scholarly journals Comparison of Per Cent Predicted and Percentile Values for Pulmonary Function Test Interpretation

2009 ◽  
Vol 16 (6) ◽  
pp. 189-193 ◽  
Author(s):  
Smita Pakhale ◽  
Zoheir Bshouty ◽  
Theodore K Marras
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Residual Volume ◽  
European Respiratory Society ◽  
Diffusion Capacity ◽  
Percentile Method ◽  
Lung Capacity ◽  
Test Characteristics ◽  
The Mean

BACKGROUND: Pulmonary function tests (PFTs) are commonly interpreted as a fraction of predicted normal values, with an abnormal test often defined as less than 80% or greater than 120% of the predicted value. However, recommendations of the American Thoracic Society/European Respiratory Society suggest using a percentile-based approach to define an abnormal test (less than the fifth or greater than the 95th percentiles).OBJECTIVE: To compare PFT values obtained by the per cent predicted method with the percentile-based method for lung function parameters.METHODS: Full PFTs performed between January 2000 and July 2004, at the Health Sciences Centre (Winnipeg, Manitoba) were analyzed. Using the Crapo and Gutierrez equations, per cent predicted and percentile values were calculated. An abnormal test was defined as less than 80% or greater than 120% of predicted (per cent predicted method) or as less than the fifth or greater than the 95th percentiles (percentile method). Using the percentile method as reference standard, the diagnostic test characteristics of the per cent predicted method were calculated.RESULTS: The full PFTs of 2176 men and 1658 women were analyzed using the Crapo and Gutierrez equations. The mean (± SD) age of all subjects was 52±15 years. Per cent agreement between the two tests was more than 94% for all parameters except for reduced residual volume (88%). Per cent predicted methods had suboptimal sensitivity for abnormal total lung capacity (88% to 89%), increased residual volume (83% to 89%) and reduced diffusion capacity (89% with Crapo equations). Suboptimal specificity (83% to 86%) was observed for decreased residual volume.CONCLUSION: The results of the per cent predicted and percentile-based approaches for PFT interpretation were similar for the majority of lung function parameters. These two methods can be used interchangeably for spirometry. However, caution may be warranted in relying solely on per cent predicted methods for assessing lung volume or diffusion capacity.

scholarly journals Follow-up pulmonary function of COVID-19 patients 4 months after hospital discharge

2021 ◽  
Vol 31 (5) ◽  
pp. 580-586
Author(s):  
Olga I. Savushkina ◽  
Alexander V. Cherniak ◽  
Evgeniy V. Kryukov ◽  
Nataliya A. Aseeva ◽  
Andrey A. Zaytsev
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Hospital Discharge ◽  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Complete Recovery ◽  
Lung Diffusion ◽  
Diffusion Capacity ◽  
Lung Capacity

The end of the acute period of COVID-19 does not mean complete recovery. Observation of patients in the post-COVID-19 period showed that a significant number of people experience shortness of breath, fatigue, muscle weakness, sleep disorders, cough, palpitations, so the term post-COVID-19 syndrome was coined. The examination to identify the causes of complaints of COVID-19 convalescents should include lung function assessment.The aim of the study was to assess the dynamics of lung function 4 months after hospitalization for COVID-19.Methods. 31 patients (26 males, the median age was 49 years) underwent traditional pulmonary function tests (PFTs) (spirometry, body plethysmography, test of diffusing lung capacity) and impulse oscillometry (IOS). Results. During the 1st visit, the average PFTs and IOS parameters were within the normal range in the whole group, apart from the diffusing lung capacity (DLCO), which was reduced mildly (on the border with moderate) in 77% of patients. During the 2nd visit, which was conducted on average 102 days after the 1st one, 58% of patients demonstrated abnormal lung diffusion capacity. The second assessment revealed a statistically significant increase in the slow and forced vital capacity (VC and FVC), the forced exhalation volume in 1 second (FEV1), total lung capacity (TLC), DLCO, and a decrease in the ratio of FEV1/FVC and the residual lung volume to TLC ratio.Conclusion. Post-COVID-19 patients show a statistically significant improvement of their lung function 4 months after hospital discharge. A systematic follow-up is essential for such patients to detect lung function abnormalities and correct them.

