Comparison Between Peak Expiratory Flow and Forced Expiratory Volume in One Second (FEV<sub>1</sub>) During Bronchoconstriction Induced by Different Stimuli

Giannini, D; Paggiaro, Pier Luigi; Moscato, Gianna; Gherson, G; Bacci, Elena; Bancalari, L; Dente, Fl; Franco, Antonella Di; Vagaggini, Barbara; Giuntini, C.

doi:10.3109/02770909709075654

Cited by 41 publications

(27 citation statements)

References 18 publications

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“…Most investigators use spirometry, although some have used peak flow meters [12]. Considering the low sensitivity of peak expiratory flow measured using portable peak flow meters [22], spirometry is preferable. The relative advantages of frequent versus occasional monitoring of lung function have not been formally studied.…”

Section: Pulmonary Function Monitoringmentioning

confidence: 99%

Sputum induction

Chanez¹,

Holz²,

Ind³

et al. 2002

Eur Respir J

125

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The aim of sputum induction is to collect an adequate sample of secretions from lower airways in subjects who do not produce sputum spontaneously in order to study the features of airway inflammation in asthma and other respiratory disorders. Inhalation of isotonic or hypertonic solutions administered by nebulisation has been demonstrated to induce a small amount of airway secretion that can be expectorated and analysed. The mechanisms by which this occurs are not known, but both direct and indirect mechanisms are likely to be involved. It is believed that the increased osmolarity of the airway lining fluid increases vascular permeability in the bronchial mucosa and induces production of mucus by submucosal glands. Animal studies have shown that hypertonic saline increases vascular permeability in the airways, and this effect can be modulated by capsaicin [1]. However, in vivo instillation of hypertonic solution into the airways of animals and humans induces an increase in the levels of several mediators but no rise in levels of albumin or other markers of increased vascular permeability [2,3]. Therefore, this hypothesis has not been confirmed, and only preliminary measurements of sputum osmolarity after induction have been reported with conflicting results [4]. Conversely, previous reports have demonstrated increased clearance of secretions from the airways in humans after administration of hypertonic saline aerosol [5], perhaps by facilitating the collection of small amounts of pre-existing airway secretions.Although sputum induction has been used extensively since the 1990s, few methodological studies have examined the influence of various technical factors on the feasibility and repeatability of sputum induction and collection. As with other techniques, the lack of a "gold standard" makes it hard to evaluate the influence of these technical factors on the adequacy and accuracy of sputum induction.The technique of sputum induction consists of inhaling an aerosol of saline (either normal or hypertonic) over different time-periods. Volunteers/ patients are instructed to expectorate into a container. Various issues must be considered with regard to this procedure: 1) facilities, equipment and personnel; 2) bronchodilator pretreatment; 3) pulmonary function monitoring; 4) concentration of saline solution and nebuliser output; 5) duration of inhalation; 6) expectoration technique; 7) spontaneous versus induced sputum; and 8) frequency of sputum induction. The influence of these factors on the feasibility of the technique must be evaluated in terms of the success rate, repeatability and accuracy of the results obtained.

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Section: Pulmonary Function Monitoringmentioning

confidence: 99%

Sputum induction

Chanez¹,

Holz²,

Ind³

et al. 2002

Eur Respir J

125

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“…PEF is not able to assess bronchodilator response compared to FEV1 (DPEF of o10%, o15%, o20% baseline has a positive predicting value of 36%, 52%, and 67%, respectively for DFEV1 o9% pred) [43]. During acute bronchoconstriction induced by different stimuli in the laboratory, the concordance (Cohen9s weighted kappa) between classes of changes in FEV1 and PEF was low (0.28-0.42 in different challenges) [44]. The sensitivity of PEF in detecting mild, induced bronchoconstriction was lower than FEV1, with a 10% change in PEF resulting in a 15% change in FEV1 ( fig.…”

Section: Technical Considerationsmentioning

confidence: 99%

“…The sensitivity of PEF in detecting mild, induced bronchoconstriction was lower than FEV1, with a 10% change in PEF resulting in a 15% change in FEV1 ( fig. 1) [44].…”

Section: Technical Considerationsmentioning

confidence: 99%

Questionnaires, spirometry and PEF monitoring in epidemiological studies on elderly respiratory patients

