scholarly journals Einfluss der Körperposition auf die Lungenfunktion: eine systematische Übersichtsarbeit

2019 ◽  
Vol 7 (3) ◽  
pp. 125-139
Author(s):  
Shikma Katz ◽  
Nissim Arish ◽  
Ariel Rokach ◽  
Yacov Zaltzmann ◽  
Esther-Lee Marcus
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Body Position ◽  
Pulmonary Function Testing ◽  
Lung Mechanics ◽  
Systematische Übersichtsarbeit ◽  
Position Change ◽  
Gesunde Probanden ◽  
Funktionelle Residualkapazität ◽  
Function Testing

Hintergrund: Die Lungenfunktionsprüfung (LFP) wird wegen der Anordnung der Messgeräte und des Patientenkomforts routinemäßig in aufrechter Position durchgeführt. In der vorliegenden systematischen Übersichtsarbeit wurde der Einfluss der Körperposition auf die Lungenfunktion bei gesunden Probanden und speziellen Patientengruppen untersucht. Methoden: Zur Identifizierung englischsprachiger Publikationen, die zwischen Januar 1998 und Dezember 2017 veröffentlicht wurden, erfolgte eine Suche in MEDLINE und Google Scholar anhand der Suchbegriffe body position, lung function, lung mechanics, lung volume, position change, positioning, posture, pulmonary function testing, sitting, standing, supine, ventilation, and ventilatory change. Bei den eingeschlossenen Studien handelte es sich um quasi-experimentelle Prä-post-Interventionen, in denen mindestens 2 Positionen, einschließlich Sitzen oder Stehen, untersucht wurden und die die Lungenfunktion bei nicht mechanisch beatmeten Probanden ≥ 18 Jahre bewerteten. Primäre Zielkriterien waren das forcierte exspiratorische Volumen in 1 Sekunde (FEV1), die forcierte Vitalkapazität (FVC, FEV1/FVC), die Vitalkapazität (VC), die funktionelle Residualkapazität (FRC), der maximale exspiratorische Druck (PEmax), der maximale inspiratorische Druck (PImax), der exspiratorische Spitzenfluss (PEF), die totale Lungenkapazität (TLC), das Residualvolumen (RV) und die Kohlenmonoxid-Diffusionskapazität der Lunge (DLCO). Folgende Positionen wurden untersucht: stehend, sitzend, Rückenlage sowie Rechts- und Linksseitenlage. Ergebnisse: 43 Studien erfüllten die Einschlusskriterien. Die Studienpopulationen umfassten gesunde Probanden (29 Studien), Patienten mit Lungenerkrankungen (9), Herzkrankheiten (4), Rückenmarksverletzungen (SCI) (7), neuromuskulären Erkrankungen (3) und Adipositas (4). In den meisten Studien mit gesunden Probanden oder Patienten mit Lungen-, Herz- oder neuromuskulären Erkrankungen oder Adipositas fielen die Werte für FEV1, FVC, FRC, PEmax, PImax und/oder PEF in den aufrechteren Positionen höher aus. Bei Patienten mit SCI-bedingter Tetraplegie waren die Werte für FVC und FEV1 in Rückenlage höher als im Sitzen. Gesunde Probanden wiesen in Rückenlage eine höhere DLCO auf als im Sitzen und im Sitzen höhere Werte als in Seitenlage. Bei Patienten mit chronischer Herzinsuffizienz fiel der Einfluss der Körperposition auf die DLCO unterschiedlich aus. Schlussfolgerungen: Die Körperposition hat Einfluss auf die Ergebnisse der LFP, doch bestehen Unterschiede hinsichtlich optimaler Position und Ausmaß des Benefits zwischen den Studienpopulationen. Die LFP erfolgt routinemäßig in sitzender Position. Wir empfehlen, bei Patienten mit Rückenmarksverletzung und neuromuskulären Erkrankungen neben der sitzenden Position auch die Rückenlage für die LFP in Betracht zu ziehen. Bei der Behandlung von Patienten mit Herz- oder Lungenerkrankungen, SCI, neuromuskulären Erkrankungen oder Adipositas ist zu berücksichtigen, dass die Physiologie und Funktion der Lunge von der Körperposition beeinflusst werden.

scholarly journals Normalization of Lung Function following Treatment of Secondary Usual Interstitial Pneumonia: A Case Report

2015 ◽  
Vol 9 ◽  
pp. CCRPM.S22878
Author(s):  
Laurie A. Hohberger ◽  
Felicia Montero-Arias ◽  
Anja C. Roden ◽  
Robert Vassallo
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Immunosuppressive Therapy ◽  
Interstitial Pneumonia ◽  
Usual Interstitial Pneumonia ◽  
Forced Expiratory Volume ◽  
Pulmonary Function Testing ◽  
Antibody Testing ◽  
One Year ◽  
Function Testing

