The Experts below are selected from a list of 306 Experts worldwide ranked by ideXlab platform
Philipp Latzin - One of the best experts on this subject based on the ideXlab platform.
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multiple breath washout a new and promising Lung Function Test for patients with idiopathic pulmonary fibrosis
Respirology, 2018Co-Authors: Sylvia Nyilas, Florian Singer, Philipp Latzin, Theresa Schreder, Alexander Poellinger, Thomas Geiser, Manuela FunkeAbstract:BACKGROUND AND OBJECTIVE Idiopathic pulmonary fibrosis (IPF) is a devastating progressive Lung disease affecting the parenchyma. Nitrogen multiple-breath washout (N -MBW) is a Lung Function Test that measures ventilation inhomogeneity, a biomarker of small airway disease. We assessed clinical properties of N -MBW in IPF. METHODS In this prospective cohort pilot study, 25 IPF patients and 25 healthy controls were assessed at baseline and 10 patients at median 6.2 months later. Outcomes included the Lung clearance index (LCI) from N -MBW, forced vital capacity (FVC) from spirometry, diffusion capacity of the Lungs for carbon monoxide (DL ), bronchiectasis score from computed tomography scans, the Gender-Age-Physiology (GAP score for IPF) stage and death or Lung transplantation (LTx). Study end points were feasibility, repeatability, discriminative capacity and correlation with disease severity and structural Lung damage. RESULTS All patients were able to perform N -MBW. LCI was repeatable and reproducible. Median (interquartile range (IQR)) LCI in IPF was 11.6 (10.1-13.8) in IPF versus 7.3 (6.9-8.4) in controls (P < 0.0001). LCI correlated with DL corrected for haemoglobin (corrDL ; r = -0.49, P = 0.016), bronchiectasis score (r = 0.45, P = 0.024) and the GAP stage (r = 0.59, P = 0.002), but not with FVC. FVC was not related to bronchiectasis. During follow-up, six patients died and one received LTx. LCI correlated with the latter compound outcome: hazard ratio (95% CI) was 2.43 (1.26; 4.69) per one LCI SD from the patient population. CONCLUSION N -MBW is a feasible, reliable and valid Lung Function Test in IPF. LCI correlates with diffusion impairment, structural airway damage and clinical disease severity. LCI is a promising surveillance tool in IPF that may predict mortality.
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An innovative Lung model for multiple breath washout Testing in health and disease
Clinical Biomechanics, 2017Co-Authors: Pinelopi Anagnostopoulou, Massimo Guidi, Sarah Vomsattel, Anne Christiane Kentgens, Severin Binggeli, Lena Kohler, Florian Singer, Philipp Latzin, Dominik ObristAbstract:Background: Multiple breath washout (MBW) is a Lung Function Test that identifies the degree of ventilation inhomogeneity (VI) in the Lungs. In vitro validation of MBW devices is recommended. So far, plastic Lung models for MBW validation ignored variable degrees of VI. Our primary aim was to create a plastic Lung model applicable for physiological Lung volumes and variable VI. Methods: A plastic box divided in two chambers was filled with water and ventilated in various Lung volumes and respiratory rates. A ventilator was used for efficient gas distribution (model with low VI). An additional divider was inserted to create a model with high VI. The model was connected to commercial MBW devices and measurements were performed using different tracer gases and conditions. Primary outcome was the precision of generated Functional residual capacity (FRC) and the ability to generate variable VI. The latter was estimated by Lung clearance index (LCI) and expiratory phase III slopes (SIII). LCI was also compared to a mathematical model. Findings: The intra-Test variability for FRC was minimal, mean(SD) coefficient of variation 0.96(0.63)%, using different tracer gases under different conditions. Compared to the model with low VI, in the model with high VI LCI and washout SIII were significantly increased. LCI compared well to the mathematical model. Interpretation: This novel Lung model shows excellent precision in Lung volumes and VI estimates independent of tracer gases and conditions. The model can mimic the Lungs of patients with uneven gas distribution.
