frankel D: 3.5% respectively. The mean VC at initial, 10 and 20 years post injury was 2586+/-948, 2803+/-940 and 2525+/-818 cc respectively. Multivariate analysis of variance revealed that there was significant difference in VC over a 20 year period, (F(2,54)=8.43, P<0.05). The difference between VC at 10 years and VC at 20 years accounted for the 19.8% of the variance in VC over time (F(1,55)=12.35, P<0.05). Age at injury, gender and severity of injury did not have a significant influence on the rate of decline in VC. Analysis of a subset of 26 patients who were followed up more than 20 years post injury (range 22 to 34.5 years) revealed similar, with a greater drop in the VC from 10 years post injury (F(1,23)=6.52, P<0.05). In this subset of patients, the mean VC at initial injury was 2840.9+/-847.3 cc, at 10 years was 2549.6+/-750.3 cc, at 20 years was 2400.9+/-724.1 cc and beyond 20 years was 2194.2+/-738.7 cc. There was no significant difference in mean VC between non smokers and ex/current smokers at initial, 10 and 20 years post injury, using the independent t-test (P>0.05). CONCLUSION: Vital capacity in tetraplegics declines significantly over the years, with a greater decline occurring at more than 20 years post injury.

Adolescent↗
PubMed2004

Conventional stepwise vs. vital capacity rapid inhalation induction at two concentrations of sevoflurane.

BACKGROUND AND OBJECTIVE: A multicentre study was conducted to compare three methods of inhalation induction with sevoflurane in adult premedicated patients. METHODS: One-hundred-and-twenty-five adult patients of ASA I-II were scheduled for short elective surgical procedures (< 90 min) under general anaesthesia with spontaneous ventilation of the lungs via a laryngeal mask airway. Patients were randomly assigned to one of three groups: conventional stepwise inhalation induction group (Group C) or vital capacity rapid inhalation induction groups at 4.5% (Group VC4.5) or at 8% sevoflurane (Group VC8). Before anaesthetic induction, fentanyl 1 micro kg(-1) was given and the face mask applied with the anaesthetic breathing system primed with sevoflurane 4.5% or 8% in the respective vital capacity groups. Loss of eyelash reflex, time to cessation of finger tapping, laryngeal mask insertion, side-effects and adequacy of induction were recorded. RESULTS: The time to loss of eyelash reflex was significantly shorter in both vital capacity groups vs. the control group: VC8: 68 +/- 7 s; and VC4.5: 94 +/- 6.5 s vs. C: 118 +/- 6.4s (P < 0.0001). Significant differences were found in all pairwise comparisons for time to cessation of tapping: Group VC8 (62 +/- 7 s), Group VC4.5 (85 +/- 6 s) and Group C (116 +/- 6 s; P < 0.0001). The time to laryngeal mask insertion was significantly shorter in the Group VC8 (176 +/- 13 s) compared with the other two groups, Group VC4.5 (219 +/- 13 s) and Group C (216 +/- 9 s). There were no significant differences in the incidence of side-effects between the three groups. CONCLUSIONS: Inhalation induction of anaesthesia with sevoflurane with the three techniques tested is safe, reliable and well accepted by the patients. The vital capacity rapid inhalation group primed with sevoflurane 8% was the fastest method with no relevant side-effects.

Adult↗
PubMed2001

Vital capacity inhalation induction with sevoflurane: an alternative to standard intravenous induction for patients undergoing cardiac surgery.

