Ozone exposure decreases the effect of a deep inhalation on forced expiratory flow in normal subjects

Sixteen healthy nonsmoking subjects (7 women), 21-49 yr old, were exposed in a climate chamber to either clean air or 300 parts/billion ozone on 4 days for 5 h each day. Before each exposure, the subjects had been pretreated with either oxidants (fish oil) or antioxidants (multivitamins). The study design was double-blind crossover with randomized allocation to the exposure regime. Full and partial flow-volume curves were recorded in the morning and before and during a histamine provocation at the end of the day. Nasal cavity volume and inflammatory markers in nasal lavage fluid were also measured. Compared with air, ozone exposure decreased peak expiratory flow, forced expiratory volume in 1 s, and forced vital capacity (FVC), with no significant effect from the pretreatment regimens. Ozone decreased the ratio of maximal to partial flow at 40% FVC by 0.08 ± 0.03 (mean ± SE, analysis of variance: P = 0.018) and at 30% FVC by 0.10 ± 0.05 ( P = 0.070). Ozone exposure did not significantly increase bronchial responsiveness, but, after treatment with fish oil, partial flows decreased more than after vitamins during the histamine test, without changing the maximal-to-partial flow ratio. The decreased effect of a deep inhalation after ozone exposure can be explained by changes in airway hysteresis relative to parenchymal hysteresis, due either to ozone-induced airway inflammation or to less deep inspiration after ozone, not significantly influenced by multivitamins or fish oil.

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Breathing at low lung volumes and chest strapping: a comparison of lung mechanics

Journal of Applied Physiology ◽

10.1152/jappl.1981.50.3.650 ◽

1981 ◽

Vol 50 (3) ◽

pp. 650-657 ◽

Cited By ~ 22

Author(s):

N. J. Douglas ◽

G. B. Drummond ◽

M. F. Sudlow

Keyword(s):

Lung Volume ◽

Maximum Flow ◽

Normal Subjects ◽

Lung Mechanics ◽

Lung Volumes ◽

Flow Rates ◽

Recoil Pressure ◽

Forced Expiratory Flow ◽

Expiratory Flow ◽

Expiratory Flow Rates

In six normal subjects forced expiratory flow rates increased progressively with increasing degrees of chest strapping. In nine normal subjects forced expiratory flow rates increased with the time spent breathing with expiratory reserve volume 0.5 liters above residual volume, the increase being significant by 30 s (P less than 0.01), and flow rates were still increasing at 2 min, the longest time the subjects could breathe at this lung volume. The increase in flow after low lung volume breathing (LLVB) was similar to that produced by strapping. The effect of LLVB was diminished by the inhalation of the atropinelike drug ipratropium. Quasistatic recoil pressures were higher following strapping and LLVB than on partial or maximal expiration, but the rise in recoil pressure was insufficient to account for all the observed increased in maximum flow. We suggest that the effects of chest strapping are due to LLVB and that both cause bronchodilatation.

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Azelastine in the Prophylactic Treatment of Bronchial Asthma: An Italian Multicentre Comparison with Ketotifen

Journal of International Medical Research ◽

10.1177/030006058901700304 ◽

1989 ◽

Vol 17 (3) ◽

pp. 218-225 ◽

Cited By ~ 2

Author(s):

L. Ambrosi ◽

F. Bariffi ◽

M. Carino ◽

E. Catena ◽

G. Ceccarelli ◽

...

Keyword(s):

Bronchial Asthma ◽

Double Blind Study ◽

Double Blind ◽

Significant Difference ◽

Effective Prophylaxis ◽

Daily Dosage Regimen ◽

Forced Expiratory Flow ◽

Expiratory Flow ◽

Low Incidence ◽

Clinical Measures

The prophylactic effectiveness of the phthalazinone derivative, azelastine was compared with ketotifen. A total of 111 patients, aged 18 – 65 years, from 10 centres was entered into this randomized, double-blind study. All patients had reversible asthma. After 1 week on placebo, patients were allocated to either 8 mg/day azelastine once or twice daily, or to 1 mg ketotifen, twice daily, for a further 12 weeks. Azelastine was more effective in improving respiratory function (forced expiratory flow in 1 s and peak expiratory flow rate) when given in the once daily regimen, whereas clinical measures (number of weekly asthma attacks) were most improved by twice daily dosing. There was no significant difference between the effectiveness of azelastine and that of ketotifen. Treatments were equally well tolerated and a low incidence of side-effects was reported. In conclusion, 8 mg/day azelastine, in either a single or twice daily dosage regimen may be regarded as providing effective prophylaxis against bronchial asthma.

