scholarly journals The Value of Spirometry in Subglottic Stenosis

2019 ◽  
Vol 98 (2) ◽  
pp. 98-101 ◽  
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.

scholarly journals EVALUATION OF ADENOIDS BY ORONASAL AND NASAL SPIROMETRY

2018 ◽  
Vol 11 (10) ◽  
pp. 272 ◽  
Author(s):  
Gayatri Devi R ◽  
Sethu G
Keyword(s):  
Flow Rate ◽  
Upper Airway ◽  
Cost Effective ◽  
Forced Expiratory Volume ◽  
Adenoid Hypertrophy ◽  
Before And After ◽  
Forced Expiratory Flow ◽  
Expiratory Flow ◽  
Age Range ◽  
Peak Inspiratory Flow Rate

Objectives: The main aim of this study is to compare the oronasal and nasal spirometry among adenoid hypertrophy children before and after surgery.Methods: A total of 40 healthy and 40 adenoid hypertrophy children were recruited for this study with the age range from 6 to 15 years. All the children were examined by two measurements (1) oronasal spirometry and (2) nasal spirometry. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV 1), FEV 1/FVC%, forced expiratory time (FET), peak expiratory flow rate, peak inspiratory flow rate (PIFR), and forced expiratory flow (FEF)25-75, FEF25%, FEF50%, FEF75%, FIF25%, FIF50%, and FIF75% were recorded.Results: All the parameters were significantly reduced in adenoid hypertrophy by nasal spirometry when compared to oronasal spirometry. FEV1/ FVC% was insignificant from oral to nasal values among adenoid hypertrophy in both the sexes. FET can act as an indicator for upper airway obstruction which shown significantly in adenoid hypertrophy but insignificant among control and adenoidectomy. Inspiratory parameters also had shown more variation in nasal than oronasal spirometry.Conclusion: Significant differences were found in many parameters between oronasal and nasal spirometry among adenoids and adenoidectomy. Nasal spirometry is a portable one, simple, and less cost-effective and so it can be used to determine the obstruction in the nose nasopharynx region.

scholarly journals Upper airway obstruction in patients with endothoracic goiter enlargement: no relationship between flow-volume loops and radiological tests

2010 ◽  
Vol 163 (4) ◽  
pp. 665-669 ◽  
Author(s):  
M Albareda ◽  
J Viguera ◽  
C Santiveri ◽  
P Lozano ◽  
A Mestrón ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Vital Capacity ◽  
Visual Analysis ◽  
Upper Airway ◽  
Forced Expiratory Volume ◽  
Upper Airway Obstruction ◽  
Flow Volume ◽  
Flow Parameters ◽  
Forced Expiratory Flow ◽  
Expiratory Flow

BackgroundIn about 16–85% of subjects with goiter, upper airway obstruction (UAO) is observed. This percentage is higher in patients affected by goiter with endothoracic enlargement. UAO is an indication for surgery. Visual analysis of flow-volume loops (FVL) are the best indicators for UAO, although various studies using clinical and radiological parameters have observed no correlation.ObjectiveTo evaluate the presence of UAO in patients with endothoracic goiter enlargement and the relationship between the FVL with the observed symptoms and the measurements obtained by computed tomography (CT).SubjectsSubjects with endothoracic goiter enlargement participated in the study.Designi) Symptom questionnaire (dysphagia, dyspnea, cough, oppression, dysphonia, and worsened symptoms when prone); ii) analysis: TSH and free thyroxine; iii) cervical ultrasound; iv) cervical-thoracic CT (measurements of area and diameter in the area of maximum stenosis and at 2 cm from the carina); v) chest radiography and vi) forced spirometry: visual analysis of FVL morphology and the maximum forced expiratory volume in 1 s (FEV1), forced expiratory flow at 50% vital capacity/forced inspiratory flow at 50% vital capacity and FEV1/peak expiratory flow parameters.ResultsFifty subjects participated in the study: 11 men/39 women, median age 73.8 years (43.76–88.43). UAO was diagnosed in 13 cases (26%, confidence interval: 14.6–40.3%) and 27 subjects (54%) presented symptoms suggesting goiter compression. No clinical or radiological variables showed the presence of UAO.ConclusionsThe frequency of UAO in subjects affected by goiter with endothoracic enlargement was lower than that described for goiter patients, and there were no clinical or radiological indicators to establish its presence.

scholarly journals Factors affecting spirometry reference range in growing children

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.

Relationship of ventilatory capacity to hyperbaric exposure in divers

1984 ◽  
Vol 56 (6) ◽  
pp. 1655-1658 ◽  
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.

Upper Airway Disorders

PEDIATRICS ◽  
1992 ◽  
Vol 90 (2) ◽  
pp. 293-295
Keyword(s):  
Work Of Breathing ◽  
Upper Airway ◽  
Forced Expiratory Volume ◽  
Endoscopic Examination ◽  
Minute Volume ◽  
Positive End Expiratory Pressure ◽  
Photographic Images ◽  
Asthmatic Patients ◽  
Study Population ◽  
Exercise Induced

