April 2007

Register Now for Section-Only Webcast, May 9
Section members are busy registering now for the section-only webcast on PFTs in Infants scheduled for May 9. This great program, to be presented by Tim Myers, will include all the latest on testing our youngest patients and, what's more, will earn everyone in the section one FREE CRCE. Visit the SECTION WEB SITE to sign up for this new benefit of section membership.

No Need for Bronchodilator Prior to Bronchoscopy
COPD patients probably don't need that pre-bronchoscopy bronchodilator, report Swiss researchers who compared pre- and post-bronchoscopy pulmonary function tests in 120 patients randomly assigned to receive salbuamol, placebo, or no treatment prior to undergoing bronchoscopy. Their results showed no difference in test results among any of the patients, with FEV1 decreasing across the board, despite which pre-bronchoscopy group they were in. The research appeared in the March issue of CHEST. READ PRESS RELEASE

Inhaled Insulin Gets Good Report
A new study out of the University of Miami finds inhaled insulin is both safe and effective over the long run. Researchers compared outcomes among 582 type 1 diabetes patients assigned to either inhaled insulin or injectable insulin over a two year period. While a larger decline in lung function was noted in the inhaled insulin patients, results showed the drop was less than 2% and occurred in the first three months of treatment. Further lung function declines were not noted. Most side effects were about the same in the two groups, although inhaled insulin patients did have a higher incidence of cough. Both treatments were effective in controlling blood sugar, but patients in the inhaled insulin group had significantly fewer incidences of dangerously low blood sugar. The research was published in the March issue of Diabetes Care. READ ARTICLE

PEF Correlates Poorly with FEV1 in the Elderly
Researchers who analyzed spirometry test results from 2,464 healthy elderly people find spirometry maneuvers cannot be excluded based on peak flow variability. The investigators set out to test the premise that within test variability in PEF is associated with corresponding variability in FEV1 during a single test session. Patients with acceptable spirometry were classified into one of two groups. The first group consisted of patients with a normal FEV1/FVC ratio. The second group was comprised of patients with a reduced ratio. From there the differences between the highest and lowest PEF (Delta PEF) and their associated differences in FEV1 (Delta FEV1) were calculated for each individual. Results showed an insignificant association between %Delta PEF and %Delta FEV1. A 29% change in PEF was associated with a 1% change in FEV1 in both groups. “Within a single spirometry test session, %Delta PEF and %Delta FEV1 contain independent information,” write the authors. “PEF has a higher degree of intrinsic variability than FEV1.” The study appeared in the Mar. 30 Epub edition of CHEST. READ ABSTRACT

Fast Deep Inspiration is Bronchoprotective
Research conducted in the pulmonary function laboratory at Mount Sinai School of Medicine suggests a fast deep inspiration (DI) prior to methacholine challenge is bronchoprotective while a slow DI is not. The study was conducted among ten healthy nonsmokers who first underwent methacholine challenge without DI to determine the concentration needed to produce a 20% reduction in FEV1. Participants then underwent additional challenges preceded by either fast DI or slow DI. Results showed a significantly lower mean percent reduction in FEV1 and FVC with a fast DI than with no DI, with slow DI having no significant effect. The authors believe further study to clarify the conditions that maximize or eliminate bronchoprotection in healthy subjects “may ultimately provide insight into the pathophysiology of asthma.” The study appeared in the Mar. 20 Epub edition of Respiratory Medicine. READ ABSTRACT

Upcoming Educational Opportunities from the AARC

• Webcast: Patient Literacy , Aug. 15, one free CRCE for AARC members.
• Summer Meetings: July 12-17 , Reno/Lake Tahoe, NV
• AARC International Respiratory Congress: Dec. 1-4 , Orlando, FL