July 2008

Notes from the Section

  • Summer Bulletin Online Now: The Summer edition of our Section Bulletin is online now, with great articles on section activities and applying the 2005 ATS/ERS PFT recommendations. READ THE ISSUE 
  • Nominate a Section Member for Specialty Practitioner of the Year: The deadline to nominate section members for our Specialty Practitioner of the Year award is coming up August 31. So take a few moments to consider a worthy member for this important award, then use the nomination form on the SECTION WEB SITE to make your nomination.

MVV Good Measure of Daily Physical Activity Levels in COPD
Brazilian researchers who studied the relationship between physical activity in daily life and COPD severity as assessed by maximal voluntary ventilation (MVV), inspiratory capacity (IC), and FEV1 found:

  • MVV was significantly correlated to total energy expenditure per day, energy expenditure per day in activities demanding more than 3 metabolic equivalents, number of steps per day, and time spent per day in moderate and vigorous activities.
  • Correlation of these variables with IC and especially FEV1 was more modest, borderline, or not statistically significant.
  • There was no difference in time spent in vigorous activities among patients classified according to the FEV1-based GOLD stages II, III, and IV; this differed from that observed when patients were classified in groups according to their MVV.

The authors believe these finding suggest MVV is a better measure of physical activity levels in daily life than either the FEV1 or IC. The study was published in the June 21 Epub edition of Respiratory Medicine. READ ABSTRACT

Symptoms Help Determine Who Needs Spirometry
The importance of primary care spirometry to earlier detection and treatment of COPD is gaining ground in health care. But determining who should be tested is less clear. A new study out of Norway identifies key symptoms that should lead to a spirometry test. Researchers performed spirometry and administered questionnaires about symptoms to 3,954 people age 60 and older. Airflow limitation prevalence was 15.5% in women and 20.8% in men, with the prevalence of severe airflow limitation identified in 3.4% and 4.9%, respectively. Chronic cough with phlegm had a positive predictive value of 37% in women and 40.4% in men (17.3% and 14.2% for severe airflow limitation, respectively). Coughing was less common among ex-smokers, but wheezing persisted despite cessation. Independent predictors of airflow limitation were wheezing, dyspnea on unhurried or quick walking, and coughing with phlegm. However, smoking status (current smoker or ex-smoker) were of greater value as predictors. Never smokers and ex-smokers with 2 of the 3 main symptoms (wheezing, dyspnea, and coughing with phlegm) were nearly twice as likely to have airflow limitation than never smokers or ex-smokers with just 1 of the symptoms. Smokers with none of the 3 symptoms had similar airflow obstruction as ex-smokers with 2 of the symptoms. The study appeared in the June issue of the Scandinavian Journal of Primary Health Care. READ ABSTRACT

Asthma Camp Results in Drop in FeNO Levels
Vermont investigators who measured fractional concentration of exhaled nitric oxide (FeNO), FEV1, and asthma control in 27 children at the beginning and end of a 1-week asthma summer camp believe the education children receive at these camps regarding adherence to therapy and/or reducing exposure to pro-inflammatory stimuli in the home environment may be resulting in a drop in FeNO levels. Results showed FeNO levels declined by a mean of 14% by the end of camp, even though none of the children had a change in their anti-inflammatory therapy. “The finding of reduced inflammation following attendance at an asthma summer camp should motivate the child, the parents and the clinician to focus their efforts on improving adherence to therapy and reducing exposures at home,” write the authors. The study was published in the June issue of the Journal of Asthma. READ ABSTRACT

Noninvasive Testing of PaCO2
Blood sampling is currently required to achieve accurate measurements of arterial PCO2 (PaCO2) because end-tidal PCO2 (PETCO2) of the expired gas does not always reflect the mean alveolar PCO2 and PaCO2 due to differences between the two that result from regional inhomogeneities in perfusion and gas exchange. Researchers from Canada and Japan decided to see whether breathing via a sequential gas delivery circuit could sufficiently reduce these inhomogeneities to allow accurate prediction of PaCO2 from PETCO2. Their study, conducted in 5 healthy middle-aged men, found:

  • The difference between PETCO2 and average PaCO2 was 0.5 +/- 1.7 mmHg, whereas the mean difference between the 2 measurements of PaCO2 was -0.1 +/- 1.6 mmHg.
  • Repeated measures ANOVAs revealed no significant differences between PETCO2 and PaCO2 over the ranges of PO2, f, and target PETCO2.

The authors conclude, “When breathing via a sequential gas delivery circuit, PETCO2 provides as accurate a measurement of PaCO2 as the actual analysis of arterial blood.” The study appeared in the June 19 Epub edition of the Journal of Physiology. READ ABSTRACT


 

Click to go to AARC.org...


© 2008, American Association for Respiratory Care.
To be removed from this list, please send your request to info@aarc.org.