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Factors affecting spirometry reference range in growing children

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.6.1212 ◽

2019 ◽

Vol 35 (6) ◽

Author(s):

Sara Sadiq ◽

Nadeem Ahmed Rizvi ◽

Fahad Khalid Soleja ◽

Muaz Abbasi

Keyword(s):

Reference Range ◽

Forced Expiratory Volume ◽

P Value ◽

Strong Positive Correlation ◽

Linear Regression Models ◽

Factors Affecting ◽

Independent Variables ◽

Creative Commons ◽

Forced Expiratory Flow ◽

Expiratory Flow

Objectives: To find out the association of weight, height and age with spirometry variables and to generate a regression equation by taking weight as an independent variable beside age and height among children and adolescents of Karachi. Methods: A modified form of ISSAC questionnaire was used. The spirometry variables recorded were Forced vital capacity (FVC), Forced expiratory volume in 1 second (FEV1), FEV1/FVC, Peak expiratory flow rate (PEF), Forced expiratory flow between 25% and 75% expired volume (FEF25-75). A person’s correlation coefficient among boys and girls were calculated for all spirometry variable considering age, height and weight as independent variables. The linear regression models were calculated. Results: The results reported a linear correlation of lung function variables with all three independent variables (i.e. p-value = 0.000), in which age and height manifested a strong positive correlation while weight reported a moderately significant correlation. All spirometry variables such as FVC, FEV1, PEF and FEF25-75 reported a significant coefficient of dependency and coefficient of correlation individually with age, height and weight. Conclusion: It is concluded that beside age, height and weight both also have significant correlation with lung volumes so these should be taken into account when using spirometry as a diagnostic test. doi: https://doi.org/10.12669/pjms.35.6.1212 How to cite this:Sadiq S, Rizvi NA, Soleja FK, Abbasi M. Factors affecting spirometry reference range in growing children. Pak J Med Sci. 2019;35(6):1587-1591. doi: https://doi.org/10.12669/pjms.35.6.1212 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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The Value of Spirometry in Subglottic Stenosis

Ear Nose & Throat Journal ◽

10.1177/0145561318823309 ◽

2019 ◽

Vol 98 (2) ◽

pp. 98-101 ◽

Cited By ~ 4

Author(s):

Alhelali Abdullah ◽

A. Alrabiah ◽

Sayed S. Habib ◽

Y. Aljathlany ◽

A. Aljasser ◽

...

Keyword(s):

Upper Airway ◽

Forced Expiratory Volume ◽

Endoscopic Examination ◽

Subglottic Stenosis ◽

King Saud University ◽

Medical City ◽

Forced Expiratory Flow ◽

Surgery Outcomes ◽

Expiratory Flow ◽

Grade 3

The diagnosis of subglottic stenosis (SGS) is usually made by clinical assessment and definitively by a direct endoscopic examination. This study aimed to evaluate different spirometric values in relation to anatomical grading and severity of subglottic stenosis cases of upper airway obstruction. Cases of SGS that underwent dilatational procedures endoscopically at the otolaryngology department of the King Saud University Medical City, Riyadh, Saudi Arabia, from June 2015 to October 2017 were collected. Pulmonary function test (PFT) pre- and postoperative parameters and the grades of subglottic stenosis were extracted. We compared different spirometric values to the severity of SGS and compared the pre- and postoperative results for each patient. There were 19 cases with a valid PFT study within 7 days preoperatively in addition to a documented intraoperative grading according to the Myer-Cotton grading system; 7 (36.8%) were grade 1, 8 (42.1%) were grade 2, and 4 (21.1%) were grade 3. The actual preoperative ratio of forced expiratory volume (FEV1) in 1 second to peak expiratory flow (PEF) for all 19 patients ranged from 7.34 to 21.40 mL/L/min. We found a significant improvement in all spirometric parameters postdilatation including PEF ( P < .001), FEV1 ( P < .001), FEV1/PEF ( P = .001), forced expiratory flow (FEF) from 25%, 50%, and 75% of vital capacity, respectively, FEF25 ( P < .001), FEF50 ( P = .001), FEF75 ( P = .048), and maximum mid-expiratory flow ( P = .002). We did not find any correlation between the severity of stenosis and spirometric values. This study revealed that spirometry is a useful marker in following up patients with subglottic stenosis and is also a good indicator to determine postairway surgery outcomes. However, these markers do not correlate with anatomical grading and the severity of subglottic stenosis.

