Comparison Of Spirometric Pulmonary Function In Subjects With Apple And Pear Shape Fat Distribution

Background: The pattern of obesity as decided by body fat distribution is an important predictor of adverse health effects such as diabetes, hypertension, hyperlipidaemia and coronary events. Waist hip ratio has been correlated with cardiovascular risk. Obesity is been known to cause restrictive respiratory impairment however; the effect of body fat distribution on the respiratory system is often underappreciated and limited evidence is available on spirometric pulmonary function in subjects with different body fat distribution. Hence here is a need to know weather pattern of obesity affects pulmonary function. Objectives: 1) To measure Waist Hip ratio (WHR) of subjects having BMI of more than 23 kg/m2 and based on this form two groups, one with apple and the other with pear shape fat distribution 2) To measure FVC and FEV1 in subjects of the above two groups.3) To compare FVC, FEV1 and %FEV1/FVC in above two groups. Methodology: In this comparative study a total of 182 subjects comprising of 91 subjects of Apple shaped and Pear shaped each were recruited in a period of 6 months. Study Settings: The study was conducted in the outpatient Physiotherapy department of a tertiary care hospital. The subjects in the study belonged to age group of 18-40 years. The mean age of the enrolled subjects was 29 years. Outcome measure: 1.FVC (L); 2. %FEV1 /FVC Results: The present study provides the evidence that FVC and %FEV1/FVC values are not statistically different in apple and pear shaped fat distribution individuals. Although both apple and pear shaped individuals showed %FEV1/FVC value more than 70% predicted, apple shaped individuals showed greater obstructive tendency i.e. reduced flow rates as compared to pear shaped individuals. Also more individuals of apple shaped showed restrictive pattern as compared to pear shaped. Conclusion: There was no statistically significant difference in the pulmonary function test in the two groups but there is a possibility of subclinical reduction in pulmonary function more in apple shaped than in pear shaped individuals

Association of Body Mass Index with Pulmonary Function Parameters in Males with Non-obstructive Airway Disease Identified by Spirometric Protocols Attending Bankura Sammilani Medical College.

Introduction: The effect of body mass index (BMI) on theincidence and prevalence of airway obstructive diseasesasthma, chronic bronchitis, and emphysema—is not clear.The nature of the relationship between BMI and airwayobstructive diseases are also complicated by the potentialeffect respiratory symptoms can have on appetite and physicalactivity. Proposed study was done to find out the associationbetween body mass index and lung functions in males withNon-obstructive airway disease identified by spirometricprotocols.Material and Methods: A retrospective analysis of thespirometry data obtained between August 2018 and January2019 was conducted in the Physiology Department, B. S.Medical College, Bankura for six months. In this study above300 test results over male subjects were taken from studydatabase. Out of those 234 test results of Non-obstructiveairway disease were included considering inclusion andexclusion criteria.Results: The Study shows FVC, FEV1, FEF25-75% PEFR,PIFR, FEF25% and FEF50% have significant positivecorrelation with BMI of underweight. But in normal subject’sonly significant positive correlation between BMI and PIFRwere observed. In overweight there is significant positivecorrelation observed between BMI and PEFR.Conclusion: Our study showed that clear association wasfound between pulmonary function parameters and BMI inmales with non-obstructive airway disease.

Comparison of pulmonary function of women in 2nd trimester and non-pregnant women, in central Uttar-Pradesh, India