Usual interstitial pneumonia (UIP) is the most common idiopathic interstitial pneumonia (IIP) and is associated with a poor prognosis and poor responsiveness to immunosuppressive therapy. We present a case of a woman with steroid-responsive biopsy-proven UIP with significant and sustained improvement in pulmonary function. A female in her 40s presented following a one-year history of progressive dyspnea, a 20 lb weight loss, and fatigue. Imaging of the chest with computed tomography (CT) showed bibasilar subpleural reticular opacities and minimal peripheral honeycombing. Comprehensive connective tissue disease (CTD) antibody testing was negative. Pulmonary function testing showed moderate impairment with reduction in forced vital capacity (FVC, 69% predicted), forced expiratory volume in one second (FEV1 73% predicted), and diffusing capacity for carbon monoxide (DLCO, 52% predicted). Surgical lung biopsy showed UIP with prominent inflammatory infiltrates. Following treatment with prednisone and azathioprine, the patient's symptoms resolved, while objective pulmonary function testing showed normalization of lung function, which is sustained at >4 years of follow-up. Improvement in lung function following immunosuppressive therapy is distinctly uncommon in either idiopathic or secondary UIP. This report suggests that occasionally, patients with secondary UIP occurring in the context of otherwise undefinable autoimmune clinical syndromes may be responsive to immunosuppressive therapy.

scholarly journals Regional correlation of emphysematous changes in lung function and structure: a comparison between pulmonary function testing and hyperpolarized MRI metrics

2011 ◽  
Vol 110 (1) ◽  
pp. 225-235 ◽  
Author(s):  
Kiarash Emami ◽  
Elaine Chia ◽  
Stephen Kadlecek ◽  
John P. MacDuffie-Woodburn ◽  
Jianliang Zhu ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Dynamic Compliance ◽  
Threshold Value ◽  
Systematic Difference ◽  
Forced Expiratory Volume ◽  
Pulmonary Function Testing ◽  
Regional Correlation ◽  
Rat Elastase ◽  
Function Testing

Regional and global relationships of lung function and structure were studied using hyperpolarized 3He MRI in a rat elastase-induced model of emphysema ( n = 4) and healthy controls ( n = 5). Fractional ventilation ( r) and apparent diffusion coefficient (ADC) of 3He were measured at a submillimeter planar resolution in ventral, middle, and dorsal slices 6 mo after model induction. Pulmonary function testing (PFT) was performed before MRI to yield forced expiratory volume in 50 ms (FEV50), airway resistance (RI), and dynamic compliance (Cdyn). Cutoff threshold values of ventilation and diffusion, r* and ADC*, were computed corresponding to 80% population of pixels falling above or below each threshold value, respectively. For correlation analysis, r* was compared with FEV50/functional residual capacity (FRC), RI and Cdyn, whereas ADC* was compared with FEV50/FRC, total lung capacity (TLC), and Cdyn. Regional correlation of r and ADC was evaluated by dividing each of the three lung slices into four quadrants. Cdyn was significantly larger in elastase rats (0.92 ± 0.16 vs. 0.61 ± 0.12 ml/cmH2O). The difference of RI and FEV50 was insignificant between the two groups. The r* of healthy rats was significantly larger than the elastase group (0.42 ± 0.03 vs. 0.28 ± 0.06), whereas ADC* was significantly smaller in healthy animals (0.27 ± 0.04 vs. 0.36 ± 0.01 cm2/s). No systematic difference in these quantities was observed between the three lung slices. A significant 33% increase in ADC* and a significant 31% decline in r* for elastase rats was observed compared with a significant 51% increase in Cdyn and a nonsignificant 26% decline in FEV50/FRC. Correlation of imaging and PFT metrics revealed that r and ADC divide the rats into two separate clusters in the sample space.

Current recommendations for pulmonary function testing during the COVID-19 pandemic

2020 ◽  
Vol 1 (14) ◽  
pp. 5-8
Author(s):  
M. Yu. Kameneva ◽  
O. I. Savushkina ◽  
A. V. Cherniak
Keyword(s):  
Lung Function ◽  
Infection Control ◽  
Pulmonary Function ◽  
Medical Staff ◽  
Pulmonary Function Testing ◽  
Cross Infection ◽  
Control Measures ◽  
Professional Communities ◽  
Infection Control Measures ◽  
Function Testing

The article summarizes the experience of leading professional communities in organizing the work of lung function laboratories during the COVID-19 pandemic. Recommendations on the choice of methods, indications for pulmonary function testing and infection control measures aimed at minimizing the risk of cross-infection of medical staff and patients are presented.

scholarly journals Lung mechanics and pulmonary function testing in cetaceans

2015 ◽  
Vol 218 (13) ◽  
pp. 2030-2038 ◽  
Author(s):  
A. Fahlman ◽  
S. H. Loring ◽  
G. Levine ◽  
J. Rocho-Levine ◽  
T. Austin ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Pulmonary Function Testing ◽  
Lung Mechanics ◽  
Function Testing

