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At least 163 records · Page 9Linked to original sources
PubMed1998

Single vital capacity inhalational anaesthetic induction in adults--isoflurane vs sevoflurane.

PURPOSE: To evaluate whether isoflurane is as suitable as sevoflurane for the single vital capacity breath (VCB) method of inhalational induction in patients premedicated with midazolam. METHODS: A randomised, controlled, double-blind study involving 67 ASA I-II patients aged between 18-50 yr undergoing elective surgery under general anaesthesia. All participants received premedication with 0.03 mg.kg-1 midazolam i.v. Using a primed circle absorber circuit, inhalational induction of anaesthesia was performed with the single VCB method using either isoflurane 3.5% or sevoflurane 7.5% in nitrous oxide 67% in oxygen, representing approximately equivalent MAC-multiples of 3.6 MAC. Isoflurane was compared with sevoflurane in terms of rapidity, efficacy, safety and acceptability of induction. RESULTS: With the single VCB method, sevoflurane produced a faster (45 +/- 21 vs 71 +/- 22 sec, P < 0.01), more successful (100% vs 75.8%, P < 0.01) induction of anaesthesia, with fewer induction-related complications (11.8% vs 84.8%, P < 0.01) than did isoflurane. There was also greater patient acceptability of induction with sevoflurane (76.4% vs 42.4%, P < 0.05). CONCLUSION: In adults given midazolam premedication, isoflurane is not as suitable as sevoflurane for single VCB inhalational anaesthetic induction technique as it is associated with slower, more complicated induction and less patient acceptability.

Adolescent↗
PubMed1979

Thoracoabdominal mechanics during relaxed and forced vital capacity.

Thoracoabdominal configuration, intrathoracic (esophageal), intra-abdominal (gastric), and transdiaphragmatic pressures were studied in six normal upright subjects during relaxed (RVC) and forced vital capacity (FVC). Chest wall configuration showed substantial departure from its relaxation characteristics during FVC. Paradoxical (outward) movement was recorded for a low lateral diameter of the rib cage (on the costal margin) at high volume during RVC and during most of FVC, while the other rib cage dimensions were decreasing. Transdiaphragmatic pressure was positive during most of the FVC, particularly toward RV, reflecting active contraction of the diaphragm. We conclude that diaphragmatic activity modulates forced expiration and that the chest wall may influence the FVC maneuver.

Abdomen↗
PubMed1985

Fall in vital capacity with posture.

In a study of 147 subjects (50 normals, 50 with obstructive, and 47 with restrictive lung function), the mean reduction in forced vital capacity from standing to supine (delta FVC) was 7.5% (SD +/- 5.7), 11.2% (+/- 13.4), and 8.2% (+/- 7.7) respectively, with no significant difference between groups. The respective 95% upper confidence limits were 19%, 38% and 24%. We conclude that delta FVC greater than 25% associated with normal or restrictive lung function or greater than 35% associated with airways obstruction should be an indication for further study of diaphragm function.

Adult↗
PubMed1996

Physiologic definitions of obliterative bronchiolitis in heart-lung and double lung transplantation: a comparison of the forced expiratory flow between 25% and 75% of the forced vital capacity and forced expiratory volume in one second.

BACKGROUND AND METHODS: A comparison of the forced expiratory flow between 25% and 75% of the forced vital capacity (FEF25-75) and forced expiratory volume in 1 second (FEV1) was conducted for the detection of obstructive airway disease as an early manifestation of obliterative bronchiolitis. Pulmonary function tests performed on heart-lung and double lung transplant recipients between March 1981 and March 1983 were reviewed. Thirty patients were identified who showed progressive deterioration in pulmonary function after transplantation. Ratios determining proportionate decreases were calculated from measurements of absolute values for the FEF25-75 and FEV1 at the point when the FEF25-75 reached < 70% and < or = 30% of predicted, divided by baseline values obtained before the decline in function. Similar ratios were obtained for FEV1 and FEF25-75 at the point the FEV1 declined > or = 20% from its baseline value. RESULTS: Comparison of the ratios for the FEF25-75 and FEV1 at FEF25-75 values < 70% and < or = 30% of predicted and a similar comparison when the FEV1 declined > or = 20% from baseline showed a greater proportional decrease in FEF25-75 than FEV1 (p < 0.01). With the use of the FEF25-75, declines in airway function were detected earlier. After transplantation a decline in FEF25-75 to < 70% of predicted occurred approximately 112 days before a 20% decline a FEV1. CONCLUSION: The FEF25-75 is more sensitive than the FEV1 for the early detection of obliterative bronchiolitis. A presumptive diagnosis of obliterative bronchiolitis can be made with physiologic criteria, providing infection or acute rejection has been ruled out. When conducting epidemiologic studies or for vital statistics we propose that a decline in FEF25-75 to < 70% be used to define the onset of obliterative bronchiolitis.

