Assessment for Rehabilitation of COVID-19
Wenguang Xia, Xiaolin Huang in Rehabilitation from COVID-19, 2021
Rehabilitation training for COVID-19 patients requires professional rehabilitation physicians to formulate exercise prescriptions based on patients’ specific conditions. The formulation of exercise prescription depends on systematic assessment for rehabilitation, which should run through the whole process of rehabilitation treatment. The system of rehabilitation assessment for COVID-19 patients mainly includes assessments for respiratory function, physical function, and psychosocial function. The examination results can determine the degree and type of lung damage caused by the disease, helping clinicians make accurate diagnoses and develop scientific treatment plans. Lung volume includes tidal volume, inspiratory reverse volume, inspiratory capacity, vital capacity, residual volume, functional residual capacity, and total lung capacity, among which vital capacity is the most commonly used. Vital capacity of healthy adults varies greatly depending on genders, ages, body types, and exercises. Common clinical indexes are maximum ventilatory volume, forced vital capacity, or forced expiratory volume.
Pulmonary Function, Asthma, and Obesity
David Heber, Zhaoping Li in Primary Care Nutrition, 2017
Obesity significantly interferes with pulmonary function by decreasing lung volumes, particularly the expiratory reserve volume (ERV) and functional residual capacity (FRC). Strength and resistance may be reduced as the result of muscle weakness, especially in those with sarcopenic obesity associated with aging. These mechanical limitations lead to inspiratory overload, which increases respiratory effort, oxygen consumption, and respiratory energy expenditure. Body fat distribution significantly influences the function of the respiratory system, likely via the direct mechanical effect of fat accumulation in the chest and abdominal regions, as well as the systemic cytokines released by visceral fat. Asthma and obstructive sleep apnea (OSA) are obesity-associated diseases that involve interactions among environmental, genetic, and behavioral factors.
Respiration
Sarah Armstrong, Barry Clifton, Lionel Davis in Primary FRCA in a Box, 2019
This chapter explains that oxygen dissociation curve describes the percentage oxygen occupancy of haemoglobin and other carrier molecules at different partial pressures of oxygen. Carbon monoxide has about 210 times the affinity for oxygen as haemoglobin thus reducing oxygen-binding capacity. Inspiration is active, while expiration is passive. Work is done to overcome elastic forces of the lung, airway resistance to gas flow, tissue resistance. The fraction of mixed venous blood bypassing oxygenation in the lungs. The chapter informs that functional residual capacity is the volume of gas remaining in the lungs at the end of a normal expiration. It is the balance point between the tendency of the chest wall to spring outwards and the tendency of the lung to collapse inwards. Airways resistance describes the obstruction to airflow by the conducting airways (larger airways) plus tissue resistance produced by friction as tissues of the lung slide over each other during respiration.
Predictors for P
Published in COPD: Journal of Chronic Obstructive Pulmonary Disease, 2014
E.W. Saure, T.M.L. Eagan, R.L. Jensen, P.S. Bakke, A. Johannessen, M. Aanerud, R.M. Nilsen, E. Thorsen, J.A. Hardie
Background: Knowledge about predictors for developing hypoxemia in the course of chronic obstructive pulmonary disease (COPD) progression is limited. The objective of the present study was to investigate predictors for overall PaO2, for a potential change in PaO2 over time, and for first occurrence of hypoxemia. Methods: 419 patients aged 40–76 years with COPD GOLD stages II-IV underwent clinical and pulmonary function measurements, including repeated arterial blood gases over three years. Airway obstruction, lung hyperinflation, markers of systemic inflammation and cardiovascular health, exacerbation frequency, smoking habits, and body composition were tested as possible predictors of PaO2 and first episode of hypoxemia. Results: In multivariate adjusted longitudinal analyses, forced expiratory volume in 1 second, total lung capacity and functional residual capacity (all in% predicted), resting heart rate and fat mass index were all associated with overall PaO2 (all P < 0.005). We found no change in PaO2 over time (ρ = 0.33), nor did we find evidence that any of the tested variables predicted change in PaO2 over time. In multivariate adjusted survival analyses, functional residual capacity and resting heart rate were predictors of episodic hypoxemia (both ρ < 0.005). Conclusions: This longitudinal study identified pulmonary, cardiac and metabolic risk factors for overall PaO2 and episodic hypoxemia, but detected no change in PaO2 over time.
Pulmonary Function Changes Which Accompany Athletic Conditioning Programs
Published in Research Quarterly. American Association for Health, Physical Education and Recreation, 1968
Pulmonary function measurements were made on swimmers and wrestlers undergoing four months of typical athletic conditioning programs and on a control group involved in no conditioning program. Significant changes were found only in the swimmers where functional residual capacity, residual volume, the ratio of residual volume/ total lung capacity, and respiratory rate decreased with training. However, vital capacity increased significantly due to a large increase in the inspiratory capacity. Total lung capacity and expiratory reserve volume remained constant. No significant alterations occurred in the pulmonary functions measured in the other two groups of subjects.
Perfluorocarbon Induced Alterations in Pulmonary Mechanics
Published in Artificial Cells, Blood Substitutes, and Biotechnology, 1998
David M. Eckmann, Melody A. Swartz, Matthew R. Glucksberg, Noam Gavriely, James B. Grotberg
Perfluorocarbon (PFC) compounds induce pulmonary hyperinflation and respiratory distress in some animals following intravenous administration. This study was designed to quantify the effects of two PFC emulsions on lung volumes and compliance and to identify the mechanism of pulmonary hyperinflation. New Zealand White rabbits received isotonic saline (3ml/kg), Fluosol (15ml/kg) or Oxygent (90% perfluorooctyl-bromide emulsion, 3ml/kg). After seven days we measured functional residual capacity, vital capacity, lung compliance and thoracic gas volume. Gross and microscopic histologic examination of the lungs was performed. Functional residual capacity after Fluosol administration was 16.0 ± 4.0 ml/kg, significantly greater than after saline (3.4 ± 1.0 ml/kg) or Oxygent (4.0 + 1.4 ml/kg). Vital capacity was lower with Fluosol (30 ± 5.0 ml/kg) than after saline (37 ± 3.0 ml/kg) or Oxygent (37 ± 2.0 ml/kg). Thoracic gas volume increased from 9 ± 1.0 ml/kg (saline) to 16 ± 13 ml/kg (Oxygent) and 33 ± 7.0 ml/kg (Fluosol). Lung compliance was the same after saline (1.6 ± 0.5 mlcm H2O-' -kg1) and Oxygent (1.5 ± 0.3 ml-cra H2O'-kg1) but lower after Fluosol (0.9 ± 0.1 ml-cm H2O4 -kg-1). Gross pathology demonstrated foam exudation from airways of animals receiving PFCs and intra-alveolar foam was identified by light microscopy. These results show intra-airway foam formation causes gas trapping and shifts tidal breathing to a less compliant region of the pressure-volume curve.