Document Detail

Trial of standard versus modified expiration to achieve end-of-test spirometry criteria.
MedLine Citation:
PMID:  8342888     Owner:  NLM     Status:  MEDLINE    
To assess whether satisfying American Thoracic Society (ATS) end-of-test spirometry criteria can be enhanced by modifying the patient's expiratory technique, we conducted a cross-over trial of two expiratory techniques in 48 patients with a range of pulmonary functions (Group 1, n = 12: FEV1/FVC < 0.45; Group 2, n = 11: FEV1/FVC, 0.45 to 0.60; Group 3, n = 16: FEV1/FVC, 0.61 to 0.74; Group 4, n = 9: FEV1/FVC > or = 0.75). After randomizing the order of testing, each patient performed three exhalations using a "standard" forced expiratory maneuver and a modified expiratory technique consisting of an initial maximal expiratory effort followed by a "relaxed expiration" for as long as possible. Patients initiated "relaxed expiration" when instructed by the supervising technician, who issued the instruction to relax when expiratory airflow fell to < or = 200 ml/s (as determined by flow-volume loop analysis). ATS end-of-test criteria were satisfied significantly more often using the modified expiratory technique (58.3% of testing sessions) than using the standard technique (18.7% of sessions, p = 0.001) because of prolongation of the forced expiratory time (FET) with the modified technique in all patient groups. In the 38 patients with FEV1/FVC < or = 0.75, the largest FVC and FET rose significantly using the modified expiratory technique, without compromising the largest FEV1 in any group. In patients with FEV1/FVC > or = 0.75, FET increased without concomitant changes in FVC or FEV1.(ABSTRACT TRUNCATED AT 250 WORDS)
J K Stoller; S Basheda; D Laskowski; M Goormastic; K McCarthy
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  148     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1993 Aug 
Date Detail:
Created Date:  1993-08-31     Completed Date:  1993-08-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  275-80     Citation Subset:  AIM; IM    
Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Foundation, OH 44195-5038.
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MeSH Terms
Aged, 80 and over
Bronchitis / physiopathology
Forced Expiratory Volume* / physiology
Maximal Midexpiratory Flow Rate
Middle Aged
Patient Compliance
Patient Satisfaction
Peak Expiratory Flow Rate
Pulmonary Emphysema / physiopathology
Pulmonary Ventilation / physiology
Reproducibility of Results
Spirometry / methods*
Time Factors
Vital Capacity* / physiology
Comment In:
Am Rev Respir Dis. 1993 Aug;148(2):274   [PMID:  8342887 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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