scholarly journals Variation in pulmonary function tests among children with sickle cell anemia: a systematic review and meta-analysis

2021 ◽  
Vol 39 ◽  
Author(s):  
Amar Taksande ◽  
Patel Zeeshan Jameel ◽  
Divya Pujari ◽  
Bharati Taksande ◽  
Revat Meshram
Keyword(s):  
Systematic Review ◽  
Pulmonary Function ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Meta Analysis ◽  
Pulmonary Function Tests ◽  
Function Tests

scholarly journals Overtesting and undertesting in primary care: a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018557 ◽  
Author(s):  
Jack W O’Sullivan ◽  
Ali Albasri ◽  
Brian D Nicholson ◽  
Rafael Perera ◽  
Jeffrey K Aronson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Pulmonary Function ◽  
Diagnostic Test ◽  
Diagnostic Tests ◽  
Meta Analysis ◽  
Pulmonary Function Tests ◽  
Upper Endoscopy ◽  
Eligibility Criteria ◽  
Function Tests

BackgroundHealth systems are currently subject to unprecedented financial strains. Inappropriate test use wastes finite health resources (overuse) and delays diagnoses and treatment (underuse). As most patient care is provided in primary care, it represents an ideal setting to mitigate waste.ObjectiveTo identify overuse and underuse of diagnostic tests in primary care.DesignSystematic review and meta-analysis.Data sources and eligibility criteriaWe searched MEDLINE and Embase from January 1999 to October 2017 for studies that measured the inappropriateness of any diagnostic test (measured against a national or international guideline) ordered for adult patients in primary care.ResultsWe included 357 171 patients from 63 studies in 15 countries. We extracted 103 measures of inappropriateness (41 underuse and 62 overuse) from included studies for 47 different diagnostic tests.The overall rate of inappropriate diagnostic test ordering varied substantially (0.2%–100%)%).17 tests were underused >50% of the time. Of these, echocardiography (n=4 measures) was consistently underused (between 54% and 89%, n=4). There was large variation in the rate of inappropriate underuse of pulmonary function tests (38%–78%, n=8).Eleven tests were inappropriately overused >50% of the time. Echocardiography was consistently overused (77%–92%), whereas inappropriate overuse of urinary cultures, upper endoscopy and colonoscopy varied widely, from 36% to 77% (n=3), 10%–54% (n=10) and 8%–52% (n=2), respectively.ConclusionsThere is marked variation in the appropriate use of diagnostic tests in primary care. Specifically, the use of echocardiography (both underuse and overuse) is consistently poor. There is substantial variation in the rate of inappropriate underuse of pulmonary function tests and the overuse of upper endoscopy, urinary cultures and colonoscopy.PROSPERO registration numberCRD42016048832.

scholarly journals Importance of Pre Operative Pulmonary Function Test to Predict Risk of Pulmonary Complications after Abdominal Surgery- An Evidence Based Study

2021 ◽  
Vol 6 (3) ◽  
pp. 236-243
Author(s):  
Krupa Pareshbhai Patel ◽  
Anjali Bhise
Keyword(s):  
Abdominal Surgery ◽  
Pulmonary Function ◽  
Pulmonary Function Test ◽  
Meta Analysis ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Evidence Based ◽  
Function Tests ◽  
Function Test

Background: Spirometry is a universal, simple, and non-invasive pulmonary function test. Spirometry, along with calculation of the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), is helpful for diagnosing obstructive or restrictive lung disease. Postoperative Pulmonary Complications are defined as unintended pulmonary abnormalities that occur as a result of surgery which cause identifiable dysfunction. Purpose: To find the evidence showing the importance of pre-operative PFT to predict risk of pulmonary complications after abdominal surgery Methodology: The study was conducted according to Preferred Reporting Items for systematic reviews and meta-analysis guidelines. Evidences selected since year 2002- 2020 from PubMed, Google Scholar, Physiotherapy Evidence Database (PEDro), ResearchGate and ScienceDirect. Key words used were: Pulmonary Function Tests, Post-Operative Pulmonary Complications, and Abdominal Surgery. Analysis was done using 2 scales: Centre for Evidence-Based Medicine Levels of Evidence Scale. Total 12 articles were found. Among them 10 were selected. Results: 5 articles showed that preoperative PFT is important in prediction of PPCs while the other half concluded that routine preoperative spirometry is not necessary before non-thoracic surgeries. Conclusion: Based on evidences, in the nutshell it is reviewed that there is controversy regarding the value of preoperative pulmonary functions test in non-thoracic surgeries. Keywords: Pulmonary Function Tests, Post-Operative Pulmonary Complications, and Abdominal Surgery

scholarly journals Endoscopic sinus surgery in patients with cystic fibrosis: a systematic review and meta-analysis of pulmonary function

