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Physiological variation

  • Chapter
Clinical Tests of Respiratory Function

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Abstract

Variations in lung function between and within individuals result from several factors, many of which may need to be taken into account in the interpretation of clinical data. For many tests, standard equations based on large populations are available, from which an average predicted or reference value can be calculated. The most commonly used incorporate factors for sex, age and body size (usually represented by height); account may, however, also need to be taken of ethnic differences, the posture of the subject or the time of day when the test was performed. For information on the commonly used equations the reader is referred to the detailed account in the classic text by Cotes.1 I have chosen to summarise here some of the more important causes of variations in normal subjects as a background against which changes in disease need to be viewed.

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References

  1. Cotes, J. E. Lung Function, 4th edn, Oxford: Blackwell, 1979.

    Google Scholar 

  2. Yernault, J. C, Baran, D. and Englert, M. Effect of growth and aging on the static mechanical lung properties. Bull. Europ. Physiopath. Respir. 1977; 13: 777–88.

    Google Scholar 

  3. Rebuck, A. S., Rigg, J. R. A., Kangalee, M. and Pengelley, L. D. Control of tidal volume during rebreathing. J. Appl. Physiol. 1974; 37: 475–8.

    Google Scholar 

  4. Hirshman, C. A., McCullough, R. E. and Weil, J. V. Normal values for hypoxic and hypercapnic ventilatory drives in man. J. Appl. Physiol. 1975; 38: 1095–8.

    Google Scholar 

  5. Agostoni, E. and Mead, J. Statics of the respiratory system. In: Fenn, W. O. and Rahn, H. (eds), Handbook of Physiology, section 3, Respiration, vol. I, Washington DC: American Physiological Society, 1964: 398.

    Google Scholar 

  6. Green, M., Mead, J. and Turner, J. M. Variability of maximum expiratory flow-volume curves. J. Appl. Physiol. 1974; 37: 67–74.

    Google Scholar 

  7. Zapletal, A., Motoyama, E. K., van de Woestijne, K. P. et al. Maximum expiratory flow-volume curves and airway conductance in children and adolescents. J. Appl. Physiol. 1969; 26: 308–16.

    Google Scholar 

  8. Osmanliev, D., Bowley, N., Hunter, D. M. and Pride, N. B. Relation between tracheal size and forced expiratory volume in one second in young men. Am. Rev. Respir. Dis. 1982; 126: 179–82.

    Google Scholar 

  9. Gibson, G. J., Pride, N. B., O’Cain, C. and Quagliato, R. Sex and age differences in pulmonary mechanics in normal non-smoking subjects. J. Appl. Physiol. 1976; 41: 20–5.

    Google Scholar 

  10. Bradley, J., Bye, C, Hayden, S. P. and Hughes, D. T. D. Normal values of transfer factor and transfer coefficient in healthy males and females. Respiration 1979; 38: 221–6.

    Article  Google Scholar 

  11. Zapletal, A., Paul, T. and Samanek, M. Pulmonary elasticity in children and adolescents. J. Appl. Physiol. 1976; 40: 953–61.

    Google Scholar 

  12. Mansell, A., Bryan, C. and Levison, H. Airway closure in children. J. Appl. Physiol. 1972; 33: 711–14.

    Google Scholar 

  13. Dunnill, M. S. The problem of lung growth. Thorax 1982; 37: 561–3.

    Article  Google Scholar 

  14. Polgar, G. and Weng, T. R. The functional development of the respiratory system. Am. Rev. Respir. Dis. 1979; 120: 625–95.

    Google Scholar 

  15. O’Brodovich, H. M., Mellins, R. B. and Mansell, A. L. Effects of growth on the diffusion constant for carbon monoxide. Am. Rev. Respir. Dis. 1982; 125: 670–3.

    Google Scholar 

  16. Mittman, C., Edelman, N. H., Norris, A. H., Shock, N. W. Relationship between chest wall and pulmonary compliance and age. J. Appl. Physiol. 1965; 20: 1211–16.

    Google Scholar 

  17. Leith, D. E. and Mead, J. Mechanism determining residual volume of the lungs in normal subjects. J. Appl. Physiol. 1967; 23: 221–7.