Airway reactivity and lung function in triiodothyronine-induced thyrotoxicosis

1985 ◽  
Vol 58 (5) ◽  
pp. 1485-1488 ◽  
Author(s):  
R. S. Irwin ◽  
M. R. Pratter ◽  
D. H. Stivers ◽  
L. E. Braverman
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Respiratory Symptoms ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Base Line ◽  
Airway Reactivity ◽  
Percent Change ◽  
Serum T3 ◽  
The Mean

To evaluate the possible relationship between asthma and hyperthyroidism, airway reactivity and lung function were prospectively compared in healthy volunteers before, during, and after liothyronine (triiodothyronine, T3)-induced hyperthyroidism. Base-line evaluation of the 10 subjects included clinical evaluation, thyroid and pulmonary function tests, and airway reactivity assessed by methacholine inhalational challenge (MIC). All studies were normal. During T3-induced hyperthyroidism, no subject developed respiratory symptoms or changes in pulmonary function or airway reactivity. The mean percent change in forced expiratory volume at 1 s from base line (delta FEV1) of -2.4 +/- 3.0 after MIC was not significantly different from that obtained before T3 administration (-1.4 +/- 1.5, P greater than 0.2). When all serum T3 concentrations and delta FEV1 values before, during and after T3-induced hyperthyroidism were compared, there was no significant correlation. We conclude that T3-induced hyperthyroidism of 3-wk duration has no effect on airway reactivity or lung function in normal volunteers.

scholarly journals Fibrocytes in early and long-standing rheumatoid arthritis: a 6-month trial with repeated synovial biopsy, imaging and lung function test

RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001494
Author(s):  
Søren Andreas Just ◽  
Christian Nielsen ◽  
Jens Christian Werlinrud ◽  
Pia Veldt Larsen ◽  
Eva Kildall Hejbøl ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Lung Function ◽  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Lung Function Test ◽  
Wrist Arthroscopy ◽  
Diffusion Capacity ◽  
Capacity Level ◽  
Registration Number

ObjectivesTo correlate the level of fibrocytes in peripheral blood, synovial tissue and in vitro culture in rheumatoid arthritis (RA) with changes in disease activity, imaging and pulmonary function.MethodsTwenty patients with early RA (ERA) and 20 patients with long-standing RA (LRA) were enrolled in a 6-month prospective study. Sixteen patients undergoing wrist arthroscopy were healthy controls. Patients with RA underwent pulmonary function tests, ultrasound and synovial ultrasound-guided needle biopsy of the same wrist at baseline and 6 months. Wrist MRI was performed at baseline (all) and 6 months (ERA). Circulating fibrocytes were measured by flow cytometry, in vitro by the number of monocytes that were differentiated to fibrocytes and in synovial biopsies by counting in histological sections.ResultsFibrocytes were primarily located around vessels and in the subintimal area in the synovium. Fibrocyte levels did not decline during the trial despite effective RA treatment. In the ERA group, increased synovitis assessed by ultrasound was moderate and strongly correlated with an increase in circulating and synovial fibrocyte levels, respectively. Increased synovitis assessed by MRI during the trial in the ERA group was moderately correlated with both increased numbers of circulating and cultured fibrocytes. Absolute diffusion capacity level was overall weakly negatively correlated with the level of circulating and synovial fibrocytes. The decline in diffusion capacity during the trial was moderately correlated with increased levels of synovial fibrocytes.ConclusionOur findings suggest that fibrocytes are involved in RA pathogenesis, both in the synovium and the reduction in lung function seen in a part of patients with RA.Trial registration numberNCT02652299.

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.

scholarly journals Lung function in patients with lymphangioleiomyomatosis

2021 ◽  
pp. 21-31
Author(s):  
A. V. Chernyak ◽  
M. A. Makarova ◽  
S. N. Avdeev
Keyword(s):  
Lung Function ◽  
Cox Regression ◽  
Pulmonary Ventilation ◽  
European Respiratory Society ◽  
Lung Diffusion ◽  
Diffusion Capacity ◽  
Risk Of Death ◽  
Medical Institutions ◽  
Moscow City ◽  
The Mean

Aim. To assess the functional parameters of the respiratory system and their impact on the survival of patients with lymphangioleiomyomatosis (LAM).Materials and methods. A study of lung function (spirometry, bodyplethysmography, diffusion test) was carried out in 131 patients with LAM (mean age 41±10 years), who were under observation and treatment in medical institutions in Moscow (Pulmonology Scientific Research Institute, Sechenov University, Moscow City Clinical Hospital named after D.D.Pletnev). The diagnosis of the disease was made based on the diagnostic criteria for LAM, formulated by a group of experts at the initiative of the European Respiratory Society in the guidelines for the diagnosis and treatment of LAM.Results. The mean VC value was 95±25% pred., FEV1 /VC − 56±20%, FEV1 − 64±31% pred., DLCO − 49±24% pred. DLCO, FEV1 /VC, FEV1 and VC were reduced in 87, 76, 70 and 27% of patients, respectively. The obstructive ventilatory defect was detected in the overwhelming majority of cases − in 75%, restrictive ventilatory defect − in 4 patients, mixed defect − in 1 patient. In 28 (21%) patients, there were no pulmonary ventilation disorders. The Cox regression model showed that baseline DLCO and FEV1 are the main factors determining the risk of death.Conclusion. In patients with LAM, the obstructive ventilatory defect predominates, the restrictive ventilatory defect is quite rare. The lung diffusion capacity is reduced in 87% of patients with LAM. Parameters of lung function are closely related to survival.

