American Association for Respiratory Care
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AARC Diagnostics Section

September 2012

OPEN FORUM 2012: Cutting Edge Content for Diagnosticians

AARC Congress 2012 is coming up Nov. 10–13 in New Orleans, and in addition to great lectures and symposiums, we’ll have 20 Open Forums with original research conducted by your peers. So take a few moments to see what’s on tap for RTs working in the diagnostic arena and then register today. It’s the best investment you can make in your career this year—and it’s a great investment for your organization too, because attendees are sure to come home with lots of great ideas aimed at delivering the highest quality pulmonary function testing available today. READ MORE

As you scroll through the Program don’t forget to check out our two great PRE-COURSES. The first addresses patient safety and the second is focused on mechanical ventilation.

IOS, FeNO Useful in Distinguishing Children with Eosinophilic Bronchitis

South Korean researchers find impulse oscillometry (IOS) and fractional exhaled nitric oxide (FeNO) can be used to identify children with chronic cough caused by eosinophilic bronchitis (EB). Their study involved 232 children with asthma, 109 with EB, and 115 healthy controls. Pulmonary function parameters and FeNO levels were measured in all the children, and a screening cutoff value of FeNO was combined with IOS parameters to distinguish children with EB from the controls and identify children with EB with more characteristics of asthma. Results showed:

  • By IOS, the bronchodilator response of the EB and asthma groups increased significantly compared to controls for both reactance at 5 Hz (Δ X5) and reactance area (Δ AX).
  • Cutoff values to distinguish EB from controls were a Δ X5 of -20% (sensitivity, 77.5%; specificity, 49.6%), and Δ AX of -30% (sensitivity, 75.0%; specificity, 46.0%), when the FeNO was 20 ppb.

The authors believe these findings suggest “EB in children shows airway characteristics similar to those of asthma, and that a continuum exists between asthma and EB.” The study was published ahead of print by Pediatric Pulmonology on July 23. READ ABSTRACT

How Hot, Humid Air Affects Asthma

Cold dry air is known to aggravate asthma, but hot humid air can have ill effects, too. Now research conducted at the University of Kentucky Medical Center is helping to explain why. The investigation involved six patients with mild asthma and six healthy controls, all of whom were asked to breathe into a device designed to deliver hot or room temperature air for four minutes. The subjects were also asked to pant. Airway resistance was measured before and for 16 minutes immediately following the challenge. Body temperature, heart rate, arterial blood pressure, and oxygen saturation were assessed pre- and post-test as well. Breathing hot, humid air triggered an immediate increase in airway resistance and a consistent cough in patients with mild asthma but led to only a very small or no response in healthy subjects. However, when the subjects with asthma used an ipratropium aerosol before the challenge, they did not experience airway constriction. Since ipratropium is known to prevent airway muscle contraction and increase airflow to the lungs, the researchers speculate hot humid air triggers asthma symptoms by activating airway sensory nerves that are sensitive to an increase in temperature. The study appeared in the June edition of the American Journal of Respiratory and Critical Care Medicine. READ PRESS RELEASE

Predicting Lung Function Decline and Mortality in Early COPD

Johns Hopkins investigators set out to clarify the course of lung function decline in smokers with early airflow obstruction and to determine the spirometic characteristics that identify individuals at risk for a rapid decline and early mortality in a new study in the June edition of the American Journal of Respiratory and Critical Care Medicine. Based on data from the Lung Health Study, they found individuals with lower lung function by any metric experienced a more rapid decline in adjusted FEV1, with a threshold for differential decline present at FEV1/FVC less than 0.65 and a Z-score less than -2. The authors conclude, “Individuals with lower baseline FEV1/FVC have more rapid decline and worse mortality.” READ ABSTRACT

Step Oximetry System Measures Exercise Capacity in PAH, CTEPH Patients

A new study out of Canada finds a step oximetry system constructed from an aerobics step equipped with pressure sensors and a pulse oximeter linked to a computer can measure exercise performance in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH). The researchers tested the system on 86 patients, 52 with PAH and 14 with CTEPH, along with 20 controls. Results were significantly worse for the PAH and CTEPH patients, and a good correlation was seen between the step test and 6 minute walk test. The investigators also found a correlation between the saturation deviation on the step test and diffusion capacity of the lung. The authors conclude, “Patients with PAH/CTEPH have significant limitation in step climbing ability that correlates with functional class and 6-min walking distance.” The study was published ahead of print in Clinical Research in Cardiology on Aug. 9. READ ABSTRACT

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