Restricted Pulmonary Function in Cystic Fibrosis: Materials and Methods

Pulmonary Function Tests
Spirometry was performed on a spirometer (Ohio 842) according to recommendations of the American Thoracic Society’s Snowbird Conference before and after bronchodilator administration. Absolute pulmonary volumes were measured by three techniques: (1) body plethysmography using a constant-volume plethysmograph (Collins); (2) open-cireuit nitrogen washout; and (3) radiographic TLC by planimetry Plethysmographic airway resistance (Raw) and maximal inspiratory pressure were also measured. Reference values used were those of Knudson and co-workers for spirometry and those of Polgar and Promadhat (age less than or equal to 16) or Naimark and co-workers (age over 16) for pulmonary volumes. type two diabetes medications

Chest Radiographic Grading Posteroanterior and lateral chest roentgenograms were graded on two separate occasions by an experienced chest radiologist (PJ.F.) using a scoring system modified from that described by Brasfield and co-workers. A grade was assigned for each of the following specific characteristics: air trapping (0 to 4); bronchial wall markings (0 to 4); small nodular or cystic lesions (0 to 4); large air-space lesions (0 to 5); and general severity (0 to 4) (0 = normal; 4 = most severe). Grades for each of the five categories were summed and subtracted from 25 to obtain a total score of 4 (most severe) to 25 (normal). On the first reading, each patients films were examined separately On the second reading, the set of 20 roentgenograms was sorted without knowledge of the initial scores according to severity for each of three criteria: bronchial markings; nodular lesions; and general severity.
Clinical Scoring
Patients who returned for the 1985-86 annual examination were evaluated and graded on the categories of physical examination, activity, and nutrition on a scale of 1 to 25 (1 = most severe disease; 25 = normal). This scale is modified from the one originally published by Shwachman and Kulczycki. The scores for each category were summed to give an overall clinical score of 3 (most severe) to 75 (normal).
Statistical Methods
Results for restricted and nonrestricted patients were compared by paired f-test for general characteristics of patients and pulmonary function tests (continuous variables) and Wilcoxons signed-rank test for clinical and radiographic grades (discrete variables). Correlations involving clinical and radiographic grades were performed by Spearmans rank correlation. Analysis of changes in pulmonary function over one year of follow-up was performed by two-way analysis of variance of group (restricted and nonrestricted) vs time (1984-85 and 1985-86 test results).

Category: Pulmonary Function

Tags: airway, cystic fibrosis, Pulmonary Function