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.

Pulmonary Function Testing

2017 ◽  
Author(s):  
Maryl Kreider
Keyword(s):  
Pulmonary Function ◽  
Forced Expiratory Volume ◽  
Pulmonary Function Testing ◽  
Flow Volume ◽  
Functional Impairments ◽  
Clinical Scenarios ◽  
Maximum Expiratory Flow ◽  
Health And Disease ◽  
The Relationship ◽  
Function Testing

Intelligent management of pulmonary disease requires a fundamental understanding of the complex interrelationships between multiple elements that interact to maintain homeostasis in the respiratory system. This chapter discusses the physiologic basis for pulmonary function testing and the use of these tests to diagnose disease, quantitate functional impairments, and follow the effects of treatment. Figures illustrate the relationships between lung volume, airway conductance, and airway resistance; the relationship between forced expiratory volume and time (spirogram); the relationship between spirometry and maximum expiratory flow volume; dynamic airway compression; patterns of abnormalities seen on flow-volume curves; lung volumes and capacities; pressure-volume relationships in health and disease; and the clinical assessment of lung function. Tables list the capacities and volumes of gas contained in the lungs during various breathing maneuvers, conditions associated with alterations in diffusing capacity, and recommendations for tests for various clinical scenarios. This review contains 7 highly rendered figures, 3 tables, and 86 references.

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 Lung Function Testing and Prediction Equations in Adult Population from Maputo, Mozambique

2020 ◽  
Vol 17 (12) ◽  
pp. 4535
Author(s):  
Olena Ivanova ◽  
Celso Khosa ◽  
Abhishek Bakuli ◽  
Nilesh Bhatt ◽  
Isabel Massango ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
South African ◽  
Adult Population ◽  
Forced Expiratory Volume ◽  
Prediction Equations ◽  
Lung Function Testing ◽  
African Countries ◽  
Cross Sectional ◽  
Function Testing

Background: Local spirometric prediction equations are of great importance for interpreting lung function results and deciding on the management strategies for respiratory patients, yet available data from African countries are scarce. The aim of this study was to collect lung function data using spirometry in healthy adults living in Maputo, Mozambique and to derive first spirometric prediction equations for this population. Methods: We applied a cross-sectional study design. Participants, who met the inclusion criteria, underwent a short interview, anthropometric measurements, and lung function testing. Different modelling approaches were followed for generating new, Mozambican, prediction equations and for comparison with the Global Lung Initiative (GLI) and South African equations. The pulmonary function performance of participants was assessed against the different reference standards. Results: A total of 212 males and females were recruited, from whom 155 usable spirometry results were obtained. The mean age of participants was 35.20 years (SD 10.99) and 93 of 155 (59.35%) were females. The predicted values for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and the FEV1/FVC ratio based on the Mozambican equations were lower than the South African—and the GLI-based predictions. Conclusions: This study provides first data on pulmonary function in healthy Mozambican adults and describes how they compare to GLI and South African reference values for spirometry.

Pulmonary Function Testing

2017 ◽  
Author(s):  
Maryl Kreider
Keyword(s):  
Pulmonary Function ◽  
Forced Expiratory Volume ◽  
Pulmonary Function Testing ◽  
Flow Volume ◽  
Functional Impairments ◽  
Clinical Scenarios ◽  
Maximum Expiratory Flow ◽  
Health And Disease ◽  
The Relationship ◽  
Function Testing

Intelligent management of pulmonary disease requires a fundamental understanding of the complex interrelationships between multiple elements that interact to maintain homeostasis in the respiratory system. This chapter discusses the physiologic basis for pulmonary function testing and the use of these tests to diagnose disease, quantitate functional impairments, and follow the effects of treatment. Figures illustrate the relationships between lung volume, airway conductance, and airway resistance; the relationship between forced expiratory volume and time (spirogram); the relationship between spirometry and maximum expiratory flow volume; dynamic airway compression; patterns of abnormalities seen on flow-volume curves; lung volumes and capacities; pressure-volume relationships in health and disease; and the clinical assessment of lung function. Tables list the capacities and volumes of gas contained in the lungs during various breathing maneuvers, conditions associated with alterations in diffusing capacity, and recommendations for tests for various clinical scenarios. This review contains 7 highly rendered figures, 3 tables, and 86 references.

scholarly journals Interpretation of Pulmonary Function Tests and Optimization of Inhalation Therapy

2021 ◽  
Vol 96 (3) ◽  
pp. 209-217
Author(s):  
Sung Yoon Lim ◽  
Ho Il Yoon
Keyword(s):  
Pulmonary Function ◽  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Pulmonary Function Testing ◽  
Inhalation Therapy ◽  
Stepwise Approach ◽  
Diagnosis And Classification ◽  
Function Testing

Spirometry, also called office-based pulmonary function testing, is a useful tool for diagnosis and classification of lung disease. Here, we outline a simple stepwise approach for interpretation of spirometry results. The first step is to determine the forced expiratory volume in a one second/forced vital capacity (FEV1/FVC) ratio. If airflow is limited, a bronchodilator is administered followed by reassessment. The next step is to determine whether FVC is low; an observed decrease in FVC indicates a restrictive patten. For patients with obstructive disease, inhalation medication is needed. Therefore, this review also describes the most appropriate inhalation device for each patient and the correct use of the device to maximize inhalation therapy benefits.

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.

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.

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