Background: Pregnancy is nothing but a process of maternal adaptation to meet the increasing needs of the growing foetus. Significant changes in the highly sensitive respiratory system occurs during pregnancy to fulfil increased demands as well as to combat stress of pregnancy. Although many studies have been done in India to study the Pulmonary Functions during pregnancy, but due to paucity of such study in central Uttar-Pradesh this study was planned.Methods: This study was carried out on 353 2nd trimester pregnant women coming to ANC clinic of Obstetrics and Gynaecology Department of Uttar-Pradesh University of Medical Sciences, Saifai, Etawah, pulmonary function parameters were recorded using Computer based Digital Spirometer. Data were compared with pulmonary function parameters of age matched 353 Non-Pregnant controls. Parameters studied were FVC, FEV1, FEV1/FVC, PEFR and MVV.Results: FVC, FEV1, FEV1/FVC and PEFR was found less in pregnant women as compared to Non-pregnant women, difference was statistically highly significant (P<0.01). MVV was also found less in pregnant women but it was insignificant (P >0.05).Conclusions: All parameters of PFT are deranged in pregnancy. Matching of other attributes of cases and controls like height, pre-pregnancy weight of cases and weight of controls, Haemoglobin, BMI, could possibly further explain the established relationship of pregnancy and PFT parameter derangements. Perhaps, a longitudinal study in expectant mothers by measuring their PFT parameters in non-pregnant states and then serial follow-up PFT measurement during their pregnancy would be a better approach to look for the effects of pregnancy on PFT parameters.

Effects of a Swimming Training Session on Pulmonary Functions in Young Adult Beginners

Introduction: It is well documented that any sort of exercisedone regularly, is beneficial for health. Swimming is noexception and considered to be a very good exercise formaintaining proper health and also has a profound effect on thelung functions. Regular swimming practice gives a positiveeffect on the lungs by increasing the pulmonary capacity andthus improves the lung functions. The proposed study wascarried out with the above background, among swimmingbeginners undergoing a swimming training session to see howa course of swimming affect the lung function parameters.Material and Methods: The study was carried out on 32males and 12 females’ healthy young adults of either sex ofage group of 18-35 yrs. At the beginning of the swimmingsession recording of pulmonary functions tests was done foreach selected candidate (control group). Again procedureswere repeated at the end of three months and at the end of sixmonths for same candidates (case group).Results: In the present study, it is observed that there issignificant increase (p value <0.05) in FVC, FEV1, PEFR andMVV after three months and after six months of swimmingboth males and females separately.Conclusion: From the present study we concluded that evenafter short course of swimming training session there issignificant benefit in some parameters of lung function. Theimprove lungs function is thought to be duo to increase inrespiratory muscle mass. More elaborate and multi-centredstudies are needed to corroborate our findings

Morfometría torácica de nadadores y su relación con la función pulmonar / Toracic morphometry in the swimmer and its relation to the pulmonary function

El objetivo del siguiente estudio fue determinar las dimensiones del tórax y su relación con la función ventilatoria en un grupo de nadadores correspondientes a la selección de natación de la Universidad Católica del Maule. Se evaluaron 42 sujetos de sexo masculino entre 18 y 26 años, 18 seleccionados de natación y 24 estudiantes sedentarios, todos de la Universidad Católica del Maule. Se les realizó antropometría corporal básica (peso y talla corporal) y específica de tórax, diámetro antero-posterior (DAT) y transverso (DTT) de tórax y perímetro mesoesternal (PME). Posterior a esto, se evaluó la función ventilatoria a través de pletismografía corporal. Para el análisis estadístico se determinó la normalidad de los datos posteriormente se utilizó t de student o U de Mann-Whitney y Pearson o Spearman según correspondiera, para establecer significancia estadística o correlación, respectivamente. Se consideró un nivel de significancia estadística de p<0,05. Se observó un aumento significativo del índice de masa corporal (IMC), mayores dimensiones de tórax en nadadores, DAT a capacidad pulmonar total (CPT) y PME a CPT y volumen residual (VR). En función ventilatoria existió un aumento significativo de presión espiratoria máxima (PEM), presión inspiratoria máxima (PIM), capacidad inspiratoria (CI) y CPT. También se observaron correlaciones de buenas a excelentes entre diámetro y perímetro de tórax con CI y CPT en los nadadores. Por tanto, se concluye que existió una relación entre la antropometría de tórax y la función ventilatoria en nadadores de la Universidad Católica del Maule.

