Pulmonary Function Testing Reference Values and Interpretations in Pediatric Training Programs

PEDIATRICS ◽  
1990 ◽  
Vol 85 (5) ◽  
pp. 768-773
Author(s):  
Edward N. Pattishall

A questionnaire was sent to all pediatric training programs to evaluate the use of pulmonary function reference standards and the interpretation of pulmonary function test results. Responses were obtained from 107 of 130 institutions, and 94 of these had pulmonary function laboratories available. Of the 94, 60 used one of three reference standards. The primary reason the reference standards were chosen was either unknown or because they came with the spirometer (24), were recommended by another person or were those used in that person's training (34), or were thought to be the best standards available or most applicable to the population to be tested (31). To define abnormality, most used an 80% predicted cutoff for forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow at 25% to 75% vital capacity. For a change in an individual through time, most used a 10% change for forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow at 25% to 75% vital capacity. Thirteen used statistical methods to define abnormal individuals and none used statistical methods to define a significant change over time. Although there are a few guidelines for reference standards and interpretations of pulmonary function tests, it appears that most laboratories are not using those guidelines and that further guidelines and education are needed.

Author(s):  
Hoshea Jeba Ruth S. ◽  
Lisha Vincent

Background: Air conditioners are used extensively these days of the modern lifestyle. Inhalation of cold dry air while using Air conditioners causes bronchoconstriction due to which alteration may occur in pulmonary function. This study was aimed to compare the Pulmonary Function tests of Car AC users and non AC users. Methods: The Study included 52 employees not exposed to car air conditioner as a control (group I) and 52 employees exposed to car air conditioner  with minimum exposure of 1 hour per day for 6 months as a subject (group II). Pulmonary function tests were performed using computerised spirometer. Statistical analysis was done by unpaired t test.Results: Age, Height and weight are not statistically significant between study group and control group. Forced vital capacity, forced expiratory volume in 1 second, Ratio of Forced vital capacity and Forced expiratory volume in 1 second, Inspiratory reserve volume, Expiratory reserve volume, Maximum voluntary ventilation are decreased in car air conditioner users compared to non-users, but was not significant. Forced expiratory flow (FEF), Peak expiratory flow rate (PEFR) values shows statistically significant decreased in car air conditioner users.Conclusions: The present study shows hyper-responsive airways on exposure to cold air which leads to bronchoconstriction. The significant decrease in PEFR, FEF suggest that upper airways as well as smaller airways are affected on exposure to car AC. So, Exposure to car Air Conditioner leads to risk of developing respiratory dysfunction.


2017 ◽  
Vol 4 (3) ◽  
pp. 729
Author(s):  
Kriti Hegde ◽  
Amit S. Saxena ◽  
Rajesh Kumar Rai

Background:The use of spirometry in the assessment of children with asthma is taking on new importance with the realization that considerable airway obstruction may exist in the absence of clinically detectable abnormalities. Hence this study was planned to evaluate, forced expired volume in 1 second (FEV1), forced vital capacity (FVC), the forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) and Peak Expiratory Flow rates (PEFR) in asthmatic children aged 6-12 years. The objective of the study was to determine prevalence of asthma according to clinical classification and identify common trigger factors and to determine which is more sensitive between FEV1, FVC, FEV1/FVC, FEF 25-75 and PEFR in different age groups.Methods: The present study was conducted among 60 patients of age group 6 to 12 years with asthma. Forced vital capacity (FVC), Forced expiratory volume in 1 second (FEV1), Ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC), PEFR and Forced expiratory flow between 25-75% were recorded. Data was analyzed using chi-square test, Karl Pearson’s correlation coefficient. Level of significance was set at 5%. All p values less than 0.05 were treated as significant.Results:In Age and Sex wise correlation with classification of asthma, a male preponderance was seen in all the age groups i.e. between 6-8 years, 9-10 years and 11-12 years. Mosquito coils were the most common indoor agents to trigger an asthmatic accounting for nearly 80%. Amongst the outdoor triggers, exacerbation of symptoms during the cold weather accounted for 90 % followed by variation during festivals like Diwali, dust, pollution, exercise and insects. Comparison of Pre and Post bronchodilator FEF 25-75 values have shown a high statistical significance.Conclusions:Parents need to be educated regarding certain modifiable factors that can improve the prognosis. Pulmonary Function tests should be performed as a routine office procedure. Peak expiratory flow meter is a handy instrument. In all children above 6 years of age suspected to have asthma, this test should be performed before beginning therapy.


