Real-time, once-daily monitoring of symptoms and FEV in cystic fibrosis patients - A feasibility study using a novel device

Clin Respir J. 2010 Apr;4(2):74-82.

Real-time, once-daily monitoring of symptoms and FEV in cystic fibrosis patients - A feasibility study using a novel device.

Sarfaraz S, Sund Z, Jarad N.

Adult CF Centre, Department of Respiratory Medicine, Bristol Royal Infirmary, Bristol, UK.

Abstract

Abstract Background and Aims: We investigated feasibility and value of a real-time electronic monitoring system adapted for early detection of cystic fibrosis (CF) pulmonary exacerbations (P Exs).

Methods: This was a 6-month prospective study. Patients recorded once daily their symptom score and spirometry using an electronic diary. The data were sent daily to the research team in real time. P Ex was considered to be present when change in symptoms and lung function values met a preset criteria. Number of P Exs during the study was compared with a parallel period of the previous and of the following years.

Results: Only 19 patients (37.2%) completed recording that could be evaluated. A total of 53 P Exs were identified, 26 (49.0%) of which needed intravenous (IV) antibiotics. The number of total P Exs in the study year did not differ from the previous or the following year, but the number of courses of oral antibiotics was greater than those given during the previous year.

Conclusion: Remote daily monitoring of symptoms and spirometry had a poor uptake among CF patients. For those who completed the study, this method early detected P Exs that were treated with oral antibiotics that might otherwise required IV antibiotics.

PMID: 20565480 [PubMed - in process]

Diurnal Variations in Human Pulmonary Function

Thanks to Skye for bringing this article to my attention!


Diurnal Variations in Human Pulmonary Function




Bottomline: The difference in the forced expiratory volume in 1 second (FEV1) between the noon (12:00–12:59 pm) and afternoon (4:00–4:59 pm) intervals was 17.6% (P<0.01).


Abstract

Pulmonary function has circadian modulations. Variations in human pulmonary function during the daytime hours (diurnal variations) remain to be well characterized. Discerning these variations will contribute to better understanding the relationship between biorhythms and lung physiology and to improving clinical management of pulmonary diseases.

The aim of this study was to determine the magnitude of pulmonary function variability during the usual daytime hours in a population of patients referred for pulmonary function testing. Diurnal fluctuations of human pulmonary function were examined by studying retrospectively a study population of 4,756 individuals with performed pulmonary function tests. We found the lowest and highest spirometric values in the 12:00–12:59 pm and 3:00–4:59 pm time intervals respectively. The difference in the forced expiratory volume in 1 second (FEV1) between the noon (12:00–12:59 pm) and afternoon (4:00–4:59 pm) intervals was 17.6% (P<0.01). F

urthermore, the highest values of diffusing capacity of the lung for carbon monoxide [DLCO] and alveolar volume [Va] were identified in the 8:00–8:59 am time interval. These findings, identifying a model of diurnal variations of pulmonary function in individuals referred for pulmonary function testing, are of interest for better understanding lung physiology and human circadian rhythms and may have clinical value in managing lung disorders.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2592592/