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multiple breath washout as a Lung Function Test in cystic fibrosis a cystic fibrosis foundation workshop report
Annals of the American Thoracic Society, 2015Co-Authors: Padmaja Subbarao, Philipp Latzin, Carlos Milla, Sonya Heltshe, Graham L Hall, Paul Aurora, Stephanie D. Davis, Anders Lindblad, Jane C. Davies, Jessica E PittmanAbstract:The Lung clearance index (LCI) is a Lung Function parameter derived from the multiple-breath washout (MBW) Test. Although first developed 60 years ago, the technique was not widely used for many years. Recent technological advances in equipment design have produced gains in popularity for this Test among cystic fibrosis (CF) researchers and clinicians, particularly for Testing preschool-aged children. LCI has been shown to be feasible and sensitive to early CF Lung disease in patients of all ages from infancy to adulthood. A workshop was convened in January 2014 by the North American Cystic Fibrosis Foundation to determine the readiness of the LCI for use in multicenter clinical trials as well as clinical care. The workshop concluded that the MBW text is a valuable potential outcome measure for CF clinical trials in preschool-aged patients and in older patients with FEV1 in the normal range. However, gaps in knowledge about the choice of device, gas, and standardization across systems are key issues precl...
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short term effects of chest physiotherapy in children with cystic fibrosis assessed by a new Lung Function Test
European Respiratory Journal, 2012Co-Authors: Chiara Abbas, Florian Singer, Carmen Casaulta, Philipp LatzinAbstract:Background: No Lung Function Test exists that is able to assess short-term effects of physiotherapeutic treatment (PT) in children with Cystic Fibrosis (CF). We recently developed a tidal single-breath washout (SBW) using two tracer gases to measure ventilation inhomogeneity (VI). Aims: We assessed whether this new SBW Test is able to measure short-term effects of PT and inhalation. Methods: Children with CF (n=25) between 6 and 16 years performed Lung-Function assessments prior to and after inhalation and PT. Assessments consisted of a double tracer gas SBW (DTG-SBW) and spirometry. DTG contained sulfur hexafluoride (SF6) and helium (He), and was inhaled during tidal breathing. A side-stream ultrasonic flowmeter measured molar mass. DTG-SBW outcome was percentage of expired volume where expired molar mass equals inspired molar mass, reflecting inspired ratio of SF6 and He (IPDTG). Results: After intervention IPDTG decreased from 66.5% (±25.8) to 59.7% (±25.4) resulting in a mean difference of -7.3% (95%CI -12.9 to -1.8) and MEF25-75 increased from 1.41 L/s to 1.62 L/s resulting in a mean difference of 0.19 L/s (95%CI 0.02 to 0.37). In a post-hoc subgroup analysis we found that the DTG-SBW is more suited to detect changes in VI in patients with mild CF Lung disease (n=14, FEV1 z-score >-2), whereas spirometry indexes increased only in patients with moderate CF Lung disease (n=11, FEV1 z-score Conclusion: The DTG-SBW seems to be a promising Test to detect short-term effects of physiotherapy and inhalation.
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tidal volume single breath washout of two tracer gases a practical and promising Lung Function Test
PLOS ONE, 2011Co-Authors: Florian Singer, Urs Frey, Georgette Stern, Oliver Fuchs, Per E Gustafsson, Cindy Thamrin, Thomas Riedel, Philipp LatzinAbstract:Small airway disease frequently occurs in chronic Lung diseases and may cause ventilation inhomogeneity (VI), which can be assessed by washout Tests of inert tracer gas. Using two tracer gases with unequal molar mass (MM) and diffusivity increases specificity for VI in different Lung zones. Currently washout Tests are underutilised due to the time and effort required for measurements. The aim of this study was to develop and validate a simple technique for a new tidal single breath washout Test (SBW) of sulfur hexafluoride (SF(6)) and helium (He) using an ultrasonic flowmeter (USFM).
Florian Singer - One of the best experts on this subject based on the ideXlab platform.
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multiple breath washout a new and promising Lung Function Test for patients with idiopathic pulmonary fibrosis
Respirology, 2018Co-Authors: Sylvia Nyilas, Florian Singer, Philipp Latzin, Theresa Schreder, Alexander Poellinger, Thomas Geiser, Manuela FunkeAbstract:BACKGROUND AND OBJECTIVE Idiopathic pulmonary fibrosis (IPF) is a devastating progressive Lung disease affecting the parenchyma. Nitrogen multiple-breath washout (N -MBW) is a Lung Function Test that measures ventilation inhomogeneity, a biomarker of small airway disease. We assessed clinical properties of N -MBW in IPF. METHODS In this prospective cohort pilot study, 25 IPF patients and 25 healthy controls were assessed at baseline and 10 patients at median 6.2 months later. Outcomes included the Lung clearance index (LCI) from N -MBW, forced vital capacity (FVC) from spirometry, diffusion capacity of the Lungs for carbon monoxide (DL ), bronchiectasis score from computed tomography scans, the Gender-Age-Physiology (GAP score for IPF) stage and death or Lung transplantation (LTx). Study end points were feasibility, repeatability, discriminative capacity and correlation with disease severity and structural Lung damage. RESULTS All patients were able to perform N -MBW. LCI was repeatable and reproducible. Median (interquartile range (IQR)) LCI in IPF was 11.6 (10.1-13.8) in IPF versus 7.3 (6.9-8.4) in controls (P < 0.0001). LCI correlated with DL corrected for haemoglobin (corrDL ; r = -0.49, P = 0.016), bronchiectasis score (r = 0.45, P = 0.024) and the GAP stage (r = 0.59, P = 0.002), but not with FVC. FVC was not related to bronchiectasis. During follow-up, six patients died and one received LTx. LCI correlated with the latter compound outcome: hazard ratio (95% CI) was 2.43 (1.26; 4.69) per one LCI SD from the patient population. CONCLUSION N -MBW is a feasible, reliable and valid Lung Function Test in IPF. LCI correlates with diffusion impairment, structural airway damage and clinical disease severity. LCI is a promising surveillance tool in IPF that may predict mortality.
