October 2013

Notes from the Section

• If you’ll be heading to Anaheim for AARC Congress 2013 next month, be sure to put our section business meeting on your schedule. We’ll be gathering from 12:15-12:45 p.m. on Sunday, Nov. 17.
• The Fall edition of our Section Bulletin is out now, so click over to read an update on section activities along with great articles on HAST testing and nSpire plethysmography system maintenance tips. READ ISSUE

BPD Has Lasting Consequences

Preterm infants with a history of bronchopulmonary dysplasia (BPD) born in the surfactant era are still more likely to suffer from lung function abnormalities and respiratory symptoms than similar infants born without BPD. That’s the take home message from German researchers who compared outcomes among 28 very low birth weight (VLBW) infants with a history of BPD and 28 VLBW infants without a history of the condition. At a mean follow up of 9.5 years, respiratory symptoms were reported in 36% of the BPD patients vs. 8% of those without BPD. Asthma medication prescriptions were seen in 21% vs. 0%, and FEV1, FVC, and forced expiratory flow rate at 50% of FVC were all significantly lower in the BPD patients. The study was published ahead of print by the Journal of Pediatrics on Sept. 19. READ ABSTRACT

Spirometry Still Underutilized for COPD

COPD guidelines clearly state that spirometry is necessary for both diagnosis of the condition and ongoing management. But according to a new study out of the University of Texas Medical Branch at Galveston, many patients are still going without the test. Researchers examined newly-diagnosed Medicare beneficiaries using a 5% sample of beneficiaries from 1999 and 2008. While the percentage of patients who received spirometry within a year before or after the initial diagnosis did increase over the time period, 51.3% vs. 58.3%, more than 40% still went without the test. Patients who were younger, male, and white were more likely to receive spirometry, as were those with a higher socioeconomic status and those who had more comorbidities. The study was published ahead of print by the Annals of the American Thoracic Society on Sept. 20. READ ABSTRACT

CDC Researchers Report Normative Values for FeNO

Researchers from the Centers for Disease Control and Prevention reported normative values for fractional exhaled nitric oxide (FeNO) ahead of print in Respiratory Medicine on Sept. 13. The values were derived from an analytic sample of 4718 youths and adults ages 6-79 years who never smoked and did not have asthma or other respiratory symptoms. Results showed:

• The geometric mean FeNO level was 8.3, 12.1, and 16.2 ppb for males 6-11, 12-19, and 20-79 years, and 8.4, 10.9, and 12.6 ppb for females in the corresponding age groups.
• Overall, FeNO levels increased with increasing age and height.
• In all age groups, FeNO levels were positively associated with eosinophil counts, and with testing in the morning.
• Among youths 6-11 and 12-19 years, non-Hispanic whites had lower FeNO values than non-Hispanic blacks and Hispanic youths.
• No race-ethnic difference in FeNO levels was evident for adults 20-79 years.
• Among adolescents and adults, FeNO levels were higher for males than for females, controlling for all other factors.

The authors believe these reference values can help clinicians evaluate the role of FeNO in airway diseases. READ ABSTRACT

Opening Interrupter Technique Measures Respiratory Resistance

Italian investigators report good results for the use of the opening interrupter technique in diagnosing airway obstruction in preschool children with asthma and cystic fibrosis. The research was conducted among 82 children with one or both of these conditions and 50 healthy controls. All were between the ages of three and five and were tested between February of 2011 to June of 2012. Respiratory resistance (o-Rint) was assessed via the opening interrupter technique during quiet breathing. Higher values of o-Rint were seen in both asthma and CF patients vs. controls, but there were no significant differences between asthma and CF patients. Likewise, a significant inverse correlation was noted between o-Rint and height in children with asthma and CF, but not in the healthy controls. The study was published ahead of print by the Journal of Asthma on Sept. 18. READ ABSTRACT