Improved Lung Function after Sinus Surgery in Cystic Fibrosis Patients with Moderate Obstruction

2017 ◽  
Vol 158 (2) ◽  
pp. 381-385 ◽  
Author(s):  
Sabrina Khalfoun ◽  
Dmitry Tumin ◽  
Maroun Ghossein ◽  
Meredith Lind ◽  
Don Hayes ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Pulmonary Function ◽  
Lung Disease ◽  
Pulmonary Function Testing ◽  
Sinus Surgery ◽  
Before And After ◽  
Function Testing ◽  
Severe Lung Disease ◽  
Severe Lung

Objectives Cystic fibrosis (CF) is characterized by infection and inflammation of the sinorespiratory tract. Functional endoscopic sinus surgery (FESS) is an option for patients with severe sinusitis. We sought to evaluate pulmonary function testing after FESS in pediatric and adult patients with CF. Study Design Retrospective chart review using data from all patients with CF who underwent FESS from January 2009 to July 2014. Setting Patients were from a single institution. Subjects and Methods Data were extracted for 181 patients and 320 surgeries. Lung function data, including the forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC, were retrieved within 1 year before and after surgery. Mixed-effects regression was used to compare FEV1 trajectories before and after surgery. The effect of surgery was stratified by presurgery FEV1 to compare patients with mild/no lung disease (FEV1 >80%) and moderate/severe lung disease (FEV1 <80%). Results Of the 181 patients reviewed, 131 with primary FESS had FEV1 data. Presurgery average age was 16 years (95% confidence interval [CI], 14.27-17.73), and FEV1 mean was 85% (95% CI, 81.02-88.98). There were 88 patients with FEV1 >80% and 43 patients with FEV1 <80%. For the entire cohort, lung function did not change related to FESS. Among patients with FEV1 <80%, FEV1 declined presurgery by 3.5% per year (95% CI, −6.1% to −0.8%; P = .010), which halted after surgery with these patients, then showing no subsequent change in FEV1 (95% CI, 0.9%-3.7%; P = .240). No benefit was identified for patients with FEV1 >80%. Conclusion Pulmonary function testing improved in patients with moderate/severe lung disease 1 year following FESS. This suggests FESS may benefit pulmonary outcomes.

Reasons for Referral for Pulmonary Function Testing: An Audit of Four Adult Lung Function Laboratories

2012 ◽  
Author(s):  
Jeffrey J Pretto ◽  
Danny J Brazzale ◽  
Paul A Guy ◽  
Russell J Goudge ◽  
Michael J Hensley
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Pulmonary Function Testing ◽  
Adult Lung ◽  
Function Testing

scholarly journals Desaturation during Six-Minute Walk Testing Predicts Major Morbidity Following Anatomic Lung Resection among Patients with COPD

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 16
Author(s):  
Christopher Towe ◽  
Katherine Wu ◽  
Alina Khil ◽  
Yaron Perry ◽  
Stephanie Worrell ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Lung Resection ◽  
Multivariable Analysis ◽  
Pulmonary Function Testing ◽  
Oxygen Desaturation ◽  
Chronic Obstructive ◽  
Major Morbidity ◽  
Function Testing ◽  
Minute Walk

Background: Pulmonary function testing (PFT) is commonly used to risk-stratify patients prior to lung resection. Guidelines recommend that patients with reduced lung function, due to chronic lung conditions such as Chronic Obstructive Pulmonary Disease (COPD), should receive additional physiologic testing to determine fitness for resection. We reviewed our experience with six-minute walk testing (SMWT) to determine the association of test results and post-operative complications. Methods: Consecutive adult patients undergoing segmentectomy, lobectomy, bilobectomy or pneumonectomy between 1 January, 2007 and 1 January, 2017 were identified in a prospectively maintained database. Patients with poor lung function, as defined by percent predicted forced expiratory volume in 1 s (FEV1) or diffusion capacity of carbon monoxide (DLCO) ≤60%, had results of SMWT extracted from their chart. Association of test result to post-operative events was performed. Results: 581 patients had anatomic lung resections with predicted post-operative FEV1 or DLCO values ≤60%, consistent with a diagnosis of COPD. Among them, 50 (8.6%) had preoperative SMWT performed. Patients who received SMWT were more likely to have a FEV1 or DLCO less than 40 percent predicted (24/50 (48.0%) vs 166/531 (31.3%), p = 0.016). Post-operatively, patients who had SMWT performed had higher rates of pneumonia, but similar rates of major morbidity. The post-exercise oxygen saturation and the amount of desaturation correlated with the occurrence of major morbidity. In multivariable regression, oxygen desaturation was an independent risk factor for the occurrence of major morbidity, and desaturation was an excellent predictor of major morbidity by receiver operating characteristic curves analsysis. Conclusions: Among patients with elevated risk, oxygen desaturation during SMWT was independently associated with the occurence of major morbidity in multivariable analysis, while pulmonary function testing was not. SMWT is an important tool for risk-stratification, and may be underutilized.

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