OBJECTIVE: To determine the respiratory and cardiovascular effects of a high concentration vital capacity induction with sevoflurane compared with an intravenous induction with etomidate in patients scheduled for elective coronary artery bypass graft (CABG) surgery. DESIGN: Prospective, randomized, double-blind, controlled clinical trial. SETTING: Cardiothoracic unit at a university hospital referral center. PARTICIPANTS: Twenty-two patients undergoing elective CABG surgery. INTERVENTIONS: The study group (group S) received a vital capacity gaseous induction with sevoflurane 8% (n = 12) and the control group (group E) were given etomidate, 0.2 to 0.3 mg/kg (n = 10). Anesthesia was supplemented with fentanyl, 8 microg/kg, and vecuronium, 0.1 mg/kg, in both groups. MEASUREMENTS AND MAIN RESULTS: The speed of induction of anesthesia was comparable between the groups. There was a significant increase in minute ventilation after induction of anesthesia in both groups. This increase was associated with a small reduction in PaCO2. There were no clinically significant changes in pH and PaO(2). The incidence of breath-holding and the need for an oropharyngeal airway were similar between the groups. Both groups had similar reductions in mean arterial pressure and cardiac output during the study period; however, a downward trend in mean pulmonary artery pressure was noted in group S, whereas in group E it remained unchanged. Absolute plasma epinephrine and norepinephrine values were low during the precardiopulmonary bypass period in both groups. CONCLUSIONS: The technique of vital capacity inhalation induction with 8% sevoflurane offers a rapid onset of anesthesia, satisfactory airway control, and a good hemodynamic profile. Consideration should be given to the benefits of single-agent anesthesia and lowered pulmonary artery pressure during the precardiopulmonary bypass period. In addition to CABG surgery, this technique could be considered in patients with coronary artery disease undergoing noncardiac surgery, particularly for procedures in which spontaneous ventilation is preferred.

Aged↗
PubMedDate not supplied

[Comparative study of inhalation induction by vital capacity breath in adults using 6% sevoflurane with oxygen or 4.5%sevoflurane in 50% nitrous oxide].

OBJECTIVE: To evaluate the efficacy, side effects and hemodynamic characteristics of induction by vital capacity breath in adults using 6% sevoflurane and oxygen versus 4.5% sevoflurane and 50% nitrous oxide. PATIENTS AND METHODS: We assigned 50 ASA I-II patients aged 20 to 70 years old randomly to two groups of 25 to receive either 6% sevoflurane in oxygen or 4.5% sevoflurane in nitrous oxide. All patients were premedicated with oral bromazepam (1.5 to 3 mg). Induction was by vital capacity breath using a Mapleson A circuit (8 l. min-1) for 5 min. We recorded induction time, side effects, hemodynamic variables and patient opinion after surgery. RESULTS: Induction time was significantly faster for the sevoflurane-oxygen group (60 +/- 10 s) than for the sevoflurane-nitrous oxide group (71 +/- 8 s) (p < 0.001). Complications were minor and hemodynamic variables stable in both groups, with no statistically significant differences. The patients expressed satisfaction with both induction techniques. CONCLUSIONS: A vital capacity breath of 6% sevoflurane provided rapid induction. Induction was no more rapid when 50% nitrous oxide was added and the incidence of side effects did not decrease. Hemodynamic variables are stable during induction with sevoflurane with or without nitrous oxide, making this a well-tolerated alternative technique that is positively evaluated by patients.

Adult↗
PubMed1989

Retrospective studies in scleroderma: pulmonary findings and effect of potassium p-aminobenzoate on vital capacity.

The principal clinical pulmonary findings were extracted from University of Michigan Hospital records of 390 patients with scleroderma. Dyspnea was the most frequent symptom and strongly correlated with pulmonary fibrosis and with decreased vital capacity (FVC) and CO diffusing capacity (DLCO). The mean value for FVC was 84% of the predicted normal for 326 patients, and that of the initial DLCO 56.8% of the predicted normal (323 patients). Pulmonary fibrosis was diagnosed on first chest X-ray in 80 of 382 patients. An additional 48 patients developed fibrosis detected on subsequent X-rays. Analyses were performed to determine whether the deterioration of pulmonary function over time was less for scleroderma patients who were adequately treated with potassium p-aminobenzoate (KPAB) than for those inadequately or never treated with KPAB, The average decrease for both FVC and DLCO was found to be less for KPAB-treated patients. However, only in the case of vital capacity was the difference significant. In the presence of radiological evidence of pulmonary fibrosis FVC decreased more rapidly (p = 0.002), but the decline in DLCO was not affected. When adjusting for the presence or absence of fibrosis the average slopes of the logarithm of vital capacity were significantly less negative (p = 0.003) for patients on KPAB.

