Changes in Forced Expiratory Volumes Throughout the Day

Lewinsohn, Hilton C.; Capel, L.H.; Smart, J.

doi:10.1136/bmj.1.5171.462

Cited by 102 publications

(47 citation statements)

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“…Circadian variations in lung function have also been described in patients with stable COPD, but have received considerably less attention [5][6][7][8]. COPD symptoms such as breathlessness are typically described as ''characteristically persistent and progressive'' [1].…”

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confidence: 99%

Symptom variability in patients with severe COPD: a pan-European cross-sectional study

Kessler

Partridge²,

Miravitlles³

et al. 2010

Eur Respir J

335

312

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In between exacerbations, chronic obstructive pulmonary disease (COPD) is usually regarded as a stable condition, but there is increasing recognition of variability in this state. This cross-sectional study assessed patients' perception of symptom variability.Participants were outpatients .45 yrs old with COPD, current or ex-smokers, forced expiratory volume in 1 s (FEV1) ,50% predicted, FEV1/forced vital capacity ,0.7 and no exacerbation leading to therapeutic intervention in the previous 3 months. Patients' perceptions of COPD symptoms and their impact on daily life activities were recorded. Alterations in therapy use in response to COPD worsening were also recorded.COPD symptoms were experienced by 2,258 (92.5%) out of 2,441 patients during the 7 days before interview. Breathlessness was the most common symptom (72.5%). Daily and/or weekly symptom variability was reported by 62.7% of symptomatic patients; the morning was the worst time of day. Factors associated with perception of variability of breathlessness included younger age, symptom severity and recruitment to the study by general practitioners. The perception of variability was significantly different between European countries or regions.Patient-perceived COPD symptoms vary over the day and the week, and impact on daily activities; morning being the worst time of day. The majority of patients appear not to adjust treatment when symptoms worsen.

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confidence: 99%

Symptom variability in patients with severe COPD: a pan-European cross-sectional study

Kessler

Partridge²,

Miravitlles³

et al. 2010

Eur Respir J

335

312

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“…It is difficult to evaluate that study because all of the results were presented as figures. (19) The patients included in that study formed a heterogeneous group with chronic bronchitis or emphysema (with or without asthma), and, during the study period, none of the patients were under pharmacological treatment, which precludes the comparison between our results and those of that study. McCarley et al (20) studied airway patency (as measured by PEF) in COPD patients, using cosinor analysis and describing the circadian rhythm of PEF on 8 consecutive days (at 11:00 a.m., 3:00 p.m., and 7:00 p.m.).…”

Section: Resultsmentioning

confidence: 60%

“…The authors measured FEV 1 and PEF significant differences between diurnal and nocturnal values having been observed in the latter. In another study, one group of authors (19) investigated the magnitude of variations in FVC and FEV 1 between 10 p.m. and 6:00 a.m. in 5 healthy male subjects and 16 male patients with obstructive airway disease, which was severe in 12. The authors found that FVC and FEV 1 were lowest at 6:00 a.m. in both groups, having reported that relatively large spontaneous variations in FVC and FEV 1 occurred between 9:00 a.m. and 5:00 p.m.…”

Section: Resultsmentioning

confidence: 99%

Variação diurna de parâmetros de função pulmonar e de força muscular respiratória em pacientes com DPOC