2012 ◽  
Vol 50 (4) ◽  
pp. 360-369
Author(s):  
K.I. Macdonald ◽  
A. Gipsman ◽  
A. Magit ◽  
M. Fandino ◽  
E. Massoud ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cystic Fibrosis ◽  
Pulmonary Function ◽  
Endoscopic Sinus Surgery ◽  
Meta Analysis ◽  
Pulmonary Function Tests ◽  
Sinus Surgery ◽  
Intravenous Antibiotics

Introduction: The role of endoscopic sinus surgery (ESS) in patients with cystic fibrosis (CF) is not clearly defined. Objective: TO perform a systematic review of subjective and objective outcomes of ESS in CF. Methods: A systematic review was performed using the keywords 'sinusitis,' 'sinus surgery,' 'nasal polyps' and 'cystic fibrosis.' The quality of papers was assessed using the NICE scoring scale. Outcomes included safety, subjective symptoms, objective endoscopy scores, days spent in hospital, courses of antibiotics, and pulmonary function tests (PFTs). Results: Nineteen studies involving 586 patients were included in the review. There were four prospective cohort trials, and three were rated as good quality. There were no major complications attributable to ESS. There was consistent evidence in four cohort studies of improved sinonasal symptoms, including nasal obstruction, facial pain, headaches, rhinorrhea and olfaction. Three studies reported conflicting results in post-operative endoscopy scores. Three studies showed a decrease in days spent in hospital, and two showed a significant decrease in courses of intravenous antibiotics. A recent study, however, did not show a difference in either days spent in hospital or courses of antibiotics. Pulmonary function tests were not improved by ESS in six cohort trials, and one small study found significant improvement. A meta-analysis of FEV1 scores confirmed no significant difference. Conclusion: THE most consistent findings of this review were that ESS in patients with CF is safe, produces symptomatic benefit, and does not consistently improve PFTs. There were more conflicting results with regards to endoscopy scores, days spent in hospital, and courses of intravenous antibiotics. Future prospective studies, utilizing validated quality of life, symptom and endoscopy scales, are needed to further elucidate the role of ESS in the management of chronic rhinosinusitis in CF patients.

Pulmonary Function in Children with Sickle Cell Anemia Following Treatment with Hydroxyurea.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1435-1435 ◽  
Author(s):  
Elizabeth Record ◽  
Tamara New ◽  
Randall Brown ◽  
LeRoy Graham ◽  
R. Clark Brown
Keyword(s):  
Pulmonary Function ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Pulmonary Function Tests ◽  
Pulmonary Complications ◽  
Acute Chest Syndrome ◽  
P Value ◽  
Chronic Injury ◽  
History Of ◽  
Abnormal Pulmonary Function