4-Aminobenzoic Acid↗
PubMed1989

Using phonation time to estimate vital capacity in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a neuromuscular disease in which progressive respiratory weakness is usually the proximate cause of death. Since continued assessment of respiratory function is important in predicting progression, phonation time was measured in a group of 41 ALS patients and correlated with measured vital capacity. The findings show that the variance in phonation time accounts for nearly 50% of the variability of vital capacity, and therefore, successive measurements of phonation time are a useful means of estimating the loss of vital capacity.

Adult↗
PubMed1980

The influence of smoking habits and body weight on vital capacity and FEV1 in male Air Force personnel: a longitudinal and cross-sectional analysis.

Vital capacity (VC) and forced expiratory volume in one second (FEV1) measured in 7,123 men during annual or biennial medical examination were analyzed as a function of age (A), weight (W), and standing height (H). The subjects were grouped according to their smoking habits. A cross-sectional and longitudinal study was performed. Vital capacity and FEV1 were found to increase with age during the first 22 to 23 yr; thereafter, a steady decline was observed, more pronounced in smokers than in nonsmokers. In both longitudinal and cross-sectional surveys, body weight influenced the values of VC and FEV1. An increase of weight tended to be accompanied by an increase in VC and FEV1 in the younger, taller, and lighter subjects. This effect lessened and even reversed with increasing age and weight, decreasing height, and heavier smoking (in the longitudinal study). The influence of height on VC and FEV1 appeared to depend markedly on the weight of the subjects.

Adolescent↗
PubMed1992

Vital capacity breath technique for rapid anaesthetic induction: comparison of sevoflurane and isoflurane.

This study compares vital capacity rapid inhalational induction of anaesthesia with sevoflurane and isoflurane. Forty-six volunteers undergoing the procedure had one of the two agents: 25 had sevoflurane and 21 isoflurane. Subjects were unpremedicated and breathed approximately 1.7 MAC equivalents of either vapour. There were no significant differences in the patients' monitored cardiovascular, respiratory, and electrocardiographic variables. The mean time for induction of anaesthesia with sevoflurane (120 s) was significantly shorter than with isoflurane (145 s), reflecting its higher blood-gas solubility. There were fewer induction complications in the sevoflurane group. Subjects in the sevoflurane group found the induction of anaesthesia more pleasant and were more willing to undergo it again compared to subjects in the isoflurane group. We conclude that sevoflurane is superior to isoflurane in vital capacity rapid inhalational induction of anaesthesia, particularly in instances where premedication should be avoided.

Adult↗
PubMed1986

Involuntary breath-stacking. An alternative method for vital capacity estimation in poorly cooperative subjects.

Performed correctly, the vital capacity (VC) is a useful indicator of the mechanical properties of the thorax and of neuromuscular performance. Unfortunately, its use is often limited by impaired comprehension, altered mental status, or inability to sustain forceful effort. Our purpose was to develop a measure of VC independent of subject cooperation. We estimated the subcomponents of VC (inspiratory capacity (IC) and expiratory reserve volume (ERV], using one-way valving of an external circuit to enforce cumulation or elimination of the tidal breaths stimulated by endogenous ventilatory drive. When configured to measure IC, gas entered the chest incrementally, until tidal effort became insufficient to overcome thoracic recoil. Valve rearrangement permitted analogous estimation of ERV. We tested the validity of this method in cooperative but naive subjects by comparing the VC measured in standard fashion (VCC) to the breath-stacked estimate (VCS). Thirty normal subjects and 20 ambulatory patients with diverse causes for respiratory impairment were studied. Peak and mean values of VCS correlated strongly with the corresponding values of VCC (r greater than or equal to 0.91). The coefficient of variation for sequential V VCS determinations (approximately equal to 5.5%) was comparable to that observed for VCC (approximately equal to 3.5%) in both subject groups, indicating acceptable reproducibility of the involuntary VCS measurement. VCS maneuvers were quickly completed and well tolerated. Involuntary breath-stacking may provide a useful estimate of VC in clinical settings where conventional methodology cannot be confidently applied.