Adult↗
PubMed1995

The repeated measurement of vital capacity is a poor predictor of the need for mechanical ventilation in myasthenia gravis.

OBJECTIVE: Testing the hypothesis that, in myasthenia gravis (MG), repeated measurements of vital capacity (VC) and various parameters derived from this measurement [median or lowest value of measured VCs during hospitalization, VC values < 20 ml/kg body weight (BW) or < 13 ml/kg BW, or an index assessing the variability of VC values during the whole ICU stay] could predict the need for intubation and mechanical ventilation (MV), as has been shown in other neuromuscular diseases with respiratory failure. DESIGN: Retrospective study with medical chart revision of all the patients with MG and respiratory failure admitted to our intensive care unit between 1985 and 1993. SETTING: Medical intensive care unit (15 beds) of a university hospital. PATIENTS AND METHODS: Five patients suffering from ten episodes of acute respiratory failure due to their decompensated MG. Repeated measurements of arterial blood gases and VC by trained respiratory therapists, at least every 4 h. RESULTS: There was no difference in any of these parameters between patients eventually requiring MV (four episodes) and those in whom mechanical ventilation was not necessary (six episodes). CONCLUSIONS: VC repeated measurements is a poor predictor of the need for further MV in MG patients. This can probably be ascribed to the erratic nature of MG, a disease whose course is largely influenced by many parameters (infection, treatment modifications, initiation of corticosteroid therapy, stress, psychological factors, etc.). Early admissions to the ICU of MG patients with respiratory dysfunction is thus recommended.

Adolescent↗
PubMed2003

Ratio between forced expiratory flow between 25% and 75% of vital capacity and FVC is a determinant of airway reactivity and sensitivity to methacholine.

STUDY OBJECTIVE: The ratio between forced expiratory flow between 25% and 75% of vital capacity (FEF(25-75)) and FVC is thought to reflect dysanapsis between airway size and lung size. A low FEF(25-75)/FVC ratio is associated with airway responsiveness to methacholine in middle-aged and older men. The current study was designed to assess this relationship in both male and female subjects over a broader range of ages. STUDY DESIGN: Data analysis of consecutive subjects who had a >or= 20% reduction in FEV(1) after <or= 189 cumulative units of methacholine over a 7-year period. SETTING: Pulmonary function laboratory in a university-affiliated hospital. PATIENTS: A total of 764 consecutive subjects aged 4 to 91 years (mean +/- SD age, 40.8 +/- 19.6 years). There were 223 male (29.3%) and 540 female (70.7%) subjects. MEASUREMENTS AND RESULTS: Airway reactivity was assessed as the dose-response slope of the reduction in FEV(1) from baseline vs the cumulative dose of inhaled methacholine. The cumulative dose of methacholine causing 20% reduction in FEV(1) (PD(20)) was used as the indicator of airway sensitivity. In a linear regression model that included age, height, and percentage of predicted FEV(1), the FEF(25-75)/FVC ratio accounted for 7.6% of variability in airway reactivity (p < 0.0001, r(2) = 0.076). Subjects with higher airway sensitivity, indicated by lower PD(20), also had a lower FEF(25-75)/FVC ratio. CONCLUSIONS: A low FEF(25-75)/FVC ratio, indicating small airway size relative to lung size, is associated with higher airway sensitivity and reactivity to methacholine in susceptible subjects.

Adult↗
PubMed1999

Hemodynamic response to tracheal intubation after vital capacity rapid inhalation induction (VCRII) with different concentrations of sevoflurane.

STUDY OBJECTIVE: To evaluate the blood pressure (BP) and heart rate (HR) response to tracheal intubation after vital capacity rapid inhalation induction (VCRII) with four concentrations of sevoflurane followed by nitrous oxide (N2O) 50% and sevoflurane in concentrations administered by clinical judgment. DESIGN: Prospective, randomized study. SETTING: University teaching hospital. PATIENTS: 60 unpremedicated, ASA physical status I and II adult patients undergoing surgery with general anesthesia. INTERVENTIONS: After fentanyl 3 micrograms/kg, VCRII was accomplished with four concentrations of sevoflurane in O2: Group 1 (n = 15): sevoflurane 3%; Group 2 (n = 15): sevoflurane 4%; Group 3 (n = 15): sevoflurane 5%; and Group 4 (n = 15): sevoflurane 6%. At loss of consciousness, rocuronium 0.6 mg/kg was given, and intubation was performed 90 seconds later. Thereafter, anesthesia continued with N2O 50% and sevoflurane. MEASUREMENTS AND MAIN RESULTS: BP and HR measurements were made at the ward (baseline), at loss of consciousness, and just prior to, and each minute after, tracheal intubation during a 5-minute period. The hemodynamic profile among groups was similar, with a slight hypertensive and tachycardic response to intubation. CONCLUSION: VCRII with sevoflurane 3% to 6% following fentanyl 3 micrograms/kg can be considered for blunting the hemodynamic response to tracheal intubation in healthy patients.