scholarly journals ERS/ATS technical standard on interpretive strategies for routine lung function tests

2021 ◽  
pp. 2101499
Author(s):  
Sanja Stanojevic ◽  
David A. Kaminsky ◽  
Martin Miller ◽  
Bruce Thompson ◽  
Andrea Aliverti ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
American Thoracic Society ◽  
International Standards ◽  
Healthy Population ◽  
European Respiratory Society ◽  
Technical Standards ◽  
Function Tests ◽  
Published Evidence

BackgroundAppropriate interpretation of pulmonary function tests (PFTs) involves the classification of observed values as within/outside the normal range based on a reference population of healthy individuals, integrating knowledge of physiologic determinants of test results into functional classifications, and integrating patterns with other clinical data to estimate prognosis. In 2005, the American Thoracic Society and the European Respiratory Society jointly adopted technical standards for the interpretation of PFTs. We aimed to update the 2005 recommendations and incorporate evidence from recent literature to establish new standard for PFT interpretation.MethodsThis technical standards document was developed by an international joint task force, appointed by the European Respiratory Society and the American Thoracic Society with multidisciplinary expertise in conducting and interpreting pulmonary function tests, and developing international standards. A comprehensive literature review was conducted, and published evidence was reviewed.ResultsRecommendations for the choice of reference equations and limits of normal of the healthy population to identify individuals with unusually low or high results, respectively are discussed. Interpretation strategies for bronchodilator responsiveness testing, limits of natural changes over time and severity are also updated. Interpretation of measurements made by spirometry, lung volumes and gas transfer are described as they relate to underlying pathophysiology with updated classification protocols of common impairments.ConclusionsPFTs interpretation must be complemented with clinical expertise and consider the inherent biological variability of the test and the uncertainty of the test result to ensure appropriate interpretation of an individual's lung function measurements.

Lung volumes during sustained microgravity on Spacelab SLS-1

1994 ◽  
Vol 77 (4) ◽  
pp. 2005-2014 ◽  
Author(s):  
A. R. Elliott ◽  
G. K. Prisk ◽  
H. J. Guy ◽  
J. B. West
Keyword(s):  
Pulmonary Function ◽  
Total Lung Capacity ◽  
Pulmonary Function Tests ◽  
Residual Volume ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Supine Posture ◽  
Residual Capacity ◽  
Flowmeter System ◽  
Made In

Gravity is known to influence the mechanical behavior of the lung and chest wall. However, the effect of sustained microgravity (mu G) on lung volumes has not been reported. Pulmonary function tests were performed by four subjects before, during, and after 9 days of mu G exposure. Ground measurements were made in standing and supine postures. Tests were performed using a bag-in-box-and-flowmeter system and a respiratory mass spectrometer. Measurements included functional residual capacity (FRC), expiratory reserve volume (ERV), residual volume (RV), inspiratory and expiratory vital capacities (IVC and EVC), and tidal volume (VT). Total lung capacity (TLC) was derived from the measured EVC and RV values. With preflight standing values as a comparison, FRC was significantly reduced by 15% (approximately 500 ml) in mu G and 32% in the supine posture. ERV was reduced by 10–20% in mu G and decreased by 64% in the supine posture. RV was significantly reduced by 18% (310 ml) in mu G but did not significantly change in the supine posture compared with standing. IVC and EVC were slightly reduced during the first 24 h of mu G but returned to 1-G standing values within 72 h of mu G exposure. IVC and EVC in the supine posture were significantly reduced by 12% compared with standing. During mu G, VT decreased by 15% (approximately 90 ml), but supine VT was unchanged compared with preflight standing values. TLC decreased by approximately 8% during mu G and in the supine posture compared with preflight standing. The reductions in FRC, ERV, and RV during mu G are probably due to the cranial shift of the diaphragm, an increase in intrathoracic blood volume, and more uniform alveolar expansion.