The main point of this study is to determine the dimensions of the thorax and its relation to the ventilatory function of a group of swimmers members of the swimming team at Universidad Católica del Maule. 42 male subjects, whose age vary between 18 and 26 years old, were evaluated. 18 subjects were on the swimming team and 24 were sedentary students, all of them study in Universidad Católica del Maule. They were performed a basic bodily anthropometry assessment (weight and body size) and they were also performed a specific anthropometric assessment of the thorax, as well as one of the anteroposterior diameter (ATD) and the transverse diameter (TDT), thorax and the mesosternal perimeter (MP). Finally, they were performed an evaluation of the ventilatory function trough body plethysmography. For the statistical analysis the normality of the data was determined, then came the use of t of student or U of Mann-Whitney and Pearson or Spearman, depending of the case, whether it was to determine the statistical significance or correlation, respectably. A level of statistical significance of p> 0,05 was considered. A significant increase of the body mass index (BMI) was observed, bigger thorax dimensions, PDA to full pulmonary capacity (FPC) and PME to FPC and residual volume. In the ventilatory function there was a significant increase of maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP), inspiratory capacity (IC) and FPC. There were also correlations that vary from good to excellent between the diameter and perimeter of the thorax and IC and FMP, among the swimmers. Thus, it is concluded that relations exist between the anthropometrical of the thorax and the ventilatory function in swimmers of the Universidad Católica del Maule, Talca, Chile.

Effects of curcumin on pulmonary functions and the expression of TGF-β1 and NF-κB of paraquat-induced pulmonary fibrosis of rats / 中华急诊医学杂志

Objective To discuss the effects and the possible mechanismof curcumin on pulmonary functions and expression of TGF-β1 and NF-κB in paraquat-induced pulmonary fibrosis of rats.Methods SPF Wistar rats were randomly (random number) divided into three groups:paraquat-poisoned group (PQ group,with PQ 50 mg/kg by gavage),Curcumin-treatment group (PC group after 30,with curcumin (200 mg/kg) by intraperitoneal injection),and Blank group (B group,with same volume of sterile saline at the same time).After 14 d,the lung function of rats was observed,and the expression of TGF-β1 and NF-κB protein were detected by immunohistochemistry.Results The survival rates of mice significant difference in the PC and PQ groups with (70.83％ vs.41.67％,P ＜0.05).Compared with the B group,lung function index (Te,PIF,PEF,EF50,TV,F) of PQ group significantly decreased (P ＜ 0.05,P ＜ 0.01).Compared with the PQ group,lung function index (Te,PEF,TV,F) of PC group significantly increased (P ＜ 0.05 or P ＜ 0.01).There are some expression of lung tissues of rats with TGF-β1,NF-κB in B group.Compared with B group,PQ group significantly enhanced (P ＜0.01or P ＜0.05).Compared with the PQ,PC group significantly decreased (P ＜ 0.01 or P ＜ 0.05).Conclusions Curcumin can relieve paraquat-induced pulmonary fibrosis by inhibiting the over expression of TGF-β1,NF-κB in lung tissue of rats.

Evaluation of symptoms & spirometry in children treated for asthma.

Background & objectives: Spirometry plays an important role in the assessment and long term monitoring of patients with asthma. Difficulty in performing spirometry in children has resulted in a paucity of Indian studies using spirometry regularly for research in the paediatric population. This study was undertaken to assess the clinical improvement and changes in spirometric measurements with treatment in children with newly diagnosed asthma and to compare the changes in the symptom score and spirometric measurements. Methods: This prospective study included 32 children between 6 to 12 yr of age (enrolled over a period of one year with follow up of six months) who were newly diagnosed as cases of asthma on the basis of symptoms and medical history. Baseline symptom score and spirometric measurements were determined at the first visit. The children were treated and followed up at six weeks, three and six months of initiating treatment. Symptom score and spirometric measurements were repeated at every visit. Results: Significant improvement in symptom score was evident at six weeks of therapy (P<0.05) while the lung function parameters FEV1 (forced expiratory volume in 1 second) and FVC (forced vital capacity) showed significant improvement at three months of therapy. Peak expiratory flow rate (PEFR) was found to improve at six months. There was a positive linear correlation between the changes in symptom score and FEV1, FVC and PEFR with treatment. Interpretation & conclusions: Symptomatic improvement became apparent before the improvement in spirometric parameters in children with asthma (after treatment initiation).