    Google Scholar 

  18. Buist, A. S. and Ross, B. B. Quantitative analysis of the alveolar plateau in the diagnosis of early airway obstruction. Am. Rev. Respir. Dis. 1973; 108: 1078–87.

    Google Scholar 

  19. McCarthy, D. S., Spencer, R., Greene, R. and Milic-Emili, J. Measurement of ‘closing volume’ as a simple and sensitive test for early detection of small airway disease. Am. J. Med. 1972; 52: 747–53.

    Article  Google Scholar 

  20. Buist, A. S. and Ross, B. B. Predicted values for closing volumes using a modified single breath nitrogen test. Am. Rev. Respir. Dis. 1973; 107: 744–52.

    Google Scholar 

  21. Mellemgaard, K. The alveolar-arterial oxygen difference. Acta Physiol. Scand. 1966; 67: 10–20.

    Article  Google Scholar 

  22. Sorbini, C. A., Grassi, V., Solinas, E. and Muiesan, G. Arterial oxygen tension in relation to age in healthy subjects. Respiration 1968; 25: 3–13.

    Article  Google Scholar 

  23. Kronenberg, R. S. and Drage, C. W. Attenuation of the ventilatory and heart rate responses to hypoxia and hypercapnia with aging in normal men. J. Clin. Invest. 1973;52: 1812–19.

    Article  Google Scholar 

  24. Sharp, J. T., Goldberg, N. B., Druz, W. S. and Danon, J. Relative contributions of rib cage and abdomen to breathing in normal subjects. J. Appl. Physiol. 1975; 39: 608–18.

    Google Scholar 

  25. Riley, R. L., Permutt, S., Said, S. et al. Effect of posture on pulmonary dead space in man. J. Appl. Physiol. 1959; 14: 339–44.

    Google Scholar 

  26. Bjurstedt, H., Hesser, C. M., Liljestrand, G. et al. Effects of posture on alveolar-arterial CO2 and O2 differences and on alveolar dead space in man. Acta Physiol. Scand. 1962; 54: 65–82.

    Article  Google Scholar 

  27. Ward, R. J., Tolas, A. G., Benveniste, R. J. et al. Effect of posture on normal arterial blood gas tensions in the aged. Geriatrics 1966; 21: 139–43.

    Google Scholar 

  28. Rigg, J. R. A., Rebuck, A. S. and Campbell, E. J. M. Effect of posture on the ventilatory response to CO2. J. Appl. Physiol. 1974; 37: 487–90.

    Google Scholar 

  29. Guberan, E., Williams, M. K., Walford, J. and Smith, M. M. Circadian variation of FEV in shift workers. Br. J. Ind. Med. 1969; 26: 121–5.

    Google Scholar 

  30. Hetzel, M. R. and Clark, T. J. H. Comparison of normal and asthmatic circadian rhythms in peak expiratory flow rate. Thorax 1980; 35: 732–8.

    Article  Google Scholar 

  31. Kerr, H. D. Diurnal variation of respiratory function independent of air quality. Arch. Env. Health 1973; 26: 144–52.

    Article  Google Scholar 

  32. Cinkotai, F. F. and Thomson, M. L. Diurnal variation in pulmonary diffusing capacity for carbon monoxide. J. Appl. Physiol. 1966; 21: 539–42.

    Google Scholar 

  33. Phillipson, E. A. Control of breathing during sleep. Am. Rev. Respir. Dis. 1978; 118: 909–39.

    Google Scholar 

  34. Bulow, K. Respiration and wakefulness in man. Acta Physiol. Scand. 1963; 59: suppl. 209.

    Google Scholar 

  35. Anthonisen, N. R. and Kryger, M. H. Ventilatory and arousal responses to hypoxaemia in sleep. Am. Rev. Respir. Dis. 1982; 126: 1–2.

    Google Scholar 

  36. Douglas, N. J., White, D. P., Pickett, C. K. et al. Respiration during sleep in normal man. Thorax 1982; 37: 840–4.

    Article  Google Scholar 

  37. Block, A. J., Boysen, P. G., Wynne, J. W. and Hunt, L. A. Sleep apnoea, hypopnoea and oxygen desaturation in normal subjects. N. Engl. J. Med. 1979; 300: 513–17.

    Article  Google Scholar 

  38. Gaensler, E. A. Lung displacement. In: Fenn, W. O. and Rahn, H. (eds), Handbook of Physiology, section 3, Respiration, vol. II, Washington DC: American Physiological Society, 1965: 1624–9.

    Google Scholar 

  39. Gazioglu, K., Kaltreider, N. L., Rosen, M. and Yu, P. N. Pulmonary function during pregnancy in normal women and in patients with cardiopulmonary disease. Thorax 1970;25:445–50.

    Article  Google Scholar 

  40. Knuttgen, H. G. and Emerson, K. Physiological response to pregnancy at rest and during exercise. J. Appl. Physiol. 1974; 36: 549–53.

    Google Scholar 

  41. Gee, J. B. L., Packer, B. S., Milien, J. E. and Robin, E. D. Pulmonary mechanics during pregnancy. J. Clin Invest. 1967: 46: 945–52.

    Article  Google Scholar 

  42. Lucius, H., Gahlenbeck, H., Kleine, H.-O. et al. Respiratory functions, buffer system and electrolyte concentrations of blood during human pregnancy. Respir. Physiol. 1970; 9: 311–17.

    Article  Google Scholar 

  43. Krumholz, R. A., Echt, C. R. and Ross, J. C. Pulmonary diffusing capacity, capillary blood volume, lung volumes and mechanics of ventilation in early and late pregnancy. J. Lab. Clin. Med. 1964; 63: 648–55.

    Google Scholar 

  44. De Graff, A. C, Grover, R. F., Johnson, R. L. et al. Diffusing capacity of the lung in Caucasians native to 3100 m. J. Appl. Physiol. 1970; 29: 71–6.

    Google Scholar 

  45. Severinghaus, J. W., Bainton, C. R. and Carcelen, A. Respiratory insensitivity to hypoxia in chronically hypoxic man. Respir. Physiol. 1966; 1: 308–34.

    Article  Google Scholar 

  46. Weil, J. V., Byrne-Quinn, E., Sodal, I. E. et al. Acquired attenuation of chemoreceptor function in chronically hypoxic man at high altitude. J. Clin Invest. 1971; 50: 186–95.

    Article  Google Scholar 

  47. Nadel, J. A. and Comroe, J. H. Acute effects of inhalation of cigarette smoke on airway conductance. J. Appl. Physiol. 1960; 16: 713–16.

    Google Scholar 

  48. Krumholz, R. A., Chevalier, R. B. and Ross, J. C. Cardiopulmonary function in young smokers. Ann. Int. Med. 1964; 60: 603–10.

    Article  Google Scholar 

  49. Burrows, B., Knudson, R. J., Cline, M. A. and Lebowitz, M. D. Quantitative relationships between cigarette smoking and ventilatory function. Am. Rev. Respir. Dis. 1977; 115: 195–205.

    Google Scholar 

  50. Hyland, R. H., Krastins, I. R. B., Aspin, N. et al. Effect of body position on carbon monoxide diffusing capacity in asymptomatic smokers and non-smokers. Am. Rev. Respir. Dis. 1978; 117: 1045–53.

    Google Scholar 

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Authors and Affiliations

  1. Freeman Hospital, Newcastle upon Tyne, UK

    G. J. Gibson B.Sc., M.D., F.R.C.P. (Consultant Physician)

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  1. G. J. Gibson B.Sc., M.D., F.R.C.P.
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© 1984 G. J. Gibson

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Gibson, G.J. (1984). Physiological variation. In: Clinical Tests of Respiratory Function. Palgrave, London. https://doi.org/10.1007/978-1-349-81333-9_6

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  • DOI: https://doi.org/10.1007/978-1-349-81333-9_6

  • Publisher Name: Palgrave, London

  • Print ISBN: 978-1-349-81335-3

  • Online ISBN: 978-1-349-81333-9

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