Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1971 Apr;46(246):144–151. doi: 10.1136/adc.46.246.144

Pulmonary Function and Response to Exercise in Cystic Fibrosis

S Godfrey, Margaret Mearns
PMCID: PMC1647451  PMID: 5576246

Abstract

Results of physiological studies at rest and during exercise in 41 patients with cystic fibrosis of the lungs are presented. The patients were evenly distributed by age between 5 and 21 years, and were grouped into 3 clinical grades corresponding to mild, moderate, and fairly severe disease.

There was a linear relation between tests of lung mechanics such as the FEV1 and the MVV and the clinical grading. These tests also correlated well with one another. Certain tests, notably those reflecting parenchymal damage such as the TLCO showed a non-linear relation to clinical severity, deteriorating more rapidly from grade 2 to 3 than from grade 1 to 2.

A very specific pattern emerged of enlargement of physiological deadspace even in the mildest cases. As the disease progressed, venous admixture occurred at rest, which was initially returned to normal by exercise. In the severest cases, there was never a complete return to normal. These changes may be explicable in terms of pathology.

Exercise was limited by pulmonary mechanics. Total ventilation was increased to accommodate the increased deadspace so that arterial Pco2 remained normal. Cardiac output was normal.

Adequate evaluation of the pulmonary physiological abnormality could be obtained by measuring the FEV1 (or MVV), TLCO, and maximum work load possible, but very useful extra information is obtained by measuring arterial saturation (or venous admixture) and dead space.

Full text

PDF
144

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BATES D. V., BOUCOT N. G., DORMER A. E. The pulmonary diffusing capacity in normal subjects. J Physiol. 1955 Aug 29;129(2):237–252. doi: 10.1113/jphysiol.1955.sp005350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Beier F. R., Renzetti A. D., Jr, Mitchell M., Watanabe S. Pulmonary pathophysiology in cystic fibrosis. Am Rev Respir Dis. 1966 Sep;94(3):430–440. doi: 10.1164/arrd.1966.94.3.430. [DOI] [PubMed] [Google Scholar]
  3. Clark T. J., Freedman S., Campbell E. J., Winn R. R. The ventilatory capacity of patients with chronic airways obstruction. Clin Sci. 1969 Apr;36(2):307–316. [PubMed] [Google Scholar]
  4. DUBOIS A. B., BOTELHO S. Y., BEDELL G. N., MARSHALL R., COMROE J. H., Jr A rapid plethysmographic method for measuring thoracic gas volume: a comparison with a nitrogen washout method for measuring functional residual capacity in normal subjects. J Clin Invest. 1956 Mar;35(3):322–326. doi: 10.1172/JCI103281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. DUBOIS A. B., BOTELHO S. Y., COMROE J. H., Jr A new method for measuring airway resistance in man using a body plethysmograph: values in normal subjects and in patients with respiratory disease. J Clin Invest. 1956 Mar;35(3):327–335. doi: 10.1172/JCI103282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Doershuk C. F., Matthews L. W., Tucker A. S., Spector S. Evaluation of a prophylactic and therapeutic program for patients with cystic fibrosis. Pediatrics. 1965 Nov;36(5):675–688. [PubMed] [Google Scholar]
  7. GOLDRING R. M., FISHMAN A. P., TURINO G. M., COHEN H. I., DENNING C. R., ANDERSEN D. H. PULMONARY HYPERTENSION AND COR PULMONALE IN CYSTIC FIBROSIS OF THE PANCREAS. J Pediatr. 1964 Oct;65:501–524. doi: 10.1016/s0022-3476(64)80286-9. [DOI] [PubMed] [Google Scholar]
  8. Godfrey S., Davies C. T. Estimates of arterial PCO2 and their effect on the calculated values of cardiac output and dead space on exercise. Clin Sci. 1970 Oct;39(4):529–537. doi: 10.1042/cs0390529. [DOI] [PubMed] [Google Scholar]
  9. Godfrey S., Kamburoff P. L., Nairn J. R. Spirometry, lung volumes and airway resistance in normal children aged 5 to 18 years. Br J Dis Chest. 1970 Jan;64(1):15–24. doi: 10.1016/s0007-0971(70)80045-6. [DOI] [PubMed] [Google Scholar]
  10. Godfrey S. Manipulation of the indirect Fick principle by a digital computer program for the calculation of exercise physiology results. Respiration. 1970;27(6):513–532. doi: 10.1159/000192707. [DOI] [PubMed] [Google Scholar]
  11. Godfrey S. Physiological response to exercise in children with lung or heart disease. Arch Dis Child. 1970 Aug;45(242):534–538. doi: 10.1136/adc.45.242.534. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Godfrey S. The physiological assessment of the effect of DSCG in the asthmatic child. Respiration. 1970;27(Suppl):353–356. doi: 10.1159/000192768. [DOI] [PubMed] [Google Scholar]
  13. Jones N. L., Campbell E. J., McHardy G. J., Higgs B. E., Clode M. The estimation of carbon dioxide pressure of mixed venous blood during exercise. Clin Sci. 1967 Apr;32(2):311–327. [PubMed] [Google Scholar]
  14. Jones N. L. Pulmonary gas exchange during exercise in patients with chronic airway obstruction. Clin Sci. 1966 Aug;31(1):39–50. [PubMed] [Google Scholar]
  15. Mearns M. B. Simple tests of ventilatory capacity in children with cystic fibrosis. I. Clinical and radiological findings in 85 patients. II. Three-year follow-up on 50 patients. Arch Dis Child. 1968 Oct;43(231):528–539. doi: 10.1136/adc.43.231.528. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Mellins R. B., Levin O. R., Ingram R. H., Jr, Fishman A. P. Obstructive disease of the airways in cystic fibrosis. Pediatrics. 1968 Mar;41(3):560–573. [PubMed] [Google Scholar]
  17. Read J., Read D. J., Pain M. C. Influence of non-uniformity of the lungs on measurement of pulmonary diffusing capacity. Clin Sci. 1965 Aug;29(1):107–118. [PubMed] [Google Scholar]
  18. SHWACHMAN H., KULCZYCKI L. L. Long-term study of one hundred five patients with cystic fibrosis; studies made over a five- to fourteen-year period. AMA J Dis Child. 1958 Jul;96(1):6–15. doi: 10.1001/archpedi.1958.02060060008002. [DOI] [PubMed] [Google Scholar]
  19. Weng T. R., Levison H. Standards of pulmonary function in children. Am Rev Respir Dis. 1969 Jun;99(6):879–894. doi: 10.1164/arrd.1969.99.6.879. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES