scholarly journals Contribution of peripheral airway function to changes in FEV1/FVC and RV/TLC with aging

2018 ◽  
Vol 125 (5) ◽  
pp. 1378-1383 ◽  
Author(s):  
Christopher Htun ◽  
Alun Pope ◽  
Samir Lahzami ◽  
Darren Luo ◽  
Robin E. Schoeffel ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Vital Capacity ◽  
Total Lung Capacity ◽  
Forced Expiratory Volume ◽  
Residual Volume ◽  
Lung Capacity ◽  
Nitrogen Washout ◽  
Airway Function ◽  
Gas Trapping ◽  
Peripheral Airway

Multiple breath nitrogen washout (MBNW) indices provide insight into ventilation heterogeneity globally [lung clearance index (LCI)] and within acinar (Sacin) and conducting (Scond) airways. Normal aging leads to an accelerated deterioration of Sacin in older adults, but little is known about the contribution of peripheral airway function to changes in pulmonary function indices reflecting expiratory airflow [forced expiratory volume in one second (FEV1)/forced vital capacity (FVC)] and gas trapping [residual volume (RV)/total lung capacity (TLC)] with aging. We aimed to examine associations between MBNW and FEV1/FVC as well as RV/TLC in healthy adults, and to determine if these relationships differ in older (≥50 yr) versus younger subjects (<50 yr). Seventy-nine healthy adult volunteers aged 23–89 yr with no cardiac or respiratory disease and a smoking history of <5 pack-years underwent spirometry, plethysmography, and MBNW. After adjustment for sex, height, and body mass index, the following relationships were present across the entire cohort: Sacin was inversely related to FEV1/FVC (R2 = 0.22, P < 0.001); Sacin and Scond were positively related to RV/TLC (R2 = 0.53, P < 0.001); on separate analyses, the relationship between Sacin and FEV1/FVC was strongest in the older group (R2 = 0.20, P = 0.003) but markedly weaker in the younger group (R2 = 0.09, P = 0.04); and Sacin and Scond were related to RV/TLC in older (R2 = 0.20, P = 0.003) but not younger subgroups. No relationships were observed between LCI and FEV1/FVC or RV/TLC. Changes in FEV1/FVC and RV/TLC are at least in part due to changes in peripheral airway function with aging. Further studies of the relationships between MBNW and standard pulmonary function indices may prove useful for their combined application and interpretation in obstructive airways disease. NEW & NOTEWORTHY This study explores associations between multiple breath nitrogen washout (MBNW) and standard pulmonary function indices reflecting expiratory airflow [forced expiratory volume in one second (FEV1)/forced vital capacity (FVC)] and gas trapping [residual volume (RV)/total lung capacity (TLC)] in healthy adults across a wide range of ages. We have demonstrated statistically significant relationships between MBNW and FEV1/FVC as well as RV/TLC. These findings provide novel evidence of the contribution of peripheral airway function to changes in standard pulmonary function indices with aging.

STUDIES OF RESPIRATORY PHYSIOLOGY IN CHILDREN

PEDIATRICS ◽  
1959 ◽  
Vol 24 (2) ◽  
pp. 181-193
Author(s):  
C. D. Cook ◽  
P. J. Helliesen ◽  
L. Kulczycki ◽  
H. Barrie ◽  
L. Friedlander ◽  
...  
Keyword(s):  
Tidal Volume ◽  
Respiratory Rate ◽  
Vital Capacity ◽  
Total Lung Capacity ◽  
Lung Compliance ◽  
Respiratory Physiology ◽  
Residual Volume ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Residual Capacity

Tidal volume, respiratory rate and lung volumes have been measured in 64 patients with cystic fibrosis of the pancreas while lung compliance and resistance were measured in 42 of these. Serial studies of lung volumes were done in 43. Tidal volume was reduced and the respiratory rate increased only in the most severely ill patients. Excluding the three patients with lobectomies, residual volume and functional residual capacity were found to be significantly increased in 46 and 21%, respectively. These changes correlated well with the roentgenographic evaluation of emphysema. Vital capacity was significantly reduced in 34% while total lung capacity was, on the average, relatively unchanged. Seventy per cent of the 61 patients had a signficantly elevated RV/TLC ratio. Lung compliance was significantly reduced in only the most severely ill patients but resistance was significantly increased in 35% of the patients studied. The serial studies of lung volumes showed no consistent trends among the groups of patients in the period between studies. However, 10% of the surviving patients showed evidence of significant improvement while 15% deteriorated. [See Fig. 8. in Source Pdf.] Although there were individual discrepancies, there was a definite correlation between the clinical evaluation and tests of respiratory function, especially the changes in residual volume, the vital capacity, RV/ TLC ratio and the lung compliance and resistance.