1991 ◽  
Vol 71 (3) ◽  
pp. 878-885 ◽  
Author(s):  
J. M. Clark ◽  
R. M. Jackson ◽  
C. J. Lambertsen ◽  
R. Gelfand ◽  
W. D. Hiller ◽  
...  

As a pulmonary component of Predictive Studies V, designed to determine O2 tolerance of multiple organs and systems in humans at 3.0–1.5 ATA, pulmonary function was evaluated at 1.0 ATA in 13 healthy men before and after O2 exposure at 3.0 ATA for 3.5 h. Measurements included flow-volume loops, spirometry, and airway resistance (Raw) (n = 12); CO diffusing capacity (n = 11); closing volumes (n = 6); and air vs. HeO2 forced vital capacity maneuvers (n = 5). Chest discomfort, cough, and dyspnea were experienced during exposure in mild degree by most subjects. Mean forced expiratory volume in 1 s (FEV1) and forced expiratory flow at 25–75% of vital capacity (FEF25–75) were significantly reduced postexposure by 5.9 and 11.8%, respectively, whereas forced vital capacity was not significantly changed. The average difference in maximum midexpiratory flow rates at 50% vital capacity on air and HeO2 was significantly reduced postexposure by 18%. Raw and CO diffusing capacity were not changed postexposure. The relatively large change in FEF25–75 compared with FEV1, the reduction in density dependence of flow, and the normal Raw postexposure are all consistent with flow limitation in peripheral airways as a major cause of the observed reduction in expiratory flow. Postexposure pulmonary function changes in one subject who convulsed at 3.0 h of exposure are compared with corresponding average changes in 12 subjects who did not convulse.


2019 ◽  
Vol 43 (4) ◽  
pp. 434-439 ◽  
Author(s):  
Gozde Yagci ◽  
Gokhan Demirkiran ◽  
Yavuz Yakut

Background:Despite the common use of braces to prevent curve progression in idiopathic scoliosis, their functional effects on respiratory mechanics have not been widely studied.Objective:The objective was to determine the effects of bracing on pulmonary function in idiopathic scoliosis.Methods:A total of 27 adolescents with a mean age of 14.5 ± 1.5 years and idiopathic scoliosis were included in the study. Pulmonary function evaluation included vital capacity, forced expiratory volume, forced vital capacity, maximum ventilator volume, peak expiratory flow, and respiratory muscle strengths, measured with a spirometer, and patient-reported degree of dyspnea. The tests were performed once prior to bracing and at 1 month after bracing (while the patients wore the brace).Results:Compared with the unbraced condition, vital capacity, forced expiratory volume, forced vital capacity, maximum ventilator volume, and peak expiratory flow values decreased and dyspnea increased in the braced condition. Respiratory muscle strength was under the norm in both unbraced and braced conditions, while no significant difference was found for these parameters between the two conditions.Conclusion:The spinal brace for idiopathic scoliosis tended to reduce pulmonary functions and increase dyspnea symptoms (when wearing a brace) in this study. Special attention should be paid in-brace effects on pulmonary functions in idiopathic scoliosis.Clinical relevanceBracing seems to mimic restrictive pulmonary disease, although there is no actual disease when the brace is removed. This study suggests that bracing may result in a deterioration of pulmonary function when adolescents with idiopathic scoliosis are wearing a brace.


