Distinctive patterns of pulmonary function change according to baseline lung volume and diffusing capacity

2020 ◽  
Vol 24 (6) ◽  
pp. 597-605
Author(s):  
J. Kang ◽  
Y-M. Oh ◽  
J-H. Lee ◽  
E. K. Kim ◽  
S. Y. Lim ◽  
...  
Keyword(s):  
South Korea ◽  
Pulmonary Function ◽  
Lung Volume ◽  
Forced Expiratory Volume ◽  
Random Coefficients ◽  
Chronic Obstructive ◽  
Diffusing Capacity ◽  
Obstructive Pulmonary Disease ◽  
Function Change ◽  
Physiological Markers

SETTING: Multicentre retrospective study in South Korea.OBJECTIVE: To longitudinally evaluate changes in lung volume and diffusing capacity for carbon monoxide (DLCO) with forced expiratory volume in 1 sec (FEV1).DESIGN: A total of 155 patients with chronic obstructive pulmonary disease (COPD), whose pulmonary function parameters were measured annually for 5 years, were selected from a prospective cohort in South Korea. A random coefficients model was used to estimate mean annual FEV1, lung volume parameter and DLCO change rates.RESULTS: Patients were classified into four groups based on baseline DLCO and residual volume/total lung capacity (RV/TLC) measurements. The annual FEV1 decline rate was greater in patients with low DLCO than in those with normal DLCO, with the greatest decline occurring in patients with low DLCO and normal RV/TLC. RV and RV/TLC declined in patients with high RV/TLC, whereas these increased in patients with normal RV/TLC. DLCO decreased longitudinally in all four groups, with the greatest decline occurring in patients with normal DLCO and normal RV/TLC.CONCLUSIONS: Different subgroups of patients with COPD exhibited distinctive pulmonary function change patterns. Baseline DLCO and RV/TLC may be used as physiological markers to predict long-term changes in pulmonary function.

scholarly journals Prognostic Marker for Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Analysis of Diffusing Capacity of the Lung for Carbon Monoxide (DLCO) and Forced Expiratory Volume in One Second (FEV1)

2021 ◽  
Author(s):  
Juwhan Choi ◽  
Jae Kyeom Sim ◽  
Jee Youn Oh ◽  
Young Seok Lee ◽  
Gyu Young Hur ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Length Of Hospital Stay ◽  
Forced Expiratory Volume ◽  
Curve Analysis ◽  
Chronic Obstructive ◽  
Diffusing Capacity ◽  
Roc Curve Analysis ◽  
Obstructive Pulmonary Disease

Abstract Background: It is important to assess the prognosis and classify patients in chronic obstructive pulmonary disease (COPD) and acute exacerbation of COPD (AECOPD) treatment. Recently, it was suggested that diffusing capacity of the lung for carbon monoxide (DLCO) should be added to multidimensional tools for assessing COPD. This study aimed to compare the DLCO and forced expiratory volume in one second (FEV1) to identify better prognostic factors for admitted patients with AECOPD.Methods: We retrospectively analyzed 342 patients with AECOPD receiving inpatient treatment. We classified 342 severe AECOPD events using DLCO and FEV1. We defined the prognostic factors of severe AECOPD as the length of hospital stay, mortality in hospital, experience of mechanical ventilation, and experience of intensive care unit (ICU) care. We analyzed the prognostic factors by multivariate analysis using logistic regression. In addition, we conducted a correlation analysis and receiver operating characteristic (ROC) curve analysis.Results: In univariate and multivariate analyses, DLCO was shown to predict mortality rate (odds ratio = 4.408; 95% confidence interval, 1.070–18.167; P = 0.040), experience of ventilator (odds ratio = 2.855; 95% confidence interval, 1.216–6.704; P = 0.016) and ICU (odds ratios = 2.685; 95% confidence interval, 1.290–5.590; P = 0.008). However, there was no statistically significant difference in mortality rate when using FEV1 classification (P = 0.075). In the correlation analysis, both DLCO and FEV1 showed a negative correlation with length of hospital stay. The correlation rate was more pronounced in the DLCO (DLCO; B = -0.103, P < 0.001) (FEV1; B = -0.075, P = 0.007). In addition, DLCO showed better predictive ability than FEV1 in ROC curve analysis. The area under the curve (AUC) of DLCO was greater than 0.68 for all prognostic factors, and in contrast, the AUC of FEV1 was less than 0.68.Conclusion: DLCO was likely to be as good as or better prognostic marker than FEV1 in severe AECOPD.

scholarly journals Clinical observation of the use of portable pulmonary function test trainer in patients with stable COPD