Adult↗
PubMed1975

Expiratory reserve volume and vital capacity of the lungs during immersion in water.

The effects of immersion by 5-cm increments on the expiratory reserve volume of the lungs (ERV) and on the vital capacity were studied in the sitting and supine positions. These effects were compared to those produced by continuous negative-pressure breathing when the subjects were in air and were counteracted by positive pressure breathing during immersion. The depth of immersion was also related to definable anatomic landmarks. In the sitting position about one-fourth of the decrease in the ERV was accounted for by the hydrostatic pressure of the water on the abdomen and the remainder by the pressure on the thorax. Immersion to the level of the spinous process of the seventh cervical vertebra was equivalent to 28 cmH2o continuous negative pressure breathing in air. In the supine position, a comparable value was 8 cmH2o. These observations agree well with those of others if differences in the levels of immersion are accounted for.

Abdomen↗
PubMed2006

Study of respiratory muscle strength, vital capacity, and ventilometry in the postoperative period of spinal surgery by posterior access.

STUDY DESIGN: Prospective. OBJECTIVE: To analyze tidal volume (TV), minute volume (VE), respiratory frequency (f), vital capacity (VC), maximal inspiratory (PImax), and expiratory (PEmax) pressures in patients submitted to spinal surgery for tumor or herniated disc by posterior access, and to investigate a possible association of respiratory function with surgery duration, site of surgical access, and diagnosis. SUMMARY OF BACKGROUND DATA: A reduction in pulmonary volumes is usually seen in patients submitted to thoracic or upper abdominal surgery, and recent studies have demonstrated such alterations during the postoperative period in patients submitted to craniotomy. METHODS: A total of 45 patients (mean age, 42 +/- 14 years) were submitted to spinal surgery in an University Hospital, and TV, VC, MV, f, PImax, and PEmax were measured in the preoperative period, and in the first and second postoperative days. RESULTS: Patients submitted to spinal surgery showed a decrease in the first and second postoperative days in VC, respectively (17% and 10%), TV (18% and 13%), PImax (17% and 12%), PEmax (12% and 7%), and an increase in f (18% and 12%) (P < 0.05). Reduction in TV, VC, PImax, and PEmax and the increase in f were associated with surgical time > or =240 minutes, diagnosis of tumor, and cervicothoracic surgical access (P < 0.05). CONCLUSIONS: Alterations in the respiratory function in the postoperative period of elective spinal surgery by posterior access for tumor removal or herniated disc were related to surgical time > or =240 minutes, tumor, or cervicothoracic surgical access.

Adolescent↗
PubMed2006

When a leak is unavoidable, preoxygenation is equally ineffective with vital capacity or tidal volume breathing.

PURPOSE: Ideally, preoxygenation is performed using a tight fitting mask either by breathing normally for three to five minutes or with four to eight vital capacity (VC) breaths in 0.5 to one minute, but in practice leaks are frequent and sometimes unavoidable. This study was designed to determine which breathing method provided the best oxygenation in the presence of leak. METHODS: Twenty volunteers were instructed to breathe from a circle circuit supplied with 6 L x min(-1) of fresh oxygen. Each subject was tested under four situations selected in random order: 1) normal breathing for three minutes without leak; 2) normal breathing for three minutes with a leak; 3) four VCs in 30 sec without a leak; and 4) four VCs in 30 sec with a leak. The leak was created by a piece of size 18 French nasogastric tube, 5 cm long, taped under the face mask. Inspired and expired O(2) and CO(2) were sampled at the nostrils. RESULTS: In the absence of a leak, the end-tidal oxygen fraction (F(EO(2)) was greater after three minutes of tidal breathing (89 +/- 3%; mean +/- SD) in comparison with the response to four VCs (76 +/- 7%; P < 0.001). Introduction of a leak decreased the F(EO(2)) significantly (P < 0.001). With a leak, the F(EO(2)) was similar with normal breathing (61 +/- 8%) and after four VCs (59 +/- 11%). CONCLUSION: Preoxygenation with tidal volume breathing for three minutes yields higher F(EO(2)) in comparison to four VCs. If a small leak (4 mm internal diameter) is introduced, the F(EO(2)) decreases significantly with both breathing methods to approximately 60%.

Adolescent↗
PubMed1982

Pocket-sized device for measuring forced expiratory volume in one second and forced vital capacity.