Interaction of inhaled LTC4 with histamine and PGD2 on airway caliber in asthma

1989 ◽  
Vol 66 (1) ◽  
pp. 304-312 ◽  
Author(s):  
G. D. Phillips ◽  
S. T. Holgate
Keyword(s):  
Time Course ◽  
Vital Capacity ◽  
Total Lung Capacity ◽  
Forced Expiratory Volume ◽  
Maximal Flow ◽  
Lung Capacity ◽  
Airway Caliber ◽  
Relevant Interaction

To investigate possible mediator interaction in asthma, the effect of inhaled leukotriene (LT) C4 on bronchoconstriction provoked by histamine and prostaglandin (PG) D2 was studied in nine asthmatic subjects. The provocation doses of histamine, PGD2, and LTC4 required to produce a 12.5% decrease in baseline forced expiratory volume in 1 s (FEV1, PD12.5) and to further this fall to 25% (PD25–12.5) were determined. On three subsequent occasions, subjects inhaled either the PD12.5 LTC4 plus vehicle or vehicle plus the PD25–12.5 of either histamine or PGD2, and FEV1 and maximal flow at 70% of vital capacity below total lung capacity after a forced partial expiratory maneuver (Vp30) followed for 45 min. From these results, predicted time-course curves for LTC4 with histamine and LTC4 with PGD2 were calculated. On two final occasions, airway caliber was followed for 45 min after inhalation of the PD12.5 LTC4 followed by the PD25–12.5 of either histamine or PGD2. During the first 9 min after LTC4-histamine and LTC4-PGD2, the decreases in airway caliber were greater than the calculated predicted response. This interaction, although small, was significant with LTC4-PGD2 for both FEV1 (P = 0.01) and Vp30 (P less than 0.05) and with LTC4-histamine for Vp30 (P less than 0.05) but not for FEV1 (P less than 0.05). We conclude that inhaled LTC4 interacts synergistically with histamine and PGD2 and that this effect, although small, may be a relevant interaction in asthma.

Response of lung volumes and ventilation to posture change and upright exercise

1962 ◽  
Vol 17 (5) ◽  
pp. 783-786 ◽  
Author(s):  
John S. Hanson ◽  
Burton S. Tabakin ◽  
Edgar J. Caldwell
Keyword(s):  
Vital Capacity ◽  
Total Lung Capacity ◽  
Treadmill Exercise ◽  
Body Position ◽  
Upright Posture ◽  
Residual Volume ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Posture Change ◽  
Normal Males

Variations in size of the various lung volumes due to changes in body position and as a consequence of treadmill exercise were studied in five normal males. Assumption of the upright posture was associated with highly significant increases in total lung capacity, vital capacity, expiratory reserve volume, and residual volume as compared to resting supine values. Level walking was associated with a decrease of expiratory reserve volume, but a further expansion of residual volume. Vital capacity decreased slightly, but total lung capacity increased by virtue of the proportionately large residual volume increases. Elevation of the treadmill to 4° resulted in slight decreases in all lung volumes, total lung capacity evidencing a barely significant decline. Positional changes in ventilation are described, and on the basis of the “lung clearance index” an increased efficiency of ventilation is seen in the upright posture. Factors possibly operative in these alterations are discussed. Submitted on February 21, 1962

Previous volume history of the lung and regional distribution of residual volume

1981 ◽  
Vol 51 (2) ◽  
pp. 313-316 ◽  
Author(s):  
F. Ruff ◽  
R. R. Martin ◽  
J. Milic-Emili
Keyword(s):  
Vital Capacity ◽  
Total Lung Capacity ◽  
Regional Distribution ◽  
Breath Hold ◽  
Small Airways ◽  
Residual Volume ◽  
Lung Capacity ◽  
Lower Lung ◽  
History Of ◽  
Collateral Ventilation