2019 ◽  
Vol 02 (04) ◽  
pp. 185-191
Author(s):  
Yuhua Wu ◽  
Jian Zhou ◽  
Mengyu Ma ◽  
Jing Xie ◽  
Ahong Wang ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Daily Living ◽  
Comparison Group ◽  
Psychological Symptoms ◽  
Social Activity ◽  
Intervention Group ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Clinical Effects ◽  
Obstructive Pulmonary Disease

Objective: To investigate the clinical effects of the use of portable pulmonary function tester in patients with stable Chronic Obstructive Pulmonary Disease (COPD). Methods: A total of 80 patients with stable COPD were enrolled in our hospital from March 2018 to March 2019. They were divided into two groups according to different treatment methods. The comparison group was used for routine pulmonary function training, and the intervention group was trained for Portable Pulmonary Function Training and Test Device (PPFTTD). Comparison was made of forced expiratory volume in one second/forced vital capacity (FEV1/FVC), measured/predicted value of the first second forced expiratory volume (FEV1 measured/predicted value), measured/predicted value of maximal voluntary ventilation per minute between the two groups. Quality of life (QOL) scores such as daily living ability, social activity, depressive psychological symptoms, and anxiety psychological symptoms were measured. Results: The FEV1/FVC value, measured/predicted value of FEV1 and MVV of intervention group were higher than those in the comparison group ([Formula: see text]). QOL scores, such as daily living ability, social activity, depression psychological symptoms, and anxiety psychological symptoms in the intervention group, were lower than those in the comparison group ([Formula: see text]). Conclusion: In the treatment of stable COPD, the use of portable pulmonary function tester is significant, and it should be widely promoted and applied in clinical practice.

scholarly journals Pulmonary Emphysema Regional Distribution and Extent Assessed by Chest Computed Tomography Is Associated With Pulmonary Function Impairment in Patients With COPD

2021 ◽  
Vol 8 ◽  
Author(s):  
Plácido Gomes ◽  
Hélder Novais e Bastos ◽  
André Carvalho ◽  
André Lobo ◽  
Alan Guimarães ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Lung Volume ◽  
Pulmonary Emphysema ◽  
Regional Distribution ◽  
Airway Disease ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Total Lung Volume ◽  
Emphysema Severity ◽  
Function Impairment

Objective: This study aimed to evaluate how emphysema extent and its regional distribution quantified by chest CT are associated with clinical and functional severity in patients with chronic obstructive pulmonary disease (COPD).Methods/Design: Patients with a post-bronchodilator forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) &lt; 0.70, without any other obstructive airway disease, who presented radiological evidence of emphysema on visual CT inspection were retrospectively enrolled. A Quantitative Lung Imaging (QUALI) system automatically quantified the volume of pulmonary emphysema and adjusted this volume to the measured (EmphCTLV) or predicted total lung volume (TLV) (EmphPLV) and assessed its regional distribution based on an artificial neural network (ANN) trained for this purpose. Additionally, the percentage of lung volume occupied by low-attenuation areas (LAA) was computed by dividing the total volume of regions with attenuation lower or equal to −950 Hounsfield units (HU) by the predicted [LAA (%PLV)] or measured CT lung volume [LAA (%CTLV)]. The LAA was then compared with the QUALI emphysema estimations. The association between emphysema extension and its regional distribution with pulmonary function impairment was then assessed.Results: In this study, 86 patients fulfilled the inclusion criteria. Both EmphCTLV and EmphPLV were significantly lower than the LAA indices independently of emphysema severity. CT-derived TLV significantly increased with emphysema severity (from 6,143 ± 1,295 up to 7,659 ± 1,264 ml from mild to very severe emphysema, p &lt; 0.005) and thus, both EmphCTLV and LAA significantly underestimated emphysema extent when compared with those values adjusted to the predicted lung volume. All CT-derived emphysema indices presented moderate to strong correlations with residual volume (RV) (with correlations ranging from 0.61 to 0.66), total lung capacity (TLC) (from 0.51 to 0.59), and FEV1 (~0.6) and diffusing capacity for carbon monoxide DLCO (~0.6). The values of FEV1 and DLCO were significantly lower, and RV (p &lt; 0.001) and TLC (p &lt; 0.001) were significantly higher with the increasing emphysema extent and when emphysematous areas homogeneously affected the lungs.Conclusions: Emphysema volume must be referred to the predicted and not to the measured lung volume when assessing the CT-derived emphysema extension. Pulmonary function impairment was greater in patients with higher emphysema volumes and with a more homogeneous emphysema distribution. Further studies are still necessary to assess the significance of CTpLV in the clinical and research fields.

scholarly journals Individualised risk in patients undergoing lung volume reduction surgery: the Glenfield BFG score