1985 ◽  
Vol 71 (3) ◽  
pp. 167-170
Author(s):  
R. Herrmann ◽  
G. M. Clifford ◽  
D. J. Smith ◽  
Caroline S. M. Searing

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.


PEDIATRICS ◽  
1975 ◽  
Vol 56 (5s) ◽  
pp. 847-850
Author(s):  
C. Warren Bierman ◽  
Isamu Kawabori ◽  
William E. Pierson

The incidence of exercise-induced asthma (EIA) was studied in 134 asthmatic, 102 nonasthmatic atopic, and 56 nonatopic children. Pulmonary function tests measuring forced vital capacity (FVC) and one-second forced expiratory volume (FEV1) were performed on each child prior to and serially for 20 minutes following free running exercise. The incidence of EIA among the asthmatic and atopic nonasthmatic children was 63% and 41% respectively, and 7% among control subjects. Airway function was studied prior to and after a standardized free running exercise test. Forty-one percent of the nonasthmatic and 63% of the asthmatic atopic children had a significant decrease in airway function as compared to 5% of the nonallergic subjects.


Author(s):  
Yuanni Huang ◽  
Mian Bao ◽  
Jiefeng Xiao ◽  
Zhaolong Qiu ◽  
Kusheng Wu

Exposure to fine particulate matter 2.5 (PM2.5) is associated with adverse health effects, varying by its components. The health-related effects of PM2.5 exposure from ore mining may be different from those of environment pollution. The aim of this study was to investigate the effects of different concentrations of PM2.5 exposure on the cardio-pulmonary function of manganese mining workers. A total of 280 dust-exposed workers who were involved in different types of work in an open-pit manganese mine were randomly selected. According to the different concentrations of PM2.5 in the working environment, the workers were divided into an exposed group and a control group. The electrocardiogram, blood pressure, and multiple lung function parameters of the two groups were measured and analyzed. The PM2.5 exposed group had significantly lower values in the pulmonary function indexes of forced expiratory volume in one second (FEV1.0), maximum mid expiratory flow (MMEF), peak expiratory flow rate (PEFR), percentage of peak expiratory flow out of the overall expiratory flow volume (PEFR%), forced expiratory flow at 25% and 75% of forced vital capacity (FEF 25, FEF75), forced expiratory flow when 25%, 50%, and 75% of forced vital capacity has been exhaled (FEF25%,FEF50%, FEF75%), and FEV1.0/FVC% (the percentage of the predicted value of forced vital capacity) than the control group (all p < 0.05). Both groups had mild or moderate lung injury, most of which was restrictive ventilatory disorder, and there was significant difference in the prevalence rate of restrictive respiratory dysfunction between the two groups (41.4% vs. 23.6%, p = 0.016). Electrocardiogram (ECG) abnormalities, especially sinus bradycardia, were shown in both groups, but there was no statistical difference of the prevalence rate between the two groups (p > 0.05). Also, no significant difference of the prevalence rate of hypertension was observed between the PM2.5 exposure and control groups (p > 0.05). PM2.5 exposure was associated with pulmonary function damage of the workers in the open-pit manganese mine, and the major injury was restrictive ventilatory disorder. The early effect of PM2.5 exposure on the cardiovascular system was uncertain at current exposure levels and exposure time.


Author(s):  
Bhumika T. Vaishnav ◽  
Tushar V. Tonde

Background: Previous studies suggest that obese individuals are prone to pulmonary function abnormalities. The aim of this study was to evaluate pulmonary function tests in obese individuals and to relate pulmonary abnormalities if any found to lipid abnormalities and to the extent and duration of obesity.Methods: This prospective study was done on 40 obese patients attending to Dr. D. Y. Patil Hospital, Mumbai with complaints of pulmonary functions during the period from January to December 2012. Pulmonary function test was done with the help of Jaegers pneumoscreen. The percentage of body fat was determined by using triceps skin fold thickness technique by using Vernier callipers. Fasting serum samples was collected to analyses cholesterol and triglycerides.Results: Female preponderance was seen in the study (57.5%). Forced expiratory volume, forced vital capacity, maximum mid expiratory flow rate was significantly reduced and the ratio of forced expiratory volume in one second to forced vital capacity was significantly increased in individuals who had abnormal pulmonary function. Decrease in pulmonary function was noted with increased levels of cholesterol and triglyceride but the correlation was not significant.Conclusions: Obese individuals although asymptomatic have significant lung function abnormality in the form of restrictive as well as obstructive pattern. Hence, reduction in the body weight may help in reversal of the pulmonary function indices.