PATHOPHYSIOLOGY LARYNGEAL CHANGES DURING EXERCISE AND EXERCISE-INDUCED ASTHMA Hurbis CG, Schild JA. Ann Otol Rhinol Laryngol. 1992;100:34-37. Purpose of the Study This study was performed to determine the effect of exercise on the larynx in healthy and asthmatic patients. Study Population Thirty subjects aged 18 to 35 years were studied. There were 15 healthy subjects and 15 with only exercise-induced asthma. Methods All subjects had an endoscopic examination of their laryngeal area where photographic images were recorded for measurement of inspiratory and expiratory glottic areas. All were then exercised at 75% to 85% of their predicted maximum heart rate for 8 minutes, breathing cold dry air. Laryngoscopy and pulmonary functions were performed after 8 minutes of exercise and again after 5 minutes of rest. Findings In healthy individuals and in asthmatic patients whose forced expiratory volume changed less than 5%, the laryngeal opening increased in size, whereas asthmatics whose forced expiratory volume dropped in excess of 5% showed a narrowing of the glottic area. Conclusions The normal enlargement of the glottic space allows for less resistance, making the increase of minute volume that is demanded by exercise less energy-intense. The moderate asthmatic, on the other hand, has a decrease in size to further increase the work of breathing. The benefits of such an increase may be an endogenous method to apply positive end-expiratory pressure, thus keeping airways open. Comments As I read this I couldn't help think of the asthmatic who is so hard to manage with laryngeal spasm. Perhaps these people have an exaggerated and prolonged physiologic response.

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

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.

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

PEDIATRICS ◽  
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.

Effects of aerosol methacholine and histamine on airways and lung parenchyma in healthy humans

1993 ◽  
Vol 74 (6) ◽  
pp. 2681-2686 ◽  
Author(s):  
R. Pellegrino ◽  
B. Violante ◽  
E. Crimi ◽  
V. Brusasco
Keyword(s):  
Vital Capacity ◽  
Transpulmonary Pressure ◽  
Lung Parenchyma ◽  
Forced Expiratory Volume ◽  
Flow Volume ◽  
Tissue Properties ◽  
Bronchodilator Effect ◽  
Healthy Humans ◽  
Forced Expiratory Flow ◽  
Expiratory Flow

To investigate whether histamine (His) and methacholine (MCh) have different effects on airways and lung parenchyma, 11 healthy subjects were given aerosol MCh until a response plateau was obtained and then two doses of His. At the plateau, forced expiratory volume in 1 s and forced expiratory flow at 40% of vital capacity from partial flow-volume curves were reduced by 19 +/- 3 (SE) and 80 +/- 4%, respectively. Aerosol His decreased forced expiratory volume in 1 s by an additional 12 +/- 1% but left partial forced expiratory flow unchanged. The bronchodilator effect of deep inhalation, as inferred from the ratio of forced expiratory flow from maximal to that from partial flow-volume curves, increased after MCh and plateaued but decreased after His. Quasi-static transpulmonary pressure-volume area determined in seven subjects was unchanged after MCh but was increased by 57 +/- 10% after His. We conclude that adding His after the response to MCh plateaued does not increase the maximal degree of bronchoconstriction but may increase parenchymal hysteresis, thus blunting the bronchodilator effect of deep inhalation. These results suggest that His and MCh have similar effects on airway smooth muscle but different effects on lung tissue properties.

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

2004 ◽  
Vol 96 (5) ◽  
pp. 1651-1657 ◽  
Author(s):  
S. K. Kjærgaard ◽  
O. F. Pedersen ◽  
M. R. Miller ◽  
T. R. Rasmussen ◽  
J. C. Hansen ◽  
...  
Keyword(s):  
Fish Oil ◽  
Normal Subjects ◽  
Lavage Fluid ◽  
Forced Expiratory Volume ◽  
Ozone Exposure ◽  
Double Blind ◽  
Forced Expiratory Flow ◽  
Clean Air ◽  
Nasal Lavage Fluid ◽  
Expiratory Flow

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.

scholarly journals Forced Expiratory Flow (FEF25–75%) as a Clinical Endpoint in Children and Adolescents with Symptomatic Asthma Receiving Tiotropium: A Post Hoc Analysis

2020 ◽  
Vol 6 (2) ◽  
pp. 151-158
Author(s):  
Stanley J. Szefler ◽  
Stanley Goldstein ◽  
Christian Vogelberg ◽  
George W. Bensch ◽  
John Given ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Correlation Coefficients ◽  
Forced Expiratory Volume ◽  
Phase Iii ◽  
Post Hoc Analysis ◽  
Children With Asthma ◽  
Peripheral Airway ◽  
Forced Expiratory Flow ◽  
Expiratory Flow ◽  
Post Hoc

Abstract Introduction In pediatric patients with asthma, measurements of forced expiratory volume in 1 s (FEV1) may be normal or may not correlate with symptom severity. Forced expiratory flow at 25–75% of the vital capacity (FEF25–75%) is a potentially more sensitive parameter for assessing peripheral airway function. This post hoc analysis compared FEF25–75% with FEV1 as an endpoint to assess bronchodilator responsiveness in children with asthma. Methods Change from baseline in trough FEF25–75% and trough FEV1 following treatment with either tiotropium (5 µg or 2.5 µg) or placebo Respimat® was analyzed in four phase III trials in children (aged 6–11 years) and adolescents (aged 12–17 years) with symptomatic moderate (VivaTinA-asthma® and PensieTinA-asthma®) and mild (CanoTinA-asthma® and RubaTinA-asthma®) asthma. Data from all treatment arms were pooled and correlations between FEF25–75% and FEV1 were calculated and analyzed. Results A total of 1590 patients were included in the analysis. Tiotropium Respimat® consistently improved FEF25–75% and FEV1 versus placebo, although in adolescents with severe asthma, the observed improvements were not statistically significant. Improvements in FEF25–75% response with tiotropium versus placebo were largely more pronounced than improvements in FEV1. Statistical assessment of the correlation of FEV1 and FEF25–75% showed moderate-to-high correlations (Pearson’s correlation coefficients 0.73–0.80). Conclusions In pediatric patients, FEF25–75% may be a more sensitive measure to detect treatment response, certainly to tiotropium, than FEV1 and should be evaluated as an additional lung function measurement.

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