Coming together: The ATS/ERS consensus on clinical pulmonary function testing

Università degli Studi di Genova, Genova, Liguria, Italy
European Respiratory Journal (Impact Factor: 7.64). 08/2005; 26(1):1-2. DOI: 10.1183/09031936.05.00034205
Source: PubMed

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    • "In general clinical practice and research the pulmonary function test (PFT) is used to evaluate respiratory motor function. In people with SCI, this test includes spirometrical and maximum airway pressure measures acquired with the test subject in the seated position (American Thoracic Society/European Respiratory Society, 2002; Brusasco et al., 2005; Jain et al., 2006; Miller et al., 2005; Stolzmann et al., 2008). While normative values are corrected for age, height, gender and race, they may also vary depending on body position (Manning et al., 1999; Segizbaeva et al., 2013) and functional capacity of the respiratory muscles (Rehder, 1998). "
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    ABSTRACT: This case-controlled clinical study was undertaken to investigate to what extent pulmonary function in individuals with chronic spinal cord injury (SCI) is affected by posture. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax) were obtained from 27 individuals with chronic motor-complete (n=13, complete group) and motor-incomplete (n=14, incomplete group) C2-T12 SCI in both seated and supine positions. Seated-to-supine changes in spirometrical (FVC and FEV1) and airway pressure (PImax and PEmax) outcome measures had different dynamics when compared in complete and incomplete groups. Patients with motor-complete SCI had tendency to increase spirometrical outcomes in supine position showing significant increase in FVC (p=.007), whereas patients in incomplete group exhibited decrease in these values with significant decreases in FEV1 (p=.002). At the same time, the airway pressure values were decreased in supine position in both groups with significant decrease in PEmax (p=.031) in complete group and significant decrease in PImax (p=.042) in incomplete group. In addition, seated-to-supine percent change of PImax was strongly correlated with neurological level of motor-complete SCI (ρ=-.77, p=.002). These results indicate that postural effects on respiratory performance in patients with SCI can depend on severity and neurological level of SCI, and that these effects differ depending on respiratory tasks. Further studies with adequate sample size are needed to investigate these effects in clinically specific groups and to study the mechanisms of such effects on specific respiratory outcome measures.
    Full-text · Article · Aug 2014 · Respiratory Physiology & Neurobiology
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    • "Spirometry was carried out using Spirosift spirometry 5000 FUKUDa NENSHI. The following activities were avoided prior to the spirometric study according to the guidelines of American Thoracic Society (2005) [8] "
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    ABSTRACT: Pulmonary surfactant protein D (SP-D) is considered a candidate biomarker for lung integrity and for disease progression. In the present study, we aimed to estimate the serum levels of SP-D in patients with chronic obstructive pulmonary disease (COPD) and to assess the correlation of these biomarkers with indices of COPD severity. Subjects and methods The study was carried out on 30 COPD male patients and 15 apparently healthy age-matched males as control. COPD patients were divided by GOLD stages into 10 patients stage I–II (group 1), and 20 patients stage III–IV (group 2). A detailed history and clinical examination, pulmonary function testing by spirometry, right ventricular function assessment by conventional echocardiography and tissue Doppler imaging were done. Serum levels of total protein and albumin were determined as well as serum SP-D by enzyme-linked immunosorbent assay in both patient and control groups was determined. Results The serum level of SP-D was significantly higher in COPD patients than controls (P < 0.001). Also, these biomarkers were significantly higher in stages III and IV (group 2) compared to stages I and II (group 2) (P < 0.01). SP-D was significantly negatively correlated with serum albumin (P < 0.01) and FEV1 (P < 0.05) and not correlated with any of right ventricular function indices measured by echocardiography. Conclusion SP-D is a promising biomarker for severity in stable COPD patient. The low serum albumin could contribute to elevated serum SPD with deteriorated lung functions in stable COPD patient.
    Full-text · Article · Jul 2014
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    • "A postbronchodilator (0.6 mg of salbutamol metered-dose aerosol) dynamic lung function test (FEV1 and FVC) was performed (MasterScreen Pneumo; CareFusion, Hoechberg, Germany) in accordance with American Thoracic Society (ATS)/European Respiratory Society standards.27 The normative values from Hedenstrom et al28,29 were used to calculate the FEV1% predicted and FVC% predicted. "
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    ABSTRACT: Several differences have been reported in the clinical characteristics of chronic obstructive pulmonary disease (COPD) between men and women. Differences have been found in the association between respiratory symptoms and lung function, and in the factors associated with dyspnea. This raises the question of whether there are differences between the sexes in the relationship between fatigue, the second most prevalent symptom, and the variables of physical capacity and disease severity. To examine the experience of fatigue and its relationship to physical capacity and disease severity in men and women with COPD. In a cross-sectional study 121 patients with COPD (54 men and 67 women), the experience of fatigue (frequency, duration, and severity) and physical capacity (lung function, 6-minute walk distance [6MWD], grip strength, and timed-stand test) were assessed. Disease severity was graded according to the Body mass index, airway Obstruction, Dyspnoea and Exercise capacity (BODE) index. Two multiple logistic regression models were tested, both of which were performed separately in men and women, to examine the association between the experience of fatigue and variables of physical capacity and the BODE index. Eighty-nine (73.6%) patients experienced fatigue, with similar proportions in men and women. The men with fatigue had worse physical capacity and more severe disease than did the men without fatigue: for men with and without fatigue, respectively, the percent of predicted forced expiratory volume in 1 second (FEV1) (mean [standard deviation]) was 47 (14) vs 64 (17); the 6MWD (mean [standard deviation]) was 398 (138) vs 539 (105) m; and the BODE index (median [quartile 1-3]) was 3 (2-5) vs 1 (0-1) (P<0.01). In women, only higher leg fatigue post-6MWD was seen among those experiencing fatigue compared with women without fatigue: for women with and without fatigue, respectively, leg fatigue (median [quartile 1-3]) was 4 (3-5) vs 2 (0-3) (P<0.001). The regression models showed that the 6MWD and the BODE index were associated with fatigue in both men and women, but in women, leg fatigue remained an independent associate in both models. Exercise capacity and disease severity were associated with fatigue in both men and women. In women, leg fatigue was strongly associated with fatigue, which warrants further investigation.
    Full-text · Article · Jan 2014 · International Journal of COPD
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