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PubMed1986

Single breath induction of anaesthesia, using a vital capacity breath of halothane, nitrous oxide and oxygen.

Inhalational induction of anaesthesia, using a single vital capacity breath of 4% halothane in 66% nitrous oxide and 33% oxygen was evaluated in 100 unpremedicated outpatients. The technique was found to be acceptable to most (91%) of the patients studied, with a mean (SD) induction time (measured from beginning of inspiration to loss of 'eyelash reflex') of 83(21) seconds. Relative cardiovascular stability was a notable finding of the technique, with a slight decrease in the mean arterial pressure of only 10%. Anaesthetic induction time was unaffected by age, weight or smoking habits. The technique of single breath induction is therefore proposed as a safe and acceptable alternative to intravenous induction in co-operative adult patients.

Adolescent↗
PubMed1993

Vital capacity rapid inhalation induction technique: comparison of sevoflurane and halothane.

Induction of anaesthesia using the vital capacity rapid inhalation induction (VCRII) technique with either sevoflurane or halothane was compared. The induction time, characteristics, and acceptability were assessed. Thirty-two volunteers were given one of the vapours: 17 received sevoflurane and 15 halothane. Subjects were unpremedicated and breathed approximately 2.6 x minimum alveolar concentration (MAC) equivalent of either agent. There were no differences in the patients' cardiovascular or respiratory variables. The mean time for induction of anaesthesia with halothane (153 +/- 46 sec, SD) was slower than with sevoflurane (81 +/- 22 sec, SD, P < 0.05), reflecting its higher blood:gas solubility. There were fewer induction complications such as coughing and movement in the sevoflurane than in the halothane group. Subjects in the sevoflurane group found the smell of anaesthetic more acceptable than those in the halothane group (65% vs 13%, respectively). Subjects in both groups had no objection to undergoing the procedure again. It is concluded that both halothane and sevoflurane are effective in VCRII of anaesthesia without premedication. However, the slower speed of induction with halothane frustrated the anaesthetist because of the longer induction time, and may increase the chance of pronounced excitatory phenomena occurring.

Adult↗
PubMed2002

Mechanisms of ventilation inhomogeneity during vital capacity breaths standing and supine.

Overall inhomogeneity of ventilation distribution, as measured by single-breath vital capacity (VC) washout (SBW) is known to be greater supine vs. standing. To establish the underlying mechanisms 13 healthy males performed VC SBW of 4% SF(6) and He, standing and supine, with or without a 10 sec breathhold (BH). Overall inhomogeneity, as indicated by normalized phase III slopes, was >50% greater supine (SF(6) 13.1 x 10(-3); He 10.7 x 10(-3) L(-1)) than standing (SF(6) 8.6 x 10(-3); He 6.4 x 10(-3) L(-1); P<0.001). The (SF(6)-He) slope, an index of intraacinar inhomogeneity, did not change with posture. Breathholding, assumed to eliminate convective dependent inhomogeneity within and/or between small lung units, produced twice as great reduction of inhomogeneity when supine vs. standing. After BH inhomogeneity remained significantly greater supine vs. standing. In conclusion, at least two events seem to underlie the increased inhomogeneity when supine: (1) a substantially increased convection dependent non-uniformity between well-separated lung regions; and (2) a somewhat increased convection dependent non-uniformity within and/or between peripherally located lung units.

Adult↗
PubMed1993

Induction of anesthesia with sevoflurane, nitrous oxide, and oxygen: a comparison of spontaneous ventilation and vital capacity rapid inhalation induction (VCRII) techniques.

In this study, the vital capacity rapid inhalation induction of anesthesia (VCRII) technique and the conventional spontaneous inhalation induction technique, each using 4.5% sevoflurane in nitrous oxide and oxygen, were compared. The VSRII group (n = 32) and conventional group (n = 32) were each tested on unpremedicated volunteers. VCRII required only half the time of conventional inhalation induction (54 s and 108 s, respectively), and was not associated with cardiovascular instability. Each of the two techniques was found acceptable by most of the volunteers studied (more than 80%). However, sevoflurane is best used with the VCRII technique because VCRII resulted in fewer excitement movements that could lead to severe complications and pronounced excitement.

Adult↗
PubMedDate not supplied

[Verification of vital capacity and 1 second forced expiratory volume values in 14,234 candidates for aviation school].

The values of vital capacity (VC), forced expiratory volume in the first second (FEV1) and Tiffeneau index (100xFEV1/VC) were determined in 14,234 examinees in the period 1977-1987. Examinations were performed using the Godart expirometer. After the statistical analysis of the results being performed, the unique table was made according to height and age of examinees. The examinees came from all regions of Yugoslavia. The results of the study can be used for establishment of standard values of pulmonary ventilation for candidates for aviation schools, i.e. for youngsters aging from 14 to 20 years.

Adolescent↗
PubMed1997

Comparison between halothane and sevoflurane for adult vital capacity induction.

We have examined the differences in ventilatory characteristics between halothane and sevoflurane when used for adult vital capacity induction of anaesthesia. The study was conducted in a randomized, double-blind manner. After 13 patients had been enrolled, the study was curtailed because the blinded observer thought that there was an unacceptably high incidence of adverse events. After the randomization code was revealed, the adverse events were found to be in the halothane group. Although the sample size was small, minute volumes appeared to be maintained in the sevoflurane group. Ventilatory frequencies were similar in the two groups after insertion of the laryngeal mask airway, but tidal volumes were significantly greater in the sevoflurane group (P = 0.0013).

Adolescent↗
PubMed1997

[Age-related decline in forced expiratory volume in one second and forced vital capacity based on a longitudinal observation of Japanese males].

Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) of 243 healthy male Japanese workers were measured on as annual basis over seven years, and their longitudinal decline was compared with the age coefficient of cross-sectional prediction equations reported previously for Japanese adults. In this study, a man, assumed to be 1.65 meter tall, was expected to have a respective 22 ml and 11 ml decline annually in FEV1 and FVC. Age-related differences of those indices obtained from cross-sectional prediction equations, however, ranged from 22 ml to 31 ml a year in FEV1 and from 16 ml to 25 ml in FVC for men of the same height. Furthermore, in those equations, age was simply employed as a first-order explanatory variable for ages ranging from the later teens to over sixties, although age-related acceleration of FVC decline is suggested in this study. These results indicate that evaluations of measurements relating to time-series pulmonary functions on cross-sectional prediction equations might be biased. This is probably due to the influence of age-cohort. It seems necessary to build up the reference standards for longitudinal pulmonary function change for an appropriate evaluation of time-series data of FVC and EFV1.

Adult↗
PubMedDate not supplied

[Alveolar pressure during forced vital capacity. Method and application (author's transl)].

A method allowing the measurement of mean alveolar pressure (Palv) during forced vital capacity is described. The basis of the method is the calculation of the difference between mouth and chest flows, which are measured with a Fleisch pneumotachograph (PTG) and a volumetric plethysmograph respectively. Metrologic conditions of the calculation are discussed. During the forced expiration, the estimation of Palv is realized in good metrological conditions. During inspiration, the thermal condition of the PTG varies and the measured flow is not accurate; thus, the calculated Palv is only an estimation. Some examples of Palv vs mouth flow loops are shown. The simultaneous recordings of this loop and the usual V/V loop allow us to know if a low mouth flow is due to a high pulmonary impedance with high Palv or to a low Palv. For a given impedance, Palv measurement seems to be a good test of the respiratory muscle function.

Humans↗
PubMed1981

Relationship between respiratory muscle strength and vital capacity during partial curarization in awake subjects.

To determine the relationship between respiratory muscle strength and changes in normal vital capacity (VC), graded levels of muscle weakness were produced in six healthy supine male subjects by four successive doses of d-tubocurarine (0.05 mg/kg each). The maximal effect of d-tubocurarine abolished hand-grip strength and ability to sustain head lift for 5 s, but VC was decreased to only 66 +/- 3 per cent of control. At each level of weakness decreases in VC were significantly less than were decreases in respiratory muscle strength (RMS) monitored by maximum static inspiratory and expiratory pressures. The first dose decreased RMS to 86 +/- 3 per cent of control, but VC was unchanged. Following the second dose,, VC (97 +/- 4 per cent). The VC after the third dose was still 85 +/- 3 per cent of control, while RMS had decreased to 58 +- 2 per cent. Following the final dose of d-tubocurarine (cumulative total 0.20 mg/kg), RMS was 39 +/- 2 per cent of control, compared with VC, 66 +/- 3 per cent of control. The relationship between VC and RMS was curvilinear and conformed to predictions based on the static mechanical characteristics of the normal respiratory system. These findings demonstrate that while VC is relatively spared during partial curarization, this sparing of VC does not indicate a similar extent of preserved RMS. Rather, it reflects the relative ease with which weakened respiratory muscles are able to drive the normal respiratory system in the supine subject. The same weakened muscles may be unable to generate sufficient force to handle mechanical challenges such as coughing and vomiting.

Adult↗
PubMed1987

Comparison of algorithms for determining the end-point of the forced vital capacity maneuver.

The criteria of the American Thoracic Society (ATS) for determining the end-point of the forced vital capacity (FVC) maneuver were compared with an algorithm employed by a computer system (Hewlett-Packard), which yields a later end-point. The 150 subjects tested were divided into five groups of 30 on the basis of the following spirometric diagnoses: normal; small airways' obstruction (SAO); mild airways' obstruction (MAO); severe chronic obstructive pulmonary disease (COPD); or restrictive disease. The subjects performed a minimum of three maneuvers according to ATS standards, and the flow-volume curves with the greatest sum of FVC and forced expiratory volume in one second (FEV) were chosen for analysis by the two algorithms. Hewlett-Packard (HP) values for FVC and FVC time were always higher than the corresponding ATS values, and the HP values for flows were always lower than the corresponding ATS values. The higher differences were observed in the SAO group. In the group with severe COPD, high FVC differences and low flow differences were observed; on the contrary, in the restrictive group, low FVC differences and high flow differences were present. These results, in addition to the different location of the FVC end point, may be explained by the different morphology of the flow-volume curves. In conclusion, the ATS algorithm caused a systematic underevaluation of FVC and a systematic overevaluation of flows, which cause practical consequences only in the SAO group. In fact, 28 percent (17/60) of the subjects with SAO characteristics were considered "normal" using ATS criteria for the end-point.

Adult↗
PubMed1990

Predictions of normal forced vital capacity and forced expired volume in one second in Tanzanian children.

Data on ventilatory function with particular reference to forced vital capacity (FVC), forced expired volume in one second (FEV1), and FEV1 expressed as percentage of FVC (FEV1%FVC) were obtained in 1413 healthy Tanzanian school children aged between 8 and 18 years. All subjects were nonsmokers and had neither symptoms nor history of cardiopulmonary diseases. Subjects in this study were significantly smaller in stature (P less than 0.05) and had smaller FVC and FEV1 (P less than 0.001) compared to values reported in children of comparable age and stature in the west. Lung volumes could best be described as a power function of standing height (y = a.Hb). The power derived from ln FVC on ln H were 3.39 and 3.24 for boys and girls respectively, while the power derived from ln FEV1 on ln H were 3.11 and 3.03 for boys and girls respectively. Constructed prediction formulae gave FEV1 and FVC which showed good agreement with FEV1 and FVC computed from prediction equations based on a similar mathematical model for black children in the Caribbean.

Adolescent↗
PubMed1987

The dependence of maximal expiratory flow on vital capacity: a theoretical analysis.

The decrease of maximal expiratory flow rates (Vmax) at the 50 or 25 per cent level of vital capacity (V50, V25) in idiopathic pulmonary fibrosis (IPF) has been reported by several investigators, and most of them simply concluded that small airway obstruction was associated with IPF. However, Jayamanne et al. (1978) stressed that the reduced airflow in this disease was due to the reduction of lung volume than to abnormally elevated resistance to airflow in small airways. Theoretical analysis on the influence of lung volume on Vmax using a mathematical model supported the opinion of Jayamanne et al.

Forced Expiratory Flow Rates↗
PubMed2003

Spinal fusion in patients with Duchenne's muscular dystrophy and a low forced vital capacity.

Traditionally, spinal fusion has been denied to patients with scoliosis secondary to Duchenne's muscular dystrophy (DMD) when their forced vital capacity (FVC) is less than 30-40% of predicted values (PFVC). The reasons for this decision are a theoretically increased risk of adverse events from a prolonged anaesthetic and extensive surgery. This paper presents a retrospective analysis of 30 patients with DMD scoliosis who underwent posterior spinal fusion at the Royal National Orthopaedic Hospital. Two subgroups of patients were compared: those with more than 30% PFVC (17 patients) and those with less than 30% PVFC (13 patients). One patient in each group required a temporary tracheotomy and there were nine complications in total. The post-operative stay for patients in each group was similar (24 days in the >30% group, 20 days in the <30% group) and the complication rate was comparable with other published series. We conclude that spinal fusion can be offered to patients with DMD even in the presence of a low FVC.

Adolescent↗
PubMed2004

A comparison between single- and double-breath vital capacity inhalation induction with 8% sevoflurane in children.

BACKGROUND: This study was conducted to determine if a double-breath (DB) vital capacity (VC) rapid inhalation induction using immediate high-inspired concentration of sevoflurane is as well tolerated as a single-breath (SB) technique and if it results in a shorter induction time. METHODS: A total of 104 children, ASA I-II, 6 year and above, undergoing elective surgery were randomly assigned to two groups: SB VC inhalation induction or DB VC inhalation induction with 8% sevoflurane in 66% nitrous oxide. The induction time, complications (cough, laryngospasm, breath-hold, movement, salivation) and level of satisfaction were documented. RESULTS: Induction was significantly faster in the DB group (41 +/- 9 s) compared with the SB group (50 +/- 14 s). DB inhalation induction was associated with fewer complications (15.4%) than the SB technique (50%). CONCLUSIONS: Double-breath VC inhalation induction with 8% sevoflurane is as well tolerated as a SB technique and results in a faster onset of anaesthesia.

Anesthesia Recovery Period↗
PubMed1984

The UCLA population studies of chronic obstructive respiratory disease. VI. Relationship of physiologic factors to rate of change in forced expiratory volume in one second and forced vital capacity.

The mean annualized changes in height (delta height), in forced expiratory volume in one second (delta FEV1), and in forced vital capacity (delta FVC), measured at a 5-yr interval, were determined by year of age for 1,458 residents 7 to 59 yr of age in 2 communities in Los Angeles. The rate of change in delta height, delta FEV1, and delta FVC increased each year until early puberty and then decreased thereafter. The age at which the delta FEV1 and delta FVC reversed from an increasing to a decreasing rate was older in males (13 yr) than in females (11 yr) and lagged about 1 yr behind the age at which rate of delta height reversed. The rate of delta FEV1 and delta FVC sharply declined thereafter until the early 20s, at which age the rate of change leveled off to a constant value. The age at which the delta FEV1 and delta FVC reversed from positive to negative ranged from 21 to 23+ yr, but was probably of less importance physiologically than the age at which the rate of change in delta FEV1 and delta FVC leveled off. The results suggest that growth factors are the major determinants for changes in delta FEV1 and delta FVC until the late teens. From the until the mid-20s, both growth factors and physiologic deterioration may affect delta FEV1 and delta FVC. Thereafter, the primary determinant of delta FEV1 and delta FVC appears to be a gradual but steady decline in physiologic status.

Adolescent↗
PubMed1983

Effect of increased abdominal muscle strength on forced vital capacity and forced expiratory volume.

The purpose of this study was to investigate the effect of increased abdominal muscle strength on forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). Twenty-five healthy volunteers were assigned randomly to either an experimental group (n = 16) or a control group (n = 9). Peak isokinetic torque of the abdominal muscles during the performance of a trunk curl-up, FVC, and FEV1 were measured before and after a 12-session training program designed to increase abdominal muscle strength. The control group did not train. Although abdominal muscle strength increased significantly after the training program, FVC and FEV1 did not increase significantly. The correlations between abdominal muscle strength and FVC, and between abdominal muscle strength and FEV1 were low. Based on these results, abdominal muscle strengthening does not appear to be an effective means of improving FVC and FEV1 in healthy subjects.

Abdominal Muscles↗