Strenuous Exercise Increases Plasmatic and Urinary Leukotriene E4 in Cyclists

2003 ◽  
Vol 28 (6) ◽  
pp. 793-806 ◽  
Author(s):  
Corinne Caillaud ◽  
Cyrille Le Creff ◽  
Patrick Legros ◽  
André Denjean
Keyword(s):  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Blood Gases ◽  
Strenuous Exercise ◽  
Diffusion Capacity ◽  
Before And After ◽  
Significant Impairment ◽  
The Mean ◽  
Pulmonary Diffusion Capacity ◽  
Partial Oxygen

The purpose of this study was to investigate plasma and urinary levels of leukotriene (LT) and the changes in pulmonary function induced by strenuous exercise in highly trained cyclists (HT) with mild exercised-induced hypoxemia (EIH). Method: Nine HT and five untrained subjects (UT) performed a 30-min exercise at 78% of their [Formula: see text] Leukotriene E4 (LTE4) was assayed in plasma and urine. Pulmonary function tests and pulmonary diffusion capacity (DLCO) were examined before and after exercising. Ear arterialized blood gases were assessed at rest and during exercise. Results: The mean drop in partial oxygen pressure was 15 mmHg in HT during exercise; and the DLCO decreased by 7.5% following exercise. No significant changes were found in forced vital capacity or forced expiratory flows. LTE4 levels increased significantly in HT following exercise: urinary LTE4 was 42.9 ± 6.3 ng•mmol−1 creatinine at rest and 66.3 ± 11.9 ng•mmol−1 creatinine 2 hrs after exercise, and plasma LTE4 rose from 528 ± 91 pg•mL−1 at rest to 897 ± 123 pg•mL−1 after exercise. By contrast, urinary LTE4 level was unchanged in the UT group. Among the HT group, there was no significant correlation between urinary LTE4 changes and PO2, air flow rates, or DLCO changes. Conclusion: These results suggest that strenuous exercise induces an increase of LTE4 release in highly trained cyclists with mild EIH. These changes in LTE4 levels were not related to significant impairment of lung function. Key words: athletes, hypoxemia, pulmonary function, leukotrienes

ISOLATED ABNORMALITIES OF DIFFUSION CAPACITY (DLCO) IN PULMONARY FUNCTION TESTS AMONG INNER CITY PATIENTS

CHEST Journal ◽  
2008 ◽  
Vol 134 (4) ◽  
pp. 49S
Author(s):  
Ibrahim H. Abou Daya ◽  
Muhammad U. Anwer ◽  
Gilda Diaz-Fuentes ◽  
Steve Blum ◽  
Latha Menon
Keyword(s):  
Pulmonary Function ◽  
Inner City ◽  
Pulmonary Function Tests ◽  
Diffusion Capacity ◽  
Function Tests

scholarly journals Pulmonary involvement in Fabry disease: effect of plasma globotriaosylsphingosine and time to initiation of enzyme replacement therapy

2018 ◽  
Vol 5 (1) ◽  
pp. e000277 ◽  
Author(s):  
Daniel Franzen ◽  
Sarah R Haile ◽  
David C Kasper ◽  
Thomas P Mechtler ◽  
Andreas J Flammer ◽  
...  
Keyword(s):  
Lung Function ◽  
Enzyme Replacement Therapy ◽  
Pulmonary Function ◽  
Fabry Disease ◽  
Replacement Therapy ◽  
Pulmonary Function Tests ◽  
Airflow Limitation ◽  
Z Score ◽  
Lung Function Decline ◽  
Enzyme Replacement

IntroductionAnderson-Fabry disease (AFD) is an X-linked lysosomal storage disorder caused by mutations of GLA gene leading to reduced α-galactosidase activity and resulting in a progressive accumulation of globotriaosylceramide (Gb3) and its deacylated derivative, globotriaosyl-sphingosine (Lyso-Gb3). Plasma Lyso-Gb3 levels serve as a disease severity and treatment monitoring marker during enzyme replacement therapy (ERT).MethodsAdult patients with AFD who had yearly pulmonary function tests between 1999 and 2015 were eligible for this observational study. Primary outcome measures were the change in z-score of forced expiratory volume in the first second (FEV1) and FEV1/FVC over time. Plasma Lyso-Gb3 levels and the age of ERT initiation were investigated for their association with lung function decline.ResultsFifty-three patients (42% male, median (range) age at diagnosis of AFD 34 (6–61) years in men, 34 (13–67) in women) were included. The greatest decrease of FEV1/FVC z-scores was observed in Classic men (−0.048 per year, 95% CI −0.081 to –0.014), compared with the Later-Onset men (+0.013,95% CI −0.055 to 0.082), Classic women (−0.008, 95% CI −0.035 to +0.020) and Later-Onset women (−0.013, 95% CI −0.084 to +0.058). Cigarette smoking (P=0.022) and late ERT initiation (P=0.041) were independently associated with faster FEV1 decline. FEV1/FVC z-score decrease was significantly reduced after initiation of ERT initiation (−0.045 compared with −0.015, P=0.014). Furthermore, there was a trend towards a relevant influence of Lyso-Gb3 (P=0.098) on airflow limitation with age.ConclusionEarly ERT initiation seems to preserve pulmonary function. Plasma Lyso-Gb3 is maybe a useful predictor for airflow limitation. Classic men need a closer monitoring of the lung function.

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