scholarly journals Pulmonary Function Testing in Work-Related Asthma: An Overview from Spirometry to Specific Inhalation Challenge

2021 ◽  
Vol 18 (5) ◽  
pp. 2325
Author(s):  
Mathias Poussel ◽  
Isabelle Thaon ◽  
Emmanuelle Penven ◽  
Angelica I. Tiotiu
Keyword(s):  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Objective Evaluation ◽  
Pulmonary Function Testing ◽  
Initial Assessment ◽  
Work Related ◽  
Specific Inhalation Challenge ◽  
Occupational Setting ◽  
Inhalation Challenge ◽  
Function Testing

Work-related asthma (WRA) is a very frequent condition in the occupational setting, and refers either to asthma induced (occupational asthma, OA) or worsened (work-exacerbated asthma, WEA) by exposure to allergens (or other sensitizing agents) or to irritant agents at work. Diagnosis of WRA is frequently missed and should take into account clinical features and objective evaluation of lung function. The aim of this overview on pulmonary function testing in the field of WRA is to summarize the different available tests that should be considered in order to accurately diagnose WRA. When WRA is suspected, initial assessment should be carried out with spirometry and bronchodilator responsiveness testing coupled with first-step bronchial provocation testing to assess non-specific bronchial hyper-responsiveness (NSBHR). Further investigations should then refer to specialists with specific functional respiratory tests aiming to consolidate WRA diagnosis and helping to differentiate OA from WEA. Serial peak expiratory flow (PEF) with calculation of the occupation asthma system (OASYS) score as well as serial NSBHR challenge during the working period compared to the off work period are highly informative in the management of WRA. Finally, specific inhalation challenge (SIC) is considered as the reference standard and represents the best way to confirm the specific cause of WRA. Overall, clinicians should be aware that all pulmonary function tests should be standardized in accordance with current guidelines.

Pulmonary Function Testing in Pediatric Practice

1994 ◽  
Vol 15 (10) ◽  
pp. 403-411
Author(s):  
Gary A. Mueller ◽  
Howard Eigen
Keyword(s):  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Airflow Obstruction ◽  
Disease Process ◽  
Pulmonary Function Testing ◽  
Response To Therapy ◽  
Lung Volumes ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Function Testing

Pulmonary function testing is an important tool in the evaluation of children who have or are suspected of having lung disease. Of particular importance, pulmonary function testing provides objective and reproducible measurements, which then can be used to follow the response to therapy. The measurements of air flow and lung volumes are the mechanical pulmonary function tests used most commonly. However, measurements of the efficiency of gas exchange also are considered a test of pulmonary function and can be assessed by such methods as arterial blood gas and oximetry. This article focuses on those tests readily available to the pediatrician in the office or hospital. Measuring pulmonary function regularly is analogous to measuring blood pressure in patients who have hypertension, allowing the physician to follow a measurement directly associated with the pulmonary disease process. As with other clinical tests, pulmonary function measurements are most effective when used to answer a specific question about the patient. For example, in a child who presents having a persistent cough and a family history of asthma, the diagnosis may be asthma, and the question "Does the child have airflow obstruction consistent with asthma?" can be answered by spirometry. Spirometry The parameters commonly measured in the assessment of respiratory function are lung volumes, air flows and timed volumes, and airway reactivity.

scholarly journals Pulmonary Function Testing Procedures: A Preliminary Study of Local Occupational Health Clinics

AAOHN Journal ◽  
1986 ◽  
Vol 34 (8) ◽  
pp. 366-369
Author(s):  
Eileen Burke-Klein
Keyword(s):  
Pulmonary Function ◽  
Random Sample ◽  
Pulmonary Function Tests ◽  
Pulmonary Function Testing ◽  
Performance Criteria ◽  
Testing Procedures ◽  
Health Clinics ◽  
Medical Clinics ◽  
Performance Specifications ◽  
Function Testing

For the results of pulmonary function testing to be valid, the examination must be administered by a knowledgeable technician and the instrument must fulfill performance criteria. In general, most small to mid-sized industries rely upon local medical clinics to provide pulmonary function tests. Because of this, a survey was undertaken to study the pulmonary function testing services available at occupational medical clinics in a large metropolitan area. The purpose of this study was: 1. to determine the percentage of clinics complying with the program prerequisites mentioned above, and 2. to identify the other predictive characteristics of clinics more likely to meet these standards. A random sample of occupational medical clinics providing pulmonary function testing were selected for this study. Of the 31 clinics providing pulmonary function testing services, a random sample of 14 were chosen to perticipate; for these clinics, administrators and/or physicians were interviewed and testing equipment was examined. It was found that 17% of clinics employed certified technicians to conduct testing and 42% had instruments meeting performance specifications. Overall, only 8% of the sample met both prerequisites. No significant relationship was found between selected variables that it was hoped would identify clinics more likely to perform valid pulmonary function testing. It is believed that a larger sample size would be necessary to establish such significant correlations.

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.

scholarly journals Pediatric Pulmonary Function Testing in COVID-19 Pandemic and Beyond. A Position Statement From the Hellenic Pediatric Respiratory Society

2021 ◽  
Vol 9 ◽  
Author(s):  
Sotirios Fouzas ◽  
Dimos Gidaris ◽  
Nikolaos Karantaglis ◽  
Harry Opsimos ◽  
Emmanouil I. Alexopoulos ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Action Plan ◽  
Pulmonary Function Tests ◽  
Relevant Literature ◽  
Position Statement ◽  
Pulmonary Function Testing ◽  
Cross Infection ◽  
Careful Evaluation ◽  
Protective Measures ◽  
Function Testing

As the COVID-19 pandemic is still evolving, guidelines on pulmonary function testing that may dynamically adapt to sudden epidemiologic changes are required. This paper presents the recommendations of the Hellenic Pediatric Respiratory Society (HPRS) on pulmonary function testing in children and adolescents during the COVID-19 era. Following an extensive review of the relevant literature, we recommend that pulmonary function tests should be carried out after careful evaluation of the epidemiologic load, structured clinical screening of all candidates, and application of special protective measures to minimize the risk of viral cross infection. These principles have been integrated into a dynamic action plan that may readily adapt to the phase of the pandemic.

Pulmonary Function Testing in Preschool Asthmatic Children

2016 ◽  
Vol 02 (01) ◽  
pp. 16
Author(s):  
Luís Miguel Borrego ◽  
◽  
◽  
Mário Morais-Almeida ◽  
◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Respiratory Diseases ◽  
Clinical Investigation ◽  
Pulmonary Function Tests ◽  
Daily Practice ◽  
Pulmonary Function Testing ◽  
Asthmatic Children ◽  
Function Testing ◽  
Preschool Aged Children

Pulmonary function tests (PFT) are usually useful to confirm the diagnosis, as well as for guidance to therapy and also to clarify the prognosis of several respiratory diseases, but only recently it gained interest in preschool aged children. Published papers have shown the feasibility of respiratory function testing in preschool aged children, as in the context of clinical investigation, as in clinical daily practice, but more investigation is needed to demonstrate PFT usefulness, particularly in clinical correlation and prospective follow-up of preschool asthmatic children.

scholarly journals Pulmonary Function Testing in Elderly Patients Treated for a Myasthenia Gravis Exacerbation

2018 ◽  
Vol 9 (2) ◽  
pp. 79-84
Author(s):  
Stephen C. van Gaal ◽  
Shane W. English ◽  
Pierre R. J. Bourque ◽  
Jocelyn C. Zwicker
Keyword(s):  
Elderly Patients ◽  
Pulmonary Function ◽  
Myasthenia Gravis ◽  
Pulmonary Function Tests ◽  
Pulmonary Function Testing ◽  
P Value ◽  
Respiratory Events ◽  
Relationship Of ◽  
Function Testing ◽  
Effect Of Age

Background and Purpose: Pulmonary function testing is a standard part of care for patients admitted to hospital with a myasthenia gravis exacerbation. It may inform clinicians’ decisions to intubate patients. It is known that pulmonary function declines with age in healthy adults. We studied the effect of age on pulmonary function and serious respiratory events, including intubation, in patients admitted to hospital for a myasthenia gravis exacerbation. Methods: Single center, retrospective cohort of consecutive patients treated for a myasthenia gravis exacerbation. Demographics, pulmonary function tests (PFTs), and respiratory events requiring intubation or emergency respiratory therapy were recorded for each encounter. Relationship of PFTs to age was analyzed using age as a continuous and as a dichotomous (cut-value 70 years) variable. Results: Forty-nine encounters from 39 patients were included. Slow vital capacity (SVC) was negatively correlated with age ( R 0.46, P value .002). Maximum inspiratory pressure (MIP) and SVC were significantly reduced in elderly versus nonelderly patients (MIP-20.0 vs −30.0 cm H2O, P value .004; SVC 16.5 vs 23.4 mL/kg, P value .013). The incidence of respiratory events did not significantly differ between elderly and nonelderly patients (χ2 P value .08). Conclusions: In patients treated for a myasthenia gravis exacerbation, pulmonary function values are significantly reduced in elderly patients compared to nonelderly patients. Despite very low SVC and MIP values most elderly patients do not require intubation however they do require intensive monitoring for serious respiratory complications.

Pulmonary function tests after whole-lung irradiation and doxorubicin in patients with osteogenic sarcoma.

1992 ◽  
Vol 10 (3) ◽  
pp. 459-463 ◽  
Author(s):  
E R Ellis ◽  
R B Marcus ◽  
M J Cicale ◽  
D S Springfield ◽  
F J Bova ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Osteogenic Sarcoma ◽  
Pulmonary Function Testing ◽  
Diffusing Capacity ◽  
Lung Volumes ◽  
Lung Irradiation ◽  
Whole Lung Irradiation ◽  
Function Testing

PURPOSE Because of the scarcity of information regarding long-term follow-up of pulmonary function after whole-lung irradiation, a prospective study was started at the University of Florida in 1979 to evaluate pulmonary function after treatment with whole-lung irradiation and doxorubicin in patients with osteogenic sarcoma. PATIENTS AND METHODS Between 1979 and 1984, 57 osteogenic sarcoma patients with no evidence of metastatic disease at diagnosis received adjuvant therapy consisting of whole-lung irradiation (with the heart shielded) followed by Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH). The whole-lung irradiation schema was 1,600 cGy in 10 fractions with 8-MV x-rays via anterior and posterior fields. This was followed by five cycles of Adriamycin for a total dose of 450 mg/m2. Pulmonary function tests (PFTs) consisting of spirometry, lung volumes, and diffusing capacity were obtained before the whole-lung irradiation, at 6 and 12 months after irradiation, and at yearly intervals thereafter. RESULTS At the time of analysis, 28 of the 57 patients were available for study, with a mean follow-up of 42 months (range, 6 to 77 months). Follow-up pulmonary function testing revealed decreased forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1) during the first 6 to 12 months after whole-lung irradiation. These values returned to baseline during the second-year posttherapy and remained at baseline throughout the remainder of the follow-up period. Changes in lung volumes demonstrated a similar early trend, with significant decreases in total lung capacity (TLC) and functional residual capacity (FRC) at 6 to 12 months. These changes, however, did not improve significantly during the remainder of the follow-up period. Diffusing capacity of the lungs for carbon monoxide (DLCO) also reached a nadir at 6 to 12 months after whole-lung irradiation, with resolution by 2 years and maintenance of at least baseline values for the remainder of the follow-up period. CONCLUSIONS Treatment with whole-lung irradiation and Adriamycin, as given in this study, caused no significant sequelae, as demonstrated by pulmonary function testing during the mean follow-up period of 42 months, although a mild, transient restrictive ventilatory defect occurred at 6 to 12 months after treatment.

Pulmonary Function Testing: A Practical Guide to Its Use in Pediatric Practice

1986 ◽  
Vol 7 (8) ◽  
pp. 235-245
Author(s):  
Howard Eigen
Keyword(s):  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Daily Practice ◽  
Pulmonary Function Testing ◽  
Emergency Room Visits ◽  
Pediatric Practice ◽  
New Techniques ◽  
The Past ◽  
Function Testing

Pulmonary function testing is a useful and important method by which to evaluate patients with or suspected of having lung disease. Pediatricians in the past have taken too little advantage of these techniques in their offices or through referral to pediatric pulmonary function laboratories and, when they have used them, have all too often relied on laboratories designed for adult patients. As with such tests as tympanometry and audiometry, pulmonary function testing should be incorporated into the daily practice of the modern pediatrician. The outlay for equipment is within the means of all pediatricians, and the charges to the patient for testing are quite reasonable, especially because they may be offset by savings from fewer emergency room visits and from a reduction in hospitalizations. One person in the office must function as "technician" and is referred to as such in this article. In most offices, this person will have other responsibilities as well, but having one person fill the role of pulmonary function technician will improve the reliability of the results of the pulmonary function tests performed. Although new techniques are being developed for testing young children and infants, these are beyond the scope of office practice because of the time and equipment they require.

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