Adult↗
PubMed2004

Comparison of single-breath vital capacity rapid inhalation with sevoflurane 5% and propofol induction on QT interval and haemodynamics for laparoscopic surgery.

BACKGROUND AND OBJECTIVE: To compare two techniques to achieve induction of anaesthesia for laparoscopic surgery. A single-breath vital capacity rapid inhalation induction with sevoflurane was compared to intravenous propofol. Their effects on haemodynamics and the QT interval of the electrocardiogram were assessed. METHODS: Forty-four ASA I-II patients scheduled to undergo elective laparoscopic gynaecological surgery were divided into two groups. In the sevoflurane group (Group S, n = 22), general anaesthesia was induced with a single-breath vital capacity rapid inhalation of sevoflurane 5% with nitrous oxide (N2O) 65% in O2 and then anaesthesia was maintained with sevoflurane 1-1.5% with N2O 65% in O2. In the propofol group (Group P, n = 22), general anaesthesia was induced with propofol 2 mg kg(-1) intravenously and maintained with propofol 6 mg kg(-1) h(-1). Systolic, diastolic and mean arterial pressures, heart rate and end-tidal CO2 values were recorded before anaesthesia (basic value), during the induction period (time X), at 10 min (time Y) and at 30 min (time Z) of CO2 insufflation in all patients. QT intervals were calculated using Bazett's equation. RESULTS: Systolic, diastolic and mean arterial pressure values during the induction period (time X) were lower than the basic value in both groups (P < 0.05). In Group S, QTc intervals were significantly longer during the induction period (time X) and at the tenth min of CO2 insufflation (time Y) than Group P (P < 0.05). Five patients at time X and two patients at time Y developed ventricular dysrhythmias, which improved spontaneously in Group S. In Group P, there was no significant difference in QTc intervals and only one patient developed a ventricular dysrhythmia at time Y. CONCLUSIONS: Single-breath vital capacity rapid inhalation induction technique with sevoflurane can cause prolongation of the QT interval and dysrhythmias, compared with induction and maintenance of anaesthesia with propofol in laparoscopic surgery.

Adult↗
PubMed1999

Vital capacity reservoir and online measurement of childhood nitrosopnea are linearly related. Clinical implications.

Hypernitrosopnea, a robust marker for childhood asthma, is measured reproducibly in mixed vital capacity (VC) expirates. Recent guidelines for measurement of expired nitric oxide (NO) in adults have favored use of an online (OL), flow-dependent technique. We compared VC and OL NO measurements in 14 asthmatic and 11 control children 5 through 18 yr of age. After spirometry, subjects breathed both into an open-ended reservoir (20 cm H2O resistance) and into a tedlar bag (VC maneuver). End-expiratory pressure > 5 cm H2O was continuously maintained during VC measurements, and the velum remained shut. Eight additional children (24% of total number of subjects) were unable reproducibly to perform the OL measurement at constant flow (six asthmatics; two control children). For subjects able to perform the OL technique, OL and VC NO measurements were linearly related (r2 = 0.88). In children, VC NO assays are reproducible, sensitive in identifying asthma, and portable. Additionally, we have shown that (1) not all children are able to perform OL measurements, and (2) VC measurements vary linearly with OL measurements. These findings suggest that there may not be compelling reason to favor OL over VC measurements for hypernitrosopnea in children with asthma.

Adolescent↗
PubMed1996

Microcirculatory vasoconstrictor response: relationship with vital capacity and smoking.