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Domiodol Treatment for Bronchopulmonary Diseases in the Paediatric Age Group: A Double-Blind Controlled Clinical Trial versus Placebo

Journal of International Medical Research ◽

10.1177/030006058801600103 ◽

1988 ◽

Vol 16 (1) ◽

pp. 31-38 ◽

Cited By ~ 3

Author(s):

A. Fiocchi ◽

U. Grasso ◽

G. Zuccotti ◽

R. Arancio ◽

E. Riva ◽

...

Keyword(s):

Vital Capacity ◽

Forced Expiratory Volume ◽

Thyroid Stimulating Hormone ◽

Controlled Clinical Trial ◽

Age Group ◽

Double Blind ◽

Bronchopulmonary Diseases ◽

Paediatric Age ◽

Group A ◽

Expiratory Flow

Thirty children (25 males, five females), mean age 9.33 ± 2.57 years, with acute infectious pulmonary diseases or acute flare-ups of chronic bronchitis, were randomly treated with either domiodol or placebo. The study was conducted between November 1986 and February 1987. Domiodol was administered orally for 14 days in doses of 0.5 mg/kg three times daily. Subjective symptoms (cough, sputum viscosity, difficulty in raising sputum and sputum characteristics) were assessed semi-quantitatively. They were all reduced significantly in the group treated with domiodol compared to those given placebo. Spirometric measures of vital capacity and peak expiratory flow rate were also improved in patients given domiodol compared with placebo. Conversely, no differences were noted in forced expiratory volume in 1 s, Tiffenau index, or mid-expiratory flow. There were no clinical side-effects and no changes in any other parameters measured; in particular, levels of thyroid hormone and thyroid stimulating hormone were unchanged. Thus, domiodol proved effective in reducing the symptoms of infection of the lower respiratory tract and in improving the consistency of mucus in children.

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Relationship of ventilatory capacity to hyperbaric exposure in divers

Journal of Applied Physiology ◽

10.1152/jappl.1984.56.6.1655 ◽

1984 ◽

Vol 56 (6) ◽

pp. 1655-1658 ◽

Cited By ~ 11

Author(s):

I. S. Davey ◽

J. E. Cotes ◽

J. W. Reed

Keyword(s):

Flow Rate ◽

Vital Capacity ◽

Positive Association ◽

Forced Expiratory Volume ◽

Elastic Tissue ◽

Significant Positive Association ◽

Cross Sectional ◽

Maximal Depth ◽

Forced Expiratory Flow ◽

Expiratory Flow

The results of divers' annual medical examinations were used to assess the effects of diving exposure independent of age, stature, and smoking on forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). Cross-sectional analysis of records for 858 men showed a significant positive association between the maximal depth that subjects had experienced and FVC but not FEV1. There was a significant negative association for FEV1/FVC%, and this index was also positively correlated with years of diving exposure. Among a subsample of 81 men the forced expiratory flow rate at low lung volume was reduced relative to that of control subjects similarly assessed; the extent of the reduction from the reference value was significantly correlated with the diving exposure. Longitudinal analysis of results for 255 men over a minimum of 5 yr showed that the change in FVC per annum (positive or negative) was correlated with the change in maximal depth; there were no similar associations for FEV1 or FEV1/FVC%. Thus diving exposure affects the vital capacity and the forced expiratory flow rate at small lung volumes. The latter is evidence for narrowing of airways that might be secondary to diving-induced loss of lung elastic tissue; this hypothesis merits further investigation.