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An innovative Lung model for multiple breath washout Testing in health and disease
Clinical Biomechanics, 2017Co-Authors: Pinelopi Anagnostopoulou, Massimo Guidi, Sarah Vomsattel, Anne Christiane Kentgens, Severin Binggeli, Lena Kohler, Florian Singer, Philipp Latzin, Dominik ObristAbstract:Background: Multiple breath washout (MBW) is a Lung Function Test that identifies the degree of ventilation inhomogeneity (VI) in the Lungs. In vitro validation of MBW devices is recommended. So far, plastic Lung models for MBW validation ignored variable degrees of VI. Our primary aim was to create a plastic Lung model applicable for physiological Lung volumes and variable VI. Methods: A plastic box divided in two chambers was filled with water and ventilated in various Lung volumes and respiratory rates. A ventilator was used for efficient gas distribution (model with low VI). An additional divider was inserted to create a model with high VI. The model was connected to commercial MBW devices and measurements were performed using different tracer gases and conditions. Primary outcome was the precision of generated Functional residual capacity (FRC) and the ability to generate variable VI. The latter was estimated by Lung clearance index (LCI) and expiratory phase III slopes (SIII). LCI was also compared to a mathematical model. Findings: The intra-Test variability for FRC was minimal, mean(SD) coefficient of variation 0.96(0.63)%, using different tracer gases under different conditions. Compared to the model with low VI, in the model with high VI LCI and washout SIII were significantly increased. LCI compared well to the mathematical model. Interpretation: This novel Lung model shows excellent precision in Lung volumes and VI estimates independent of tracer gases and conditions. The model can mimic the Lungs of patients with uneven gas distribution.
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short term effects of chest physiotherapy in children with cystic fibrosis assessed by a new Lung Function Test
European Respiratory Journal, 2012Co-Authors: Chiara Abbas, Florian Singer, Carmen Casaulta, Philipp LatzinAbstract:Background: No Lung Function Test exists that is able to assess short-term effects of physiotherapeutic treatment (PT) in children with Cystic Fibrosis (CF). We recently developed a tidal single-breath washout (SBW) using two tracer gases to measure ventilation inhomogeneity (VI). Aims: We assessed whether this new SBW Test is able to measure short-term effects of PT and inhalation. Methods: Children with CF (n=25) between 6 and 16 years performed Lung-Function assessments prior to and after inhalation and PT. Assessments consisted of a double tracer gas SBW (DTG-SBW) and spirometry. DTG contained sulfur hexafluoride (SF6) and helium (He), and was inhaled during tidal breathing. A side-stream ultrasonic flowmeter measured molar mass. DTG-SBW outcome was percentage of expired volume where expired molar mass equals inspired molar mass, reflecting inspired ratio of SF6 and He (IPDTG). Results: After intervention IPDTG decreased from 66.5% (±25.8) to 59.7% (±25.4) resulting in a mean difference of -7.3% (95%CI -12.9 to -1.8) and MEF25-75 increased from 1.41 L/s to 1.62 L/s resulting in a mean difference of 0.19 L/s (95%CI 0.02 to 0.37). In a post-hoc subgroup analysis we found that the DTG-SBW is more suited to detect changes in VI in patients with mild CF Lung disease (n=14, FEV1 z-score >-2), whereas spirometry indexes increased only in patients with moderate CF Lung disease (n=11, FEV1 z-score Conclusion: The DTG-SBW seems to be a promising Test to detect short-term effects of physiotherapy and inhalation.