2017 ◽  
Vol 49 (6) ◽  
pp. 1601766 ◽  
Author(s):  
Neil J. Greening ◽  
Paul Vaughan ◽  
Inger Oey ◽  
Michael C. Steiner ◽  
Mike D. Morgan ◽  
...  
Keyword(s):  
Risk Score ◽  
Lung Volume ◽  
Characteristic Curve ◽  
Risk Groups ◽  
Forced Expiratory Volume ◽  
Volume Reduction ◽  
Chronic Obstructive ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction ◽  
Obstructive Pulmonary Disease

Lung volume reduction surgery (LVRS) has been shown to be beneficial in patients with chronic obstructive pulmonary disease, but there is low uptake, partly due to perceived concerns of high operative mortality. We aimed to develop an individualised risk score following LVRS.This was a cohort study of patients undergoing LVRS. Factors independently predicting 90-day mortality and a risk prediction score were identified. Reliability of the score was tested using area under the receiver operating characteristic curve (AUROC).237 LVRS procedures were performed. The multivariate analysis factors associated independently with death were: body mass index (BMI)<18.5 kg·m−2 (OR 2.83, p=0.059), forced expiratory volume in 1 s (FEV1)<0.71 L (OR 5.47, p=0.011) and transfer factor of the lung for carbon monoxide (TLCO) <20% (OR 5.56, p=0.031). A risk score was calculated and total score assigned. AUROC for the risk score was 0.80 and a better predictor than individual components (p<0.01). The score was stratified into three risk groups. Of the total patients, 46% were classified as low risk. Similar improvements in lung function and health status were seen in all groups. The score was introduced and tested in a further 71 patients. AUROC for 90-day mortality in this cohort was 0.84.It is possible to provide an individualised predictive risk score for LVRS, which may aid decision making for both clinicians and patients.

scholarly journals Sex-related differences in bronchial parameters and pulmonary function test results in patients with chronic obstructive pulmonary disease based on three-dimensional quantitative computed tomography

2017 ◽  
Vol 46 (1) ◽  
pp. 135-142 ◽  
Author(s):  
Yan Li ◽  
Yong-liang Dai ◽  
Nan Yu ◽  
You-min Guo
Keyword(s):  
Computed Tomography ◽  
Chronic Obstructive Pulmonary Disease ◽  
Smoking Cessation ◽  
Pulmonary Function ◽  
Pulmonary Disease ◽  
Quantitative Computed Tomography ◽  
Three Dimensional ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Objective This study was performed to evaluate the effect of sex on bronchial parameters and the predicted forced expiratory volume in 1 s expressed as a percentage of the forced vital capacity (FEV1% pred) on pulmonary function testing. Methods The data of 359 patients with chronic obstructive pulmonary disease (COPD) with available FEV1% pred and computed tomography (CT) images were retrospectively reviewed. FACT-Digital lung TM software (DeXin, Xi’an, China) was used to perform fully automated three-dimensional CT quantitative measurements of the bronchi. Generation 5 to 7 bronchi were measured, and the parameters analyzed were the lumen diameter (LD), wall thickness (WT), lumen area (LA), and WA% [WA / (WA + LA) × 100%]. Results In the smoking, smoking cessation, and nonsmoking groups, women had a significantly larger WA% and smaller LD, WT, and LA than men. The FEV1% pred was significantly lower in women than men in the smoking and smoking cessation groups. The FEV1% pred was significantly higher in women than men in the nonsmoking group. Conclusion Sex-related differences may partially explain why smoking women experience more severe pulmonary function impairment than men among patients with COPD.

scholarly journals Obesity Impact on Respiratory Function

2021 ◽  
Vol 18 (1) ◽  
pp. 41-58
Author(s):  
Anca Hâncu ◽  
Florin Mihălţan
Keyword(s):  
Pulmonary Function ◽  
Respiratory Function ◽  
Healthy Lifestyle ◽  
Respiratory Health ◽  
Forced Expiratory Volume ◽  
Overweight And Obesity ◽  
Chronic Obstructive ◽  
Dietary Recommendations ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Abstract Not so much emphasize in literature and studies, obesity consequences on respiratory function may influence chronic obstructive pulmonary disease COPD and asthma, triggering important healthcare issues. Pulmonary function is a mortality predictor. The largest populational study European Community Respiratory Health Survey shows the impact of overweight and obesity on pulmonary function by decreasing forced expiratory volume in first second FEV1 and forced vital capacity FVC. By the contrary, weight loss is decreasing both. Inflammatory and mechanical mechanisms should be considered in lung function impairment, as a consequence of obesity. Important aspect, lifestyle, will consider tobacco, physical activity, diet. Adopting a healthy lifestyle with a Mediterranean Diet MD will preserve a good pulmonary function on long term. We detailed below specific dietary recommendations, favorable nutrients or foods to be avoided. In conclusion comprehensive lifestyle interventions should become populational based interventions for a better prevention for pulmonary diseases and NCD’s and finally for a better health status.

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