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Adverse Pulmonary Responses to Aspirin and Acetaminophen in Chronic Childhood Asthma

PEDIATRICS ◽

10.1542/peds.71.3.313 ◽

1983 ◽

Vol 71 (3) ◽

pp. 313-318

Author(s):

Thomas J. Fischer ◽

Timothy D. Guilfoile ◽

Hemant H. Kesarwala ◽

John G. Winant ◽

Gregory L. Kearns ◽

...

Keyword(s):

Pulmonary Function ◽

Flow Rate ◽

Past History ◽

Forced Expiratory Volume ◽

Base Line ◽

Double Blind ◽

Asthmatic Children ◽

Significant Difference ◽

History Of ◽

Expiratory Flow

Because aspirin (ASA) is often reported to have an adverse effect on pulmonary function in children with chronic asthma, acetaminophen is commonly used as an ASA substitute in these children. To study acetaminophen effects on pulmonary functions, double-blind, oral challenges of ASA (600 mg), acetaminophen (600 mg), or lactose were administered on separate days to 25 chronic asthmatics, ten boys and 15 girls, ranging in age from 8 to 18 years (mean age ± 1 SD: 12.5 ± 2.8 years). No patient had a past history of adverse reactions to either drug. Forced expiratory volume in 1 second (FEV1), peak expiratory flow rate (PEFR), maximal mid-expiratory flow rate (FEF25-75), forced vital capacity (FVC), maximal voluntary ventilation (MVV), and flow volume curves were measured at base line and ½, 1, 2, 3, and 4 hours after ingestion of drug or placebo. Persistent decreases from base line FEV1 (> 20%) or FEF25-75 (> 30%) occurred in four ASA- and two acetaminophen-challenged patients. One ASA-sensitive patient was placebo intolerant; another reacted to acetaminophen. The acetaminophen responses were of less intensity than the ASA responses. Analysis of group mean pulmonary function responses to ASA, acetaminophen, and lactose showed no significant difference among the three agents at any time. Aspirin should be used cautiously in asthmatic children. Acetaminophen appears to be an adequate, although not completely, innocuous ASA substitute.

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Effectiveness of Terbutaline and Theophylline Alone and in Combination in Exercise-Induced Bronchospasm

PEDIATRICS ◽

10.1542/peds.67.4.508 ◽

1981 ◽

Vol 67 (4) ◽

pp. 508-513

Author(s):

Gail G. Shapiro ◽

Joseph J. McPhillips ◽

Kevin Smith ◽

Clifton T. Furukawa ◽

William E. Pierson ◽

...

Keyword(s):

Drug Administration ◽

Study Drug ◽

Forced Expiratory Volume ◽

Exercise Tests ◽

Double Blind ◽

Study Drug Administration ◽

Before And After ◽

Forced Expiratory Flow ◽

Exercise Induced ◽

Better Than

Theophylline and terbutaline, alone and in combination, were evaluated for effectiveness in treating exercise-induced bronchospasm (EIB) when used at doses that should be tolerated by adolescents taking them intermittently: theophylline, 250 mg (fast release), and terbutaline, 2.5 mg. Twenty-one subjects, 12 to 19 years of age, with EIB performed standardized exercise tests on four separate days and received either theophylline, terbutaline, the combination, or placebo in a prerandomized double-blind manner prior to exercise. Exercise tests were performed two and five hours after each study drug administration. Blood samples were drawn before and again two and five hours after drug administration for theophylline level. Pulmonary function [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and forced expiratory flow rate (FEF25% to 75%)] was recorded before and after exercise. All of the active treatments were better than placebo in diminishing EIB. The combination was statistically better than terbutaline or theophylline alone. The effect of theophylline was not significantly different from that of terbutaline. The combination induced significantly more tremor than either agent individually. Either drug alone or the two in combination is effective for diminishing EIB. Although the combination may have additive properties for some patients, the increased incidence of tremor may diminish its appeal. Either drug alone or in combination is effective in decreasing EIB for at least five hours, which makes them practical choices for treatment of school-aged children.