Bellia¹,

Pistelli²,

Giannini³

et al. 2003

Eur Respir J

Self Cite

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Questionnaires are the most used subjective instrument of measurement in respiratory epidemiology. The standardisation of the questionnaires aims to limit bias by maximising validity and reliability, and comparability. Within the European Union project BIOMED1, a compendium of respiratory standard questionnaires (CORSQ) was developed for adults covering 18 topics from general information to early life events, through environmental risk factors and respiratory symptoms and diseases.Reliable spirometry data needs a rigorous quality control programme, as in the "Salute Respiratoria nell9Anziano" (Sa.R.A.) project, Italian for "Respiratory Health in the Elderly". Reproducibility rates were 95.8% for forced expiratory volume in one second (FEV1). Male sex and age were independent risk factors for a poorer reproducibility, as well as cognitive and physical impairment (shorter 6-min walking distance) and lower educational level for a poorer acceptability. Reference values for people aged 65-85 yrs have been produced; these results suggest that the effect of aging should be corrected for physical and mental disability. A revision of interpretative strategies included in current guidelines is needed.Peak expiratory flow monitoring has several methodological problems: reliability and sensitivity of the measurement in order to detect changes in airway calibre; compliance with long-term monitoring; choice of the best variability index; difference between asthmatic and nonasthmatic subjects; age-related differences. Despite these methodological problems, peak expiratory flow monitoring has been successfully used in the evaluation of the effects of air pollution in normal and asthmatic subjects, and in the elderly. Eur Respir J 2003; 21: Suppl. 40, 21s-27s.

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“…If the origin of the exposure, e.g. a physical form of gas or mixtures, is not clear, an environment provocation test made at the workplace of the patients by means of observation of the appearance of the symptoms and lung function changes may be necessary (23,24). If causative allergens are clear, they may be used to examine skin reactions and to detect specific-IgE antibodies.…”

Section: Diagnosismentioning

confidence: 99%

Diagnosis and prevention of diseases induced by isocyanate

Nakashima

Takeshita

Morimoto

2002

Environ Health Prev Med

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Isocyanates are among the most frequent causes of occupational asthma in industrialized countries. Early diagnosis of diisocyanate asthma followed by prompt termination of chemical exposure can prevent chronic morbidity due to persistent asthma. Chronic exposure to isocyanates also induces hypersensitivity pneumonitis (HP). The accurate diagnosis of diisocynate asthma requires a systematic approach that combines information obtained from the occupational history, immunologic tests and physiologic studies. The prevention of health problems from toluene diisocyanate (TDI), 4,4'-methylenediphenyl diisocyanate (MDI) and 1,6'-hexamethylene diisocyanate (HDI) is essential for all those handling the chemicals. Regulatory exposure limits should be observed. However, wheezing, coughing or even asthmatic attacks may occur after exposure much below the regulatory exposure limits especially in sensitive individuals. Preventing or minimizing exposure is of prime importance and should be supported by the installation of engineering controls, by education of the workforce, by regular monitoring of the workplace exposure and by medical surveillance. To prevent such asthma it is suggested that workers should be tested airway sensitivity and should avoid working in areas that have dust containing specific-IgE. Such tests must be periodically performed after working. Symptoms induced by isocyanate need earlier discover and early isolation of the associated individuals.

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Comparison Between Peak Expiratory Flow and Forced Expiratory Volume in One Second (FEV₁) During Bronchoconstriction Induced by Different Stimuli

Cited by 41 publications

References 18 publications

Sputum induction

Sputum induction

Questionnaires, spirometry and PEF monitoring in epidemiological studies on elderly respiratory patients

Diagnosis and prevention of diseases induced by isocyanate

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Comparison Between Peak Expiratory Flow and Forced Expiratory Volume in One Second (FEV1) During Bronchoconstriction Induced by Different Stimuli

Cited by 41 publications

References 18 publications

Sputum induction

Sputum induction

Questionnaires, spirometry and PEF monitoring in epidemiological studies on elderly respiratory patients

Diagnosis and prevention of diseases induced by isocyanate

Contact Info

Product

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About

Comparison Between Peak Expiratory Flow and Forced Expiratory Volume in One Second (FEV₁) During Bronchoconstriction Induced by Different Stimuli