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tidal volume single breath washout of two tracer gases a practical and promising Lung Function Test
PLOS ONE, 2011Co-Authors: Florian Singer, Urs Frey, Georgette Stern, Oliver Fuchs, Per E Gustafsson, Cindy Thamrin, Thomas Riedel, Philipp LatzinAbstract:Small airway disease frequently occurs in chronic Lung diseases and may cause ventilation inhomogeneity (VI), which can be assessed by washout Tests of inert tracer gas. Using two tracer gases with unequal molar mass (MM) and diffusivity increases specificity for VI in different Lung zones. Currently washout Tests are underutilised due to the time and effort required for measurements. The aim of this study was to develop and validate a simple technique for a new tidal single breath washout Test (SBW) of sulfur hexafluoride (SF(6)) and helium (He) using an ultrasonic flowmeter (USFM).
Lennart Nathell - One of the best experts on this subject based on the ideXlab platform.
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Lung Function Testing influences the attitude toward smoking cessation.
Nicotine & Tobacco Research, 2009Co-Authors: Britt Marie Sundblad, Kjell Larsson, Lennart NathellAbstract:Introduction: Smoking cessation is the single most effective way to prevent or delay the development of airflow limitation or to reduce its progression in subjects with chronic obstructive pulmonary disease (COPD). The aim of the study was to explore whether performing a spirometry changes attitudes toward smoking cessation. Method: A random sample of 513 smokers, of whom 77 had COPD, answered a questionnaire before, shortly after (less than 4 weeks), and 3 months after performing a Lung Function Test. Results: Prior to spirometry, 57% of the smokers with COPD and 52% of those with normal spirometry claimed that they were not planning to quit smoking within the next 6 months. After the spirometry, 9% (p < .0001) of those with COPD and 38% (p = .009) of those with normal spirometry had no intention to stop smoking. Three months later, corresponding figures were 28% in COPD and 48% in smokers with normal spirometry, and the point prevalence of quitters was 30% for the COPD group and 14% for the normal group (p = .02). Discussion: We conclude that performing spirometry changes the attitude toward smoking for a short time. We hypothesize that smokers may be more susceptible to smoking cessation activities during this period.
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Lung Function Testing influences the attitude toward smoking cessation
Nicotine and Tobacco Research, 2009Co-Authors: Britt Marie Sundblad, Kjell Larsson, Lennart NathellAbstract:INTRODUCTION: Smoking cessation is the single most effective way to prevent or delay the development of airflow limitation or to reduce its progression in subjects with chronic obstructive pulmonary disease (COPD). The aim of the study was to explore whether performing a spirometry changes attitudes toward smoking cessation. METHOD: A random sample of 513 smokers, of whom 77 had COPD, answered a questionnaire before, shortly after (less than 4 weeks), and 3 months after performing a Lung Function Test. RESULTS: Prior to spirometry, 57% of the smokers with COPD and 52% of those with normal spirometry claimed that they were not planning to quit smoking within the next 6 months. After the spirometry, 9% (p < .0001) of those with COPD and 38% (p = .009) of those with normal spirometry had no intention to stop smoking. Three months later, corresponding figures were 28% in COPD and 48% in smokers with normal spirometry, and the point prevalence of quitters was 30% for the COPD group and 14% for the normal group (p = .02). DISCUSSION: We conclude that performing spirometry changes the attitude toward smoking for a short time. We hypothesize that smokers may be more susceptible to smoking cessation activities during this period.
Britt Marie Sundblad - One of the best experts on this subject based on the ideXlab platform.
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Lung Function Testing influences the attitude toward smoking cessation.
Nicotine & Tobacco Research, 2009Co-Authors: Britt Marie Sundblad, Kjell Larsson, Lennart NathellAbstract:Introduction: Smoking cessation is the single most effective way to prevent or delay the development of airflow limitation or to reduce its progression in subjects with chronic obstructive pulmonary disease (COPD). The aim of the study was to explore whether performing a spirometry changes attitudes toward smoking cessation. Method: A random sample of 513 smokers, of whom 77 had COPD, answered a questionnaire before, shortly after (less than 4 weeks), and 3 months after performing a Lung Function Test. Results: Prior to spirometry, 57% of the smokers with COPD and 52% of those with normal spirometry claimed that they were not planning to quit smoking within the next 6 months. After the spirometry, 9% (p < .0001) of those with COPD and 38% (p = .009) of those with normal spirometry had no intention to stop smoking. Three months later, corresponding figures were 28% in COPD and 48% in smokers with normal spirometry, and the point prevalence of quitters was 30% for the COPD group and 14% for the normal group (p = .02). Discussion: We conclude that performing spirometry changes the attitude toward smoking for a short time. We hypothesize that smokers may be more susceptible to smoking cessation activities during this period.