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An assessment of forced expiratory volumes and flow rates in the detection of early ventilatory impairment in RN submariners

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-71-167 ◽

1985 ◽

Vol 71 (3) ◽

pp. 167-170

Author(s):

R. Herrmann ◽

G. M. Clifford ◽

D. J. Smith ◽

Caroline S. M. Searing

Keyword(s):

Forced Vital Capacity ◽

Vital Capacity ◽

Linear Regression Analysis ◽

Smoking Habit ◽

Multiple Linear Regression Analysis ◽

Forced Expiratory Volume ◽

Single Breath ◽

Forced Expiratory Flow ◽

Expiratory Flow ◽

Highly Correlated

AbstractA prospective study of an early diagnostic test of small airway dysfunction, the forced expiratory flow between 75 and 85% of the forced vital capacity, was carried out in 230 RN submariners. All the subjects were male caucasians, of whom 105 were smokers and 125 non-smokers. Measurements were performed using a single breath wedge spirometer (Vitalograph®) and forced vital capacity (FVC), forced expiratory volume in one second (FEV1), ratio of the FEV1 to the FVC (FEV1/FVC%) and the forced expiratory flow between 75 and 85% of the forced vital capacity (FEF75–85) obtained from the tracings in accordance with the recommendations of the American Thoracic Society. Multiple linear regression analysis of these four measurements together with height, age and smoking habit showed age to be the most significant factor for FEF75–85, followed by height Height was the most significant factor for FVC and FEV1 followed by age. Age was the only significant factor for FEV1/FVC%. FEF75-85 was highly correlated with FEV1/FVC% (r = 0.72) and to a lesser extent with FEV1 and FVC (r = 0.70 and 0.37 respectively). In the presence of age and height no significant effect of smoking habit on FEF75–85 could be demonstrated. However when the FEV1/FYC%, age and smoking habit were examined, there was found to be a significantly greater decrease in FEV1/FYC% with age in the smokers. It would appear that in this study FEV1/FVC% is a more sensitive index of early obstructive changes induced by smoking than measurement of flow at low lung volumes.

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Wheezing in Infants with Cystic Fibrosis: Clinical Course, Pulmonary Function, and Survival Analysis

PEDIATRICS ◽

10.1542/peds.90.5.703 ◽

1992 ◽

Vol 90 (5) ◽

pp. 703-706

Author(s):

Joseph Reisman ◽

Mary Corey ◽

Gerard Canny ◽

Henry Levison ◽

Eitan Kerem ◽

...

Keyword(s):

Cystic Fibrosis ◽

Pulmonary Function ◽

Flow Rate ◽

Forced Expiratory Volume ◽

Common Finding ◽

Study Cohort ◽

Expiratory Phase ◽

Significant Difference ◽

Forced Expiratory Flow ◽

Expiratory Flow

Wheezing is a common finding in infants with cystic fibrosis (CF). This study was undertaken to determine the prevalence of wheezing in infants with CF and to compare the clinical outcome of those who wheezed in infancy with that of those who did not. The study cohort included 229 CF patients born between 1965 and 1979 with CF diagnosed before 2 years of age. Fifty-seven (25%) had physician-documented wheezing during the first 2 years of life. Wheezing had resolved by the age of 2 years in 50% of the patients and by the age of 4 years in 75%. Although wheezing seemed to be linked to a family history of allergy and asthma, the frequency of the ΔF508 mutation was similar to that of the non-wheezers. There was no significant difference in survival at the age of 13 years between the two groups. At the age of 7 years, patients who had wheezed had significantly lower forced expiratory flow rate at mid-expiratory phase (85 ± 34% predicted) compared with those with no wheezing history (101 ± 34% predicted). At the age of 13 years, forced expiratory volume in 1 second values was lower in the wheezing group (69 ± 24% predicted vs 78 ± 21% predicted), as was forced expiratory flow rate at mid-expiratory phase (56 ± 33% predicted vs 69 ± 30% predicted). In conclusion, although wheezing in infants with CF seems to have diminished with age, pulmonary function abnormalities were more evident at 7 and 13 years of age in the group that wheezed than in the group that did not.

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