By use of 133Xe, the regional distribution of residual volume (RV) was measured in six seated healthy men, following a fast vital capacity (VC) expiration a) without and b) with a breath hold at residual volume of approximately 30 s and c) following a slow (greater than 30 s) VC expiration from total lung capacity (TLC) without a breath hold at RV. After the breath hold at RV, regional RV/TLC in the lower lung zones decreased significantly compared wih results obtained with fast expiratory VC and no breath hold at RV. At lung top the opposite was true. The distribution of regional RV/TLC was the same following the slow VC expiration with no breath hold at RV as with the fast expiration with the breath hold at RV. The different regional distribution of RV in b and c relative to a was probably due mainly to collateral ventilation, i.e., during the breath hold at RV and the slow expiration some of the gas that was trapped in the dependent lung zones behind closed airways escaped into the upper regions of the lung where the small airways had remained patent, leading to increased expansion of upper alveoli.

Pulmonary Function Abnormalities in Thalassemia Patients on a Hypertransfusion Program

PEDIATRICS ◽  
1980 ◽  
Vol 65 (5) ◽  
pp. 1013-1017
Author(s):  
Thomas G. Keens ◽  
Margaret H. O'Neal ◽  
Jorge A. Ortega ◽  
Carol B. Hyman ◽  
Arnold C.G. Platzker
Keyword(s):  
Carbon Monoxide ◽  
Pulmonary Function ◽  
Total Lung Capacity ◽  
Small Airway ◽  
Phase Iii ◽  
Diffusing Capacity ◽  
Lung Capacity ◽  
Nitrogen Washout ◽  
Single Breath ◽  
Expiratory Flow

Pulmonary function tests were performed in 12 thalassemia patients on a hypertransfusion program (age 18.4 ± 2.6 SEM years) to determine the presence of any abnormalities of lung function. These included spirometry, expiratory flow rates, body plethysmography, single-breath nitrogen washout, single breath carbon monoxide diffusing capacity, and arterial blood gases. Only one patient had normal pulmonary function. Arterial hypoxemia was present in ten of 12 patients at rest. The total lung capacity (TLC) was normal. The residual volume was abnormally increased in five of 12 patients. The slope of phase III of single breath nitrogen washout curve was abnormal in five of 12 patients, but the closing volume was normal. The maximal expiratory flow rate at 60% total lung capacity was decreased in four of 12 patients, suggesting the presence of small airway disease. The single breath carbon monoxide diffusing capacity was normal in all patients. These pulmonary function abnormalities did not correlate with age or the cumulative amount of iron via blood transfused. The small airway obstruction, hyperinflation; and hypoxemia observed in thalassemia patients on a hypertransfusion program may result from the basic disease, iron deposition in the lungs, or other factors.

Incidence of Exercise-Induced Asthma in Children

PEDIATRICS ◽  
1975 ◽  
Vol 56 (5s) ◽  
pp. 847-850
Author(s):  
C. Warren Bierman ◽  
Isamu Kawabori ◽  
William E. Pierson
Keyword(s):  
Pulmonary Function ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Running Exercise ◽  
Airway Function ◽  
Free Running ◽  
Asthma In Children ◽  
Exercise Induced

The incidence of exercise-induced asthma (EIA) was studied in 134 asthmatic, 102 nonasthmatic atopic, and 56 nonatopic children. Pulmonary function tests measuring forced vital capacity (FVC) and one-second forced expiratory volume (FEV1) were performed on each child prior to and serially for 20 minutes following free running exercise. The incidence of EIA among the asthmatic and atopic nonasthmatic children was 63% and 41% respectively, and 7% among control subjects. Airway function was studied prior to and after a standardized free running exercise test. Forty-one percent of the nonasthmatic and 63% of the asthmatic atopic children had a significant decrease in airway function as compared to 5% of the nonallergic subjects.

Interpretation of pulmonary function tests: beyond the basics

2016 ◽  
Vol 65 (2) ◽  
pp. 301-310 ◽  
Author(s):  
Bashar S Staitieh ◽  
Octavian C Ioachimescu
Keyword(s):  
Pulmonary Function ◽  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Practical Method ◽  
Forced Expiratory Volume ◽  
European Respiratory Society ◽  
Prognostic Information ◽  
Lung Capacity ◽  
Function Tests ◽  
Functional Indices