Vasoconstrictor response (VR) induced by inspiratory gasp exhibited a strong positive correlation with vital capacity (VC) which reflects the magnitude of the input stimulus for VR (Lau et al., Clin. Sci. 89:233-237, 1995). Whether a stoichiometric relationship existed between VC and VR is not known. We examined this question in two studies by determining VC and microcirculatory blood flow with laser Doppler flowmetry in healthy subjects. We first studied 40 non-smokers of different gender and age and found that the variation in VR cannot be eliminated by normalization with VC. In the second study we examined 10 young male smokers as well as matched non-smokers of identical VC, we found that smokers had reduced VR. Taking together, the present studies demonstrated that vasoconstrictor response (VR) was not determined by vital capacity alone and that smoking adversely affected VR in the absence of altered VC.

Adult↗
PubMed2001

Forced vital capacity in two large outpatient populations with chronic spinal cord injury.

OBJECTIVE: To determine the expected vital capacity in persons with chronic spinal cord injury (SCI) in relation to injury level, completeness of injury, smoking and duration of injury, as an aid to diagnosis and management of respiratory complications. SETTING: A New York City veterans' hospital and a Los Angeles public rehabilitation hospital. METHODS: Case series from the two hospitals were pooled. Participants (adult outpatients with SCI of duration >1 year, not ventilator-dependent) were evaluated by conventional forced expiratory spirometry. Cross-sectional analysis was performed, using multiple regression, on the entire population and defined subgroups. The principal outcome measure was forced vital capacity (FVC). RESULTS: In the subjects with complete-motor lesions, FVC ranged from near 100% of normal predicted values in the group with low paraplegia, to less than 50% in those with high tetraplegia. Incomplete lesions mitigated FVC loss in tetraplegia. In subjects with paraplegia, longer duration of injury was associated with greater loss, and smoking-related loss was evident at older but not at younger ages, presumably due to greater pack years in older subjects. CONCLUSIONS: Vital capacity/SCI level relationships determined here may have diagnostic and prognostic value. Smoking-related FVC loss is important in persons with SCI as in others, although at higher levels it may be obscured by SCI-related loss.

Adult↗
PubMed1999

Comparison of vital capacity induction with sevoflurane to intravenous induction with propofol for adult ambulatory anesthesia.

UNLABELLED: We compared vital capacity inhaled induction (VC) with sevoflurane with i.v. induction with propofol for adult ambulatory anesthesia. Patients were randomly assigned to receive either 8% sevoflurane in 75% N2O/O2 from a primed circuit (VC, 32 patients) or propofol 2-mg/kg bolus (i.v., 24 patients). Times to loss of consciousness (response to command) and induction side effects (airway, hemodynamic, motor) were assessed. Anesthesia was maintained with sevoflurane/N2O via a face mask for both groups. At the end of surgery, recovery times were measured and psychomotor function tests were performed. Patients were also asked to assess the quality of their anesthesia. Of the VC patients, 59% lost responsiveness in one breath, taking 39 +/- 3 s. All VC patients completed the induction, and all measures of induction time were significantly shorter for VC than for i.v. Induction side effects were different in the two groups (cough and hiccough for VC versus movement and blood pressure changes for i.v.), but overall incidences were similar. There were no significant differences in any index of early or intermediate recovery. Mild nausea occurred more often with VC, but no antiemetics were needed, and discharge was not delayed. Patients' assessments of the quality of induction or wake up were not significantly different between VC and i.v. Thus, VC induction with sevoflurane is an acceptable alternative to propofol i.v. induction of general anesthesia for adult ambulatory surgical patients. IMPLICATIONS: A vital capacity induction with sevoflurane produced a faster loss of consciousness and had side effects, recovery times, and patient satisfaction similar to that of a propofol induction in adults undergoing ambulatory surgery.

Adult↗
PubMedDate not supplied

[Relation between body mass, body height and the blood picture to vital capacity in students exposed to air pollution].

The authors examined the relationship between body mass, body height, haemogram and vital capacity in two groups of pupils exposed to long aeropollution. The first group consisted of children with low vital capacity. In the second group the spirometric test was normal. The authors found differences between these two groups in relation to body mass and hemoglobin concentration.

Adolescent↗