2019 ◽  
Vol 3 (3) ◽  
pp. 89
Author(s):  
Arief Bakhtiar ◽  
Renny Irviana Eka Tantri

Pulmonary function is an examination to measure lung volume function using spirometry. Tests with spirometry to detect abnormalities associated with respiratory distress. Spirometry examination is not only to determine the diagnosis but also to assess the severity of obstruction, restriction, and the effects of treatment. Spirometry examination is a test to measure the volume of a person’s static and dynamic lungs with a spirometer tool. Dynamic lung spirometry consists of Forced vital capacity (FVC), Forced expiratory volume (FEVT), Forced expiratory flow200-1200 / FEF 200-1200, Forced expiratory flow25% -75% / FEF 25% -75%, Peak expiratory flow rate / PEFR, Maximum voluntary ventilation / MVV / MBC, FEV1 / FVC Ratio. Ventilation disorders consist of: restriction and obstruction disorders. Restriction is a disorder of lung development by any cause. In obstruction disorder, it shows a decrease in velocity of expiratory flow and normal vital capacity. FEV values, which are widely used are FEV1 / FVC, abnormal when <80%, FEV1 / FVC ratio <80%. This parameter is very important because the accuracy level for obstruction in the central airway is quite large. In obstructive disorder there is generally a decrease in pulmonary dynamic volume. Significant parameters are FEV 1 / FVC, PEFR, and FEF 25-75. The FEV1 / FVC ratio is important because the accuracy level for obstruction in the central airway is considerable, whereas FEF 25-75 indicates obstruction in the small airway.


2019 ◽  
Vol 34 (4) ◽  
pp. 377-390
Author(s):  
Somayeh Rahimi Moghadam ◽  
Mahdi Afshari ◽  
Mahmood Moosazadeh ◽  
Narges Khanjani ◽  
Ali Ganjali

Abstract Introduction Exposure to petrol and gasoline can have harmful effects on the lungs. This review aimed to summarize the reported effects of this exposure on pulmonary function parameters. Methods Relevant studies were identified by a comprehensive search in PubMed, Scopus, Science Direct and Google Scholar databases. Irrelevant studies were excluded. Quality assessment was performed using the Newcastle-Ottawa score (NOS). The standard mean difference of pulmonary parameters between exposed and unexposed petrol station attendants was pooled using random effects. Meta-regression was used to investigate factors probably related to heterogeneity. Studies affecting the total estimates were assessed during sensitivity analysis. The Egger test was performed to investigate any evidence of publication bias. Results Eventually, 26 studies entered the meta-analysis, and the pooled standard difference [95% confidence interval (CI)] of forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, vital capacity (VC), peak expiratory flow (PEF), forced expiratory flow (FEF25-75) and maximum voluntary ventilation (MVV) in the exposed minus unexposed groups was −1.08 L (95% CI: −1.38, −0.78), −0.92 L (−1.15, −0.69), −0.65 (−1.01, −0.30), −0.51 L (−0.96, −0.06), −0.96 L/s (−1.21, −0.69), −0.78 L/s (1.14, −0.42) and −0.58 L/min (−0.90, −0.27), respectively, and showed a decrease in all pulmonary parameters in the exposed group. Conclusion Occupational exposure to petrol fumes is a risk factor for lung function and there is a reverse relation between lung function and the duration of exposure.


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