The Type of Obesity and Its Impact on Pulmonary Functions.

Obesity has been associated with many health consequences, including but not limited to diabetes, hypertension, hyperlpidemia, ischemic heart diseases, obstructive sleep apnea, stroke, premature death, osteoporosis and a reduction of the overall quality of life. Obesity affects the respiratory system as well. To investigate the effect of obesity on the respiratory system, most researchers use values of pulmonary function tests (PFT). Poor respiratory function and obesity are associated with all-cause and cardiovascular disease mortality. Obese persons may also have impaired lung function, but the mechanism is unclear. Waist:hip ratio was used to assess abdominal obesity, and forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), obtained by spirometry, were used to assess respiratory function. Both FEV1 and FVC were linearly and inversely related across the entire range of waist:hip ratio in both men and women. Objectives of the study: 1) To evaluate the effect of obesity on pulmonary functions. 2) To find out whether there is any difference in breathing pattern with the type of obesity.

Effect of formalin vapours on pulmonary functions of medical students in anatomy dissection hall over a period of one year.

Formalin is extensively used for preservation of cadavers in department of Anatomy. However it is a noxious chemical which vaporises at normal room temperature in the air and may cause respiratory health problems among first year medical students. The study was planned to observe the effect of formalin vapours on lung function tests of first year medical students who are exposed routinely for 2 hrs every day for 6 days per week throughout the year. Following written informed consent clinically healthy 100 medical students between age group 18-23 yrs were subjected to pulmonary function testing by computerised spirometery. The dynamic lung function tests (FVC, FEV1, FEV1%, FEF25-75, PEFR) were measured on four occasions-basal (before exposure), 1 month, 6 months, 11 months of exposure to formalin vapours in anatomy dissection hall. The study revealed statistically significant (P<0.0001) decreases in FVC, FEV1%, FEF25-75, PEFR except FEV1 after 1 month of exposure to anatomy dissection hall. The decrease in all the parameters slowly reverted back towards normal basal values across 6 and 11 months and was statistically significant in all (P<0.0001) except FVC. Acute exposure to formalin vapours at anatomy dissection hall decreases the respiratory functions, however on long term exposure the body corrects the damage. Further studies are required to see the changes at cellular levels and the extent of damage to respiratory system.

Normative spirometric values in adult kashmiri population.

Background. Normative values of pulmonary functions of healthy population are affected by different geographic, ethnic, climatic and demographic factors. Objective. Present study was designed to derive normative spirometric values, prediction equations for future reference in adult Kashmiri population. Methods. Pulmonary function testing was carried out on 3080 normal healthy non-smoking individuals (1974 males; age 18-65 years) of Kashmir valley. Multiple regression analysis was used to develop prediction equations for use in this population. Results. Forced vital capacity (FVC, L/s) (4.3±0.8 versus 3.0±0.5; p<0.05), forced expiratory volume in the first second (FEV1, L/s) (3.9±0.7 versus 2.6±0.5; p<0.05) and peak expiratory flow rate (PEFR, L/s) (7.9±1.8 versus 5.3±1.2; p<0.05) were significantly higher in males in comparison with females. All the other parameters except FEV1/PEFR ratio were significantly higher among males (p<0.05). Irrespective of gender, all the parameters declined with increasing age. Females had higher FEV1/PEFR ratio (p<0.05) in age group of 15-30 years. Overall the inter-group difference across the districts studied was not significant. Spirometric parameters manifested an overall negative correlation with increasing body mass index (BMI), although FVC and FEV1 in males with low BMI were high (p<0.05). Conclusion. These prediction equations can be utilised as reference values for future use in adult Kashmiri population.

A study on pulmonary manifestations in patients with malaria from north-western India (Bikaner).

