November-December 2013
Panneerselvam Receives Specialty Practitioner of the Year Award
Balamurugan Panneerselvam, BS, RST, RPSGT, CPFT, was named our 2013 Specialty Practitioner of the Year at AARC Congress 2013 in Anaheim. We’ll have more on Balamurugan in the Winter edition of our section Bulletin.
Nitric Oxide Levels in CF
A new study out of The Netherlands looked at whether fractional exhaled nitric oxide (FENO) and nasal NO (nNO) levels are associated with genotype, nutritional status, presence of nasal polyps, pulmonary function, and airway colonization with Staphylococcus aureus and Pseudomonas aeruginosa in children with cystic fibrosis. The study also aimed to investigate the effect of functional endoscopic sinus surgery (FESS) on FENO and nNO levels in a subset of children also suffering from persistent sinonasal disease. Results showed significantly lower nNO levels in children with nasal polyposis and these values were negatively associated with S aureus colonization. nNO values increased significantly following FESS, although levels remained below normal. The study was published in the Sept. edition of JAMA Otolaryngology-Head & Neck Surgery. READ ABSTRACT
Excessive Body Weight Affects PFTs in Kids
Canadian investigators publishing ahead of print in Pediatric Pulmonology on Oct. 25 find children who are overweight or obese suffer from poorer lung function. They reached that conclusion after analyzing the medical records of 327 children without cardiopulmonary, neuromuscular, or chest wall disease who successfully performed pulmonary function testing at two university children’s hospitals between 2000 and 2007. Results showed:
- Percent predicted ERV was lowest in the obese group while RV was lowest in the overweight and obese groups.
- Underweight participants had a lower percent predicted FVC and VC.
- Obese participants had the lowest FEV1 /FVC.
- A positive linear relationship existed between BMI z-score and percent predicted FVC, VC, and DLCO.
- A negative linear relationship was found between BMI z-score and percent predicted FRC, ERV, RV, and absolute FEV1/FVC.
The authors conclude, “Our results show that increasing weight status in children and adolescents is associated with a general reduction in lung volume measurements, which may reflect impaired lung function, increased respiratory symptoms, and decreased functional status.” READ ABSTRACT
PFTs in Adolescents Impacted by Obesity
Obese adolescents in a study conducted in Brazil presented changes in pulmonary function during rest and exercise, suggesting the model of fat distribution alters pulmonary function differently in these young people. The research was conducted among 92 adolescents, 47 of whom were considered obese. The obese participants had higher blood pressure and heart rate during exercise and SatO2 values decreased. When compared to obese and non-obese females, obese males had higher levels of maximum inspiratory and expiratory pressures as well. When compared to non-obese males, obese males had lower values of maximum voluntary ventilation, FVC, and FEV1 before and after exercise. Greater inspiratory capacity was seen in obese females vs. non-obese females. Lower expiratory reserve volume was seen in obese subjects across the board. The study was published ahead of print by the Jornal de Pediatria on Oct. 31. READ ABSTRACT
Rint in Non-collaborative Subjects
Researchers who compared the resistance by the interrupter technique (Rint) with oscillometry and plethysmography in the measurement of airway resistance in non-collaborative children find mixed results for the value of Rint in this population. The study involved 460 children, 47.6% of whom were under the age of seven. Valid measurements were available for 82.6%. Results showed:
- Reproducibility was very good, and no differences were found among the measurements obtained at separate time intervals.
- Reproducibility of the measurements was not affected by use of mask or mouthpiece, cheek support, or nose clip.
- Resistance values obtained by plethysmography and oscillometry were higher than those obtained using Rint, with a positive correlation between them.
- The higher the degree of airway obstruction, the worse the correlation with plethysmography.
The authors conclude that the Rint measurement is a plausible and reproducible technique, and has an adequate correlation with the resistance measurements obtained using oscillometry or plethysmography. But since it could underestimate resistance in patients with airway obstruction it may not be advisable in “follow-up subjects with a moderate to severe obstructive disease or in bronchial challenge tests.” The study appears in the December edition of the Archivos Argentinos de Pediatria. READ ABSTRACT