Although the general framework described in the joint American Thoracic Society/European Respiratory Society guidelines provides a useful and practical method for the interpretation of pulmonary function tests, several other measurements and functional indices, if understood correctly, may help in diagnosis and management of patients with respiratory diseases and in design of research protocols. This review provides information on the underlying physiology, interpretative caveats, and the evidence supporting the use of a number of these indices. Some of these measurements, such as the inspiratory fraction, inspiratory capacity/total lung capacity (IC/TLC), may offer additional prognostic information, while others, such as residual volume (RV)/TLC and forced expiratory volume in 3 s/forced vital capacity (FEV3/FVC), may help fill in the gaps between patient symptoms and more traditional indices of pulmonary function. Although most studies of non-traditional indices focus on airflow-limiting disorders, many can be fruitfully applied in other settings. Understanding the physiology that catalyzed these investigations will undoubtedly enrich the functional assessment armamentarium of the practicing clinician and researcher.

Effects of swim training on lung volumes and inspiratory muscle conditioning

1987 ◽  
Vol 62 (1) ◽  
pp. 39-46 ◽  
Author(s):  
T. L. Clanton ◽  
G. F. Dixon ◽  
J. Drake ◽  
J. E. Gadek
Keyword(s):  
Vital Capacity ◽  
Total Lung Capacity ◽  
Inspiratory Muscle ◽  
Residual Volume ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Muscle Conditioning ◽  
Mouth Pressure ◽  
Before And After ◽  
Residual Capacity

Lung volumes and inspiratory muscle (IM) function tests were measured in 16 competitive female swimmers (age 19 +/- 1 yr) before and after 12 wk of swim training. Eight underwent additional IM training; the remaining eight were controls. Vital capacity (VC) increased 0.25 +/- 0.25 liters (P less than 0.01), functional residual capacity (FRC) increased 0.39 +/- 0.29 liters (P less than 0.001), and total lung capacity (TLC) increased 0.35 +/- 0.47 (P less than 0.025) in swimmers, irrespective of IM training. Residual volume (RV) did not change. Maximum inspiratory mouth pressure (PImax) measured at FRC changed -43 +/- 18 cmH2O (P less than 0.005) in swimmers undergoing IM conditioning and -29 +/- 25 (P less than 0.05) in controls. The time that 65% of prestudy PImax could be endured increased in IM trainers (P less than 0.001) and controls (P less than 0.05). All results were compared with similar IM training in normal females (age 21.1 +/- 0.8 yr) in which significant increases in PImax and endurance were observed in IM trainers only with no changes in VC, FRC, or TLC (Clanton et al., Chest 87: 62–66, 1985). We conclude that 1) swim training in mature females increases VC, TLC, and FRC with no effect on RV, and 2) swim training increases IM strength and endurance measured near FRC.

scholarly journals Attenuation of induced bronchoconstriction in healthy subjects: effects of breathing depth

2005 ◽  
Vol 98 (3) ◽  
pp. 817-821 ◽  
Author(s):  
Francesco G. Salerno ◽  
Riccardo Pellegrino ◽  
Gianluca Trocchio ◽  
Antonio Spanevello ◽  
Vito Brusasco ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Vital Capacity ◽  
Total Lung Capacity ◽  
Flow Limitation ◽  
Residual Volume ◽  
Expiratory Flow Limitation ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Forced Expiratory Flow ◽  
Expiratory Flow

The effects of breathing depth in attenuating induced bronchoconstriction were studied in 12 healthy subjects. On four separate, randomized occasions, the depth of a series of five breaths taken soon (∼1 min) after methacholine (MCh) inhalation was varied from spontaneous tidal volume to lung volumes terminating at ∼80, ∼90, and 100% of total lung capacity (TLC). Partial forced expiratory flow at 40% of control forced vital capacity (V̇part) and residual volume (RV) were measured at control and again at 2, 7, and 11 min after MCh. The decrease in V̇part and the increase in RV were significantly less when the depth of the five-breath series was progressively increased ( P < 0.001), with a linear relationship. The attenuating effects of deep breaths of any amplitude were significantly greater on RV than V̇part ( P < 0.01) and lasted as long as 11 min, despite a slight decrease with time when the end-inspiratory lung volume was 100% of TLC. In conclusion, in healthy subjects exposed to MCh, a series of breaths of different depth up to TLC caused a progressive and sustained attenuation of bronchoconstriction. The effects of the depth of the five-breath series were more evident on the RV than on V̇part, likely due to the different mechanisms that regulate airway closure and expiratory flow limitation.

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