Background & objectives: Plasmodium falciparum (Pf) and Plasmodium vivax (Pv) are responsible for most of the global burden of malaria. With changing spectrum of clinical presentation in malaria, pulmonary system involvement has always been under diagnosed. The present study was planned to estimate the pulmonary system involvement in patients with malaria from north-western India (Bikaner). Study design & description of the patients: Our study was conducted during 2007 to 2009 in 200 cases of severe malaria [Pf , Pv, and mixed (Pf + Pv)] with pulmonary involvement. It included adult patients of both sexes (145 males and 55 females) belonging to all age groups. The diagnosis of Pf and Pv was confirmed by demonstrating asexual form of parasites in peripheral blood smear and OptiMal test. Main outcome measures: Pulmonary involvement was observed in 30% (60/200) patients among which cough in 24% , dyspnea in 12%, acute respiratory distress syndrome (ARDS) in 7% , bronchitis in 3% and pneumonia in 1.5% were the major clinical manifestations of malaria. Metabolic acidosis and low oxygen saturation was observed in 7% patients. Chest X-ray abnormality in 11.5% patients, 7% had bilateral infiltrates, 1.5% had inflammatory patch and 3% had findings suggestive of bronchitis. Spirometry findings showed 17% patients had early small airway obstruction. All the patients with ARDS had poor disease outcome. Results & conclusion: Our results suggest that pulmonary system involvement was observed in patients infected with Pf and Pv. If these clinical presentations are ignored, it may lead to delay in diagnosis and can alter the outcome and prognosis of the disease. Therefore, early diagnosis of malaria induced ARDS can significantly affect the outcome.

Acute effects of deep breathing for a short duration (2-10 minutes) on pulmonary functions in healthy young volunteers.

Breathing is the most vital function for maintenance of life. Slow and deep breathing is an integral part of Pranayama and it reduces dead space ventilation and renews air throughout the lungs. The reported beneficial effects of deep breathing as a part of either long term or short term practice of pranayama are well documented. However our knowledge about the effects of a few minutes’ of deep breathing on human ventilatory parameters is poor. In the present study, we examined the relationship between exposure to short duration of deep breathing and performance on Pulmonary Function Tests before and after the deep breathing. The study was conducted in a homogenous group of 12 volunteers containing 4 females and 8 males who were well trained in pulmonary function testing (PFT) before the start of the study. The volunteers performed deep breathing (DB) exercise for 2, 5 and 10 minutes at the rate of 6 breaths per minute under guidance, and the duration of DB exercise for that day was randomly selected for each group. PFT was done before and after the DB exercise. There was a significant (P<0.05) increase in vital capacity (VC) after 2 and 5 minutes’ DB exercise and a consistent improvement in tidal volume (TV) and minute ventilation (MV) after the DB exercise in all the three groups, though it wasn’t statistically significant. There was a significant (P<0.05) increase in forced vital capacity (FVC) after 2 minutes’ of DB exercise and a consistent increase in all the three groups in forced inspiratory vital capacity (FIVC) and peak inspiratory flow rate (PIFR), though this increase was not statistically significant. This shows that deep breathing exercise, even for a few minutes’ duration is beneficial for the lung functions.

Pulmonary functions in plastic factory workers: A preliminary study.

Exposure to long term air pollution in the work environment may result in decreased lung functions and various other health problems. A significant occupational hazard to lung functions is experienced by plastic factory workers. The present study is planned to assess the pulmonary functions of workers in the plastic factory where recycling of pastic material was done. These workers were constantly exposed to fumes of various chemicals throughout the day. Thirty one workers of plastic factory were assessed for their pulmonary functions. Parameters were compared with 31 age and sex matched controls not exposed to the same environment. The pulmonary function tests were done using Sibelmed Datospir 120 B portable spirometer. A significant decrease in most of the flow rates (MEF 25%, MEF 50%, MEF 75% and FEF 25-75%) and most of the lung volumes and capacities (FVC, FEV1, VC, TV, ERV, MVV) were observed in the workers. Smoking and duration of exposure were not affecting the lung functions as the non smokers also showed a similar decrement in pulmonary functions. Similarly the workers working for less than 5 years also had decrement in pulmonary functions indicating that their lungs are being affected even if they have worked for one year. Exposure to the organic dust in the work environment should be controlled by adequate engineering measures, complemented by effective personal respiratory protection.