An inexpensive pocket-sized instrument--the turbine spirometer--has been developed that measures and gives a direct digital display of the forced expiratory volume in one second and forced vital capacity. The instrument is as accurate as and considerably cheaper than spirometers in general use. Condensation does not affect the calibration. The turbine spirometer will enable spirometry to be easily monitored in hospital wards and general practice and by patients at home.

Calibration↗
PubMed1985

[Effect of obesity on the ventilatory capacity of the respiratory system. I. Relation between basic spirometric indicators: vital capacity (VC) and forced expiratory volume (FEV1) and obesity].

The following procedures have been applied for evaluation of obesity of 1087 men, steel mill workers: all examined men have been divided into intervals of relative body weight (after Lorentz), indices including measurements of the current body weight and height, indices including measurements of the current body weight, height and skinfolds thickness. All examined persons have undergone measurements of spirometric parameters. The strongest correlation with spirometric values was that of the index of obesity including, apart from the body weight and height, also skinfolds thickness. This index of obesity provides good estimation of respiratory efficiency, which diminishes as obesity intensifies.

Adult↗
PubMed1988

Evaluation of a hand-held spirometer, the Respiradyne, for the measurement of forced expiratory volume in the first second (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR).

A hand-held spirometer, the Respiradyne (R), was evaluated for the measurement of forced expiratory volume in the first second (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR) by comparing it with a Vitalograph spirometer (V) and a Wright's peak flow meter (W) in 70 subjects (normals and patients). The results showed close agreement for FEV1; r = 0.99, R = 0.961V + 0.03 X 10(-5) and FVC; r = 0.99, R = 1.003V-0.044. Results for PEFR using the Respiradyne were generally higher than with the peak flow meter; r = 0.98, R = 1.151W-17.576. The Respiradyne is portable and simple to operate and may be suited to use in a variety of non-laboratory situations.

Evaluation Studies as Topic↗
PubMed1987

Relation of alveolar size to forced vital capacity in professional divers.

Eight cases have been studied in which both lung function and histological morphometric data was available on divers' lungs. A correlation was found between the increase in forced vital capacity measured at routine annual medical examination and the morphometric measurement of alveoli by mean cord length. The results suggest that reduction of forced expiratory volume in one second may be due to narrowing of small airways by distention of the alveoli.

Adult↗
PubMed1999

A study of forced vital capacity and its predictors among the sand stone quarry workers.

The study assesses the relationship of selected demographic, anthropometric, radiological, work-history and smoking-history related variables with Forced Vital Capacity (FVC) in a sample of 168 sand stone quarry workers in a desert environment. Except the variables related to smoking behaviour, all are found significantly associated with FVC. The predictors of FVC screened through the multiple regression analysis were age, weight, height, profusion of opacities in chest X-ray and duration of work. Mean FVC was found significantly lower as compared to the healthy adult population. On an average FVC% was 90% of predicted (Percentage deviation of 10%). A clear increasing trend in FVC% along age/duration of work was observed among the young workers, which may be due to building of muscles in this job. Percentage deviation of 20% or more in FVC was significantly associated with presence of radiological opacities suggestive of silicosis (odds Ratio = 3.3). The diagnostic utility of the same is also assessed.

Adult↗
PubMed1990

Greater maximal O2 uptakes and vital capacities in Tibetan than Han residents of Lhasa.

Maximal O2 uptake provides an index of the integrated functioning of the O2 transport system. Whether lifelong high altitude residents have greater maximal exercise capacities than acclimatized newcomers is of interest for determining whether years to generations of high altitude exposure influence maximal O2 uptake and, if so, what components of O2 transport are involved. We studied 16 Tibetan lifelong residents of Lhasa, Tibet, China (3658 m) and 20 Han ("Chinese") 8 +/- 1 year residents of the same altitude who were matched for age, height, weight and lack of exercise training. At maximal effort, the Tibetans compared to the Hans had greater O2 uptakes (51 +/- 1 vs 46 +/- 1 ml STPD.min-1.(kg bw)-1, P less than 0.05), exercise workloads (177 +/- 5 vs 155 +/- 6 watts, P less than 0.05), minute ventilations (149 +/- 6 vs 126 +/- 4 IBTPS/min, P less than 0.01) and O2 pulse (15.2 +/- 0.4 vs 13.3 +/- 0.5 ml O2 consumption/heart beat, P less than 0.05). Equally high heart rates were present at maximal effort (191 +/- 3 vs 187 +/- 3 beats/min, P = NS), supporting the likelihood that true maxima were achieved in both groups. The greater minute ventilation in the Tibetans resulted from greater tidal volume and the greater maximal tidal volume correlated positively with the resting vital capacity. We concluded that the Tibetans achieved a higher maximal O2 uptake than the Hans, implying an increased capacity for O2 transport to the working muscle.

Acclimatization↗