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Lung Function Testing influences the attitude toward smoking cessation
Nicotine and Tobacco Research, 2009Co-Authors: Britt Marie Sundblad, Kjell Larsson, Lennart NathellAbstract:INTRODUCTION: Smoking cessation is the single most effective way to prevent or delay the development of airflow limitation or to reduce its progression in subjects with chronic obstructive pulmonary disease (COPD). The aim of the study was to explore whether performing a spirometry changes attitudes toward smoking cessation. METHOD: A random sample of 513 smokers, of whom 77 had COPD, answered a questionnaire before, shortly after (less than 4 weeks), and 3 months after performing a Lung Function Test. RESULTS: Prior to spirometry, 57% of the smokers with COPD and 52% of those with normal spirometry claimed that they were not planning to quit smoking within the next 6 months. After the spirometry, 9% (p < .0001) of those with COPD and 38% (p = .009) of those with normal spirometry had no intention to stop smoking. Three months later, corresponding figures were 28% in COPD and 48% in smokers with normal spirometry, and the point prevalence of quitters was 30% for the COPD group and 14% for the normal group (p = .02). DISCUSSION: We conclude that performing spirometry changes the attitude toward smoking for a short time. We hypothesize that smokers may be more susceptible to smoking cessation activities during this period.
Mihaela Ghita - One of the best experts on this subject based on the ideXlab platform.
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low frequency forced oscillation Lung Function Test can distinguish dynamic tissue non linearity in copd patients
Frontiers in Physiology, 2019Co-Authors: Mihaela Ghita, Dana Copot, Eric Derom, Claramihaela IonescuAbstract:: This paper introduces the use of low frequencies forced oscillation technique (FOT) in the presence of breathing signal. The hypothesis Tested is to evaluate the sensitivity of FOT to various degrees of obstruction in COPD patients. The measurements were performed in the frequency range 0-2 Hz. The use of FOT to evaluate respiratory impedance has been broadly recognized and its complementary use next to standardized method as spirometry and body plethysmography has been well-documented. Typical use of FOT uses frequencies between 4-32 Hz and above. However, interesting information at frequencies below 4 Hz is related to viscoelastic properties of parenchyma. Structural changes in COPD affect viscoelastic properties and we propose to investigate the use of FOT at low frequencies with a fourth generation fan-based FOT device. The generator non-linearity introduced by the device is separated from the linear approximation of the impedance before evaluating the results on patients. Three groups of COPD obstruction, GOLD II, III, and IV are evaluated. We found significant differences in mechanical parameters (tissue damping, tissue elasticity, hysteresivity) and increased degrees of non-linear dynamic contributions in the impedance data with increasing degree of obstruction (p < 0.01). The results obtained suggest that the non-linear index correlates better with degrees of heterogeneity linked to COPD GOLD stages, than the currently used hysteresivity index. The protocol and method may prove useful to improve current diagnosis percentages for various COPD phenotypes.
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A medical information system for monitoring respiratory Function and related nonlinear dynamics*
2019 IEEE International Conference on Systems Man and Cybernetics (SMC), 2019Co-Authors: Mihaela Ghita, Dana Copot, Clara M. IonescuAbstract:In this paper the nonlinear effects in the respiratory systems at low frequencies are measured and evaluated in healthy children and healthy adults. To this aim forced oscillations technique (FOT) has been used to non-invasively measure the Lung tissue mechanics. FOT does not require any special effort from the patient in contrast with standardized Tests where maneuvers are necessary. Hence, FOT is an ideal Lung Function Test for extreme ages, more specifically children and elderly, given the simpleness of measurement technique. Hitherto, measurements at low frequencies (i.e. close to the breathing frequency ≈0.3 Hz) have been invasively performed in sacrificed animals and on anesthetized humans. Here we measure in the frequency interval 0.1-2 Hz a total number of 94 volunteers (37 adults with ages between 25-35 years and 57 children with ages between 8-11 years). To evaluate the non-linear contributions of the respiratory tissue, a novel T-index has been introduced. We have Tested the hypothesis whether the nonlinear distortions are changing with growth/development of the respiratory tree and aim to quantity its dependence to biometric values. The results obtained indicate that the proposed index can differentiate between the two analyzed groups and that there is a dependence to age, height and weight. A medical information system may use this information to update predictions of respiratory Function and provide aid in decision-making process of drug therapy.