et al. 2012

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Objective: To evaluate the magnitude of diurnal changes in the parameters of pulmonary function and respiratory muscle strength/endurance in a sample of patients with COPD. Methods: A group of 7 patients underwent spirometry, together with determination of MIP and MEP, at two distinct times (between 8:00 and 8:30 a.m. and between 4:30 and 5:00 p.m.) on a single day. Between assessments, the patients remained at rest in the laboratory. Results: In accordance with the Global Initiative for Chronic Obstructive Pulmonary Disease staging system, COPD was classified as moderate, severe, and very severe in 1, 3, and 3 of the patients, respectively. From the first to the second assessment, there were significant decreases in FVC, FEV 1 , and MEP (of 13%, 15%, and 10%, respectively), as well as (less than significant) decreases in PEF, MIP, and maximal voluntary ventilation (of 9%, 3%, and 11%, respectively). Conclusions: In this sample of COPD patients, there were diurnal variations in the parameters of pulmonary function and respiratory muscle strength. The values of FEV 1 , FVC, and MEP were significantly lower in the afternoon than in the morning.Keywords: Pulmonary disease, chronic obstructive; Respiratory function tests; Respiratory muscles. ResumoObjetivo: Avaliar a magnitude de mudanças diurnas em parâmetros de função pulmonar e de força e resistência dos músculos respiratórios em uma amostra de pacientes com DPOC. Métodos: Um grupo com 7 pacientes foi submetido a espirometria e a determinação de PImáx e PEmáx em dois momentos (entre 8h00 e 8h30 e entre 16h30 e 17h00) em um único dia. Os pacientes permaneceram em repouso na área do laboratório entre as avaliações. Resultados: De acordo com o sistema de estadiamento da Global Initiative for Chronic Obstructive Pulmonary Disease, a doença foi classificada como moderada, grave e muito grave em 1, 3 e 3 pacientes, respectivamente. Da primeira para a segunda avaliação, houve uma queda significativa em CVF, VEF 1 e PEmáx (de 13%, 15% e 10%, respectivamente), bem como uma queda não significativa em PFE, PImáx e ventilação voluntária máxima (de 9%, 3% e 11%, respectivamente). Conclusões: Nesta amostra de pacientes com DPOC, houve variações diurnas nos parâmetros de função pulmonar e de força de músculos respiratórios. Os valores de VEF 1 , CVF e PEmáx foram significativamente menores à tarde do que de manhã.Descritores: Doença pulmonar obstrutiva crônica; Testes de função respiratória; Músculos respiratórios. ethics committee, and written informed consent was given by all of the patients. The patients underwent pulmonary function testing, together with determination of MIP and MEP, at two different times (between 8:00 and 8:30 a.m. and between 4:30 and 5:00 p.m.) on a single day. Between tests, the participants remained at rest in a comfortable room. They were allowed to read or walk in a garden around the laboratory and were served a meal during the period between tests. A maximum of two individuals were studied on the same day. All of the patients took their re...

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“…The maximal effect of bambuterol occurs during the night, which is shown in this study to be around 4 a.m., i.e. the time when patients often experience a worsening of their symptoms [14][15][16]. In another study, in which bambuterol was given either in the morning or in the evening, the evening administration was found to produce a maximal effect around 4 a.m. about 29% better than placebo [17].…”

Section: Discussionmentioning

confidence: 99%

One month treatment with the once daily oral beta 2-agonist bambuterol in asthmatic patients

Persson

Baas²,

Knight³

et al. 1995

Eur Respir J

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O On ne e m mo on nt th h t tr re ea at tm me en nt t w wi it th h t th he e o on nc ce e d da ai il ly y o or ra al l β 2 2 --a ag go on ni is st t b ba am mb bu ut te er ro ol l i in n a as st th hm ma at ti ic c p pa at ti ie en nt ts s The study was conducted as a double-blind, randomized, parallel group placebocontrolled, multicentre trial. It started with a one week run-in period with placebo, when oral bronchodilators were withdrawn. At the end of this reference period, the patients were randomized to one of three treatments: placebo, bambuterol 10 mg, or bambuterol 20 mg, once daily in the evening. The treatment period lasted for 4 weeks. Four hundred and eighty seven patients with a mean age of 45 yrs were included.Mean baseline forced expiratory volume in one second (FEV 1 ) and FEV 1 % of predicted were 2.05 l and 62%, respectively. Administration of 10 mg bambuterol resulted in a significant 24 h effect duration, expressed as an increase in mean daily morning and evening peak expiratory flow (PEF) (+11 l·min -1 , adjusted means) throughout the study, as compared with placebo. Bambuterol, 20 mg, gave a significant 24 h effect duration in both FEV 1 and morning and evening PEF as compared with placebo. Furthermore, the adverse events observed during the study were relatively few and mild.In conclusion, once daily oral bambuterol is a long-acting bronchodilator, leading to improvements in spirometry and in peak flows during regular treatment. Therefore, bambuterol should be considered as a suitable alternative for treatment of asthma.

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Changes in Forced Expiratory Volumes Throughout the Day

Abstract: ESTIMATING ARTERIAL AND MIXED VENOUS pCO, MED] a plateau. Less commonly we have also seen apparent

Cited by 102 publications

References 1 publication

Symptom variability in patients with severe COPD: a pan-European cross-sectional study

Symptom variability in patients with severe COPD: a pan-European cross-sectional study

Variação diurna de parâmetros de função pulmonar e de força muscular respiratória em pacientes com DPOC

One month treatment with the once daily oral beta 2-agonist bambuterol in asthmatic patients

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