Abstract Background: Pulmonary function is particularly susceptible to acute and chronic injury occurring in patients with sickle cell anemia (SCA). Acute Chest Syndrome (ACS), a common and potentially fatal complication of SCA, can be the cause or the consequence of abnormal pulmonary function (Siddiqui & Ahmed, 2003). Use of hydroxyurea therapy (HU) is increasing for children with recurrent pulmonary complications, following the findings that HU reduces risk of ACS in adults (Charache et al, 1995). How HU may improve pulmonary function in children with SCA is still ill-defined. The purpose of this study was to assess the change observed on serial pulmonary function tests (PFT) for children prescribed HU for abnormal pulmonary function. Methods: Over 240 children with pulmonary complications, such as acute chest syndrome, reactive airway disease, and chronic hypoxia, have been evaluated in the Sickle Cell Pulmonary Clinic at Children’s Healthcare of Atlanta since beginning in July 2000. As part of the Clinic’s standard of care, PFT were routinely attempted on children over the age of 5. A retrospective review of PFT results was done for the children with SCA and prior abnormal PFT. Children were included in the HU cohort (+HU) if repeat PFTs were available following > 3 months on HU therapy and if time on HU did not include frequent RBC transfusions. Children without history of HU therapy (−HU) were selected for comparison. PFTs were performed on a standard plethysmograph. Paired t-test was used to evaluate observed differences. Results: Thirty-one children with prior abnormal PFT had test before and following prescription of HU. Their mean age was 12.6 (range 6–20) years and mean duration of HU was 21 (range 4–47) months at the time of the repeat PFT. Hematologic changes expected on HU occurred for all 31 children. Twenty-four children followed for abnormal PFT had no history of HU (−HU) and matched the +HU group by gender, age (mean 12.3, range 7–19 years), duration followed at time of repeat PFT (mean 19, range 3–66 months; p=0.36), and initial hematologic parameters. Spirometry findings changed for +HU group, and remained stable for −HU group. Mean FVC and FEV1 values improved significantly on HU, when compared to initial (PreHU) PFT and to −HU controls. Conversion to a normal PFT, as interpreted by a pediatric pulmonologist masked to treatment status, occurred in 18 (58%) and 2 (8%) children in the +HU and −HU groups, respectively. Table 1: Serial PFT and hematologic parameters according to HU exposure −HU (n=24) +HU (n=31) Initial Repeat # PreHU Repeat 1 % predicted value for age, sex and height of subject. 2Mean (SD) #No significant changes compared to Initial, p > 0.05. *P value < 0.001 compared to PreHU; ++P value < 0.001 compared to −HU repeat. PFT parameter 1 TLC 88 (13.6)2 85 (11.7) 85 (13.4) 90 (13.5) FVC 78 (9.8) 79 (9.9) 75 (12.6) 90 (13.2)*,++ FEV1 75 (9.6) 74 (12.2) 72 (11.4) 86 (10.2)*,++ FEF 25-75 75 (22) 72 (28.0) 77 (23.4) 79 (26.8) FEV1/FVC (%) 85(6.7) 82 (9.8) 87 (11.8) 86 (11.1) Pulse oximetry (%) 95 (3.1) 96 (2.4) 94 (4.4) 97 (2.8)* WBC (x103/ul) 14 (3.8) 13 (2.9) 13.02 (2.9) 9.0 (2.1) *,++ Hb (g/dl) 8.0 (0.1) 8.0 (0.9) 7.8 (1.1) 9.1 (1.3) *,++ MCV (fl) 84 (9.2) 85 (10.0) 87.3 (8.1) 101.2 (10.1) *,++ HbF (%) 4.3 (1.5) 5.2 (5.2) 6.0 (3.8) 14.0 (7.3) *,++ Conclusions: Serial PFTs showed improved pulmonary function, following initiation of HU therapy in children with prior abnormal PFT. Routine PFT assessments of children prescribed HU may serve as an objective measure of clinical response in children with SCA and pulmonary complications. These results will help in the design of future prospective studies examining the clinical benefits of HU therapy for children at risk for long-term pulmonary complications.

scholarly journals Pulmonary function tests as outcomes for systemic sclerosis interstitial lung disease

2018 ◽  
Vol 27 (148) ◽  
pp. 170102 ◽  
Author(s):  
Melissa Caron ◽  
Sabrina Hoa ◽  
Marie Hudson ◽  
Kevin Schwartzman ◽  
Russell Steele
Keyword(s):  
Systematic Review ◽  
Systemic Sclerosis ◽  
Interstitial Lung Disease ◽  
Pulmonary Function ◽  
Lung Disease ◽  
Validation Studies ◽  
Pulmonary Function Tests ◽  
Outcome Studies ◽  
Surrogate Markers ◽  
Function Tests

Interstitial lung disease (ILD) is the leading cause of morbidity and mortality in systemic sclerosis (SSc). We performed a systematic review to characterise the use and validation of pulmonary function tests (PFTs) as surrogate markers for systemic sclerosis-associated interstitial lung disease (SSc-ILD) progression.Five electronic databases were searched to identify all relevant studies. Included studies either used at least one PFT measure as a longitudinal outcome for SSc-ILD progression (i.e. outcome studies) and/or reported at least one classical measure of validity for the PFTs in SSc-ILD (i.e. validation studies).This systematic review included 169 outcome studies and 50 validation studies. Diffusing capacity of the lung for carbon monoxide (DLCO) was cumulatively the most commonly used outcome until 2010 when it was surpassed by forced vital capacity (FVC). FVC (% predicted) was the primary endpoint in 70.4% of studies, compared to 11.3% for % predicted DLCO. Only five studies specifically aimed to validate the PFTs: two concluded that DLCO was the best measure of SSc-ILD extent, while the others did not favour any PFT. These studies also showed respectable validity measures for total lung capacity (TLC).Despite the current preference for FVC, available evidence suggests that DLCO and TLC should not yet be discounted as potential surrogate markers for SSc-ILD progression.

Pulmonary Function Tests in Sickle Cell Disease

2016 ◽  
Vol 83 (8) ◽  
pp. 783-786 ◽  
Author(s):  
Raviraj Purohit ◽  
Sanjeev S. Rao ◽  
Jagdish P. Goyal ◽  
Vijay B. Shah ◽  
Jaykaran Charan
Keyword(s):  
Sickle Cell Disease ◽  
Pulmonary Function ◽  
Sickle Cell ◽  
Pulmonary Function Tests ◽  
Cell Disease ◽  
Function Tests

Pulmonary Hypertension in Sickle Cell Disease: Correlation With Echocardiographic Assessment and Serum Brain Natriuretic Peptide Concentration

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4680-4680
Author(s):  
Salam Alkindi ◽  
Zeba Jabeen ◽  
Anil Pathare ◽  
Mohammed Al-Huneini ◽  
Murtadha Al Khabori ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Sickle Cell Disease ◽  
Pulmonary Function ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Sickle Cell ◽  
Pulmonary Function Tests ◽  
Direct Bilirubin ◽  
Cell Disease ◽  
Function Tests

Background & Purpose Pulmonary hypertension (PH) in sickle cell disease (SCD) is an important risk factor for complications including sudden death. In this study, we aimed to determine the prevalence of PH and correlate the echocardiographic parameters and general laboratory data with markers of hemolysis and serum NT pro-brain natriuretic peptide [BNP] concentrations in Omani SCD patients. Methods A cohort of 163 SCD patients [Mean age 25.4±8.4 years], in steady state was prospectively screened for PH with Doppler echocardiography (defined as a tricuspid regurgitation jet flow velocity of ≥ 2.5 m/sec and/or mean pulmonary artery pressure [mPAP] ≥25 mmHg). After a written informed consent, all patients were investigated with a complete blood count, renal chemistry, hemolytic parameters including LDH, haptoglobin, liver function tests, coagulation studies, HPLC studies including HbS and HbF level estimations, X ray Chest, ECG, ABG, Pulmonary function tests, Pulse oximetry, and Serum NT pro-BNP levels. Results In the evaluable patient cohort of 116 subjects [63 females, 53-males], the prevalence of PH was 5.2%. No statistically significant differences were detected in Hb levels, ECG, chest radiography, pulmonary function tests between patients with and without PH. However, plasma NT pro-BNP levels were significantly correlated with PAH [r=0.934, p<0.000], TRV jet [r=.671, p<0.000], Abnormal ECHO [r=0.672, p<0.000], and direct Bilirubin levels [r=0.278,p<0.009] in SCD patients. Furthermore, in SCD patients with PH, there was a statistically significant increase in plasma NT pro-BNP levels [ p<0.001], ALT [p<0.02], S. Creatinine [p=0.045] and Total bilirubin [p<0.0001] and direct Bilirubin levels [p<0.0001][Table]. Conclusions Serum NT pro-BNP is a strong indicator of PH in SCD patients. Doppler ultrasound echocardiography is a useful initial screen for PH in SCD patients. The correlation between PH and hemolytic markers suggests an implication in the pathogenesis of PH. Disclosures: No relevant conflicts of interest to declare.

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