Comparafive study on arterial blood gas analysis and pulmonary functions of emphysematous rabbits after unilateral and bilateral lung volume reduction surgery / 中华胸心血管外科杂志

Objective Describes the changes of arterial blood gas analysis and pulmonary functions of emphysematous rabbits after unilateral and bilateral lung volume reduction surgery.Methods Sixty rabbits were randomly and equally divided into 6 groups:control group(A),emphysema group( B),unilateral sham operation group(C),unilateral lung volume reduction surgery group( D),bilateral sham operation group( E ) and bilateral lung volume reduction surgery group(F).Obstructive emphysema was induced with somg and papain in tie rabbits of the remaining groups except the control one.Eight weeks later,arterial blood gas analysis and pulmonary functions were detected.Results Compared with group B,pH,PaO2,PaCO2,SaO2,forced expirratory volume in 0.5 s,froced expiratory capacity,functional residual capacity,total lung capacity,dynamic compliance,and resistance in expiartory phase could be improved in group D ( P ＜ 0.05 ).The amelioration of those results were more obvious in group F ( P ＜0.05).Two rabbits in group F died after opertation.Conclusion Bilateral lung volume reduction surgery could more markedly improve the arterial blood gas analysis and pulmonary functions of emphysematous rabbits than unilateral operation.

A study of the effect of yoga training on pulmonary functions in patients with bronchial asthma.

The role of yoga breathing exercises, as an adjunct treatment for bronchial asthma is well recognized. One hundred twenty patients of asthma were randomized into two groups i.e Group A (yoga training group) and Group B (control group). Each group included sixty patients. Pulmonary function tests were performed on all the patients at baseline, after 4 weeks and then after 8 weeks. Majority of the subjects in the two groups had mild disease (34 patients in Group A and 32 in Group B). Group A subjects showed a statistically significant increasing trend (P<0.01) in % predicted peak expiratory flow rate (PEFR), forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), forced mid expiratory flow in 0.25–0.75 seconds (FEF25-75) and FEV1/FVC% ratio at 4 weeks and 8 weeks as compared to Group B. Thus, yoga breathing exercises used adjunctively with standard pharmacological treatment significantly improves pulmonary functions in patients with bronchial asthma.

Acute effects of formalin on pulmonary functions in gross anatomy laboratory.

Formaldehyde is a common indoor pollutant with irritant properties. The present study was undertaken in first year medical students to study the acute effects of it on their first exposure in gross anatomy laboratory. Twenty randomly selected subjects aged between 18 to 20 years and non smokers had undergone pulmonary function testing thrice. First being baseline values then immediately after their first dissection class (2 hrs.) and lastly 24 hrs after their first exposure. All the tests were performed on Siblemed 120 B portable spirometer with inbuilt computer programme under standard laboratory conditions. It was observed that FVC decreased in subjects immediately after their first exposure but reverted back to normal within 24 hrs. While all other lung function parameters remained unchanged, indicating some mild transient bronchoconstriction on acute exposure to formalin. The study needs to be extended with larger number of subjects.

Effect of paternal smoking on the pulmonary functions of adolescent males.

Objective : The present study was conducted to evaluate the effect of paternal smoking on the respiratory function of adolescents. Study method : The study group comprised thirty healthy males between the ages of 12–18 years whose fathers were smokers (Group 1). They were compared with age and sex matched thirty active smoker males (Group 2). The control group comprised age and sex matched thirty males who were neither active nor passive smokers (Group 3). Pulmonary function was assessed using Sibelmed Datospir120B spirometer in a closed room. Results : FEV1/FVC ratio and FEF25%–75% (forced expiratory flow at 25%–75% of vital capacity) were significantly lower in the subjects exposed to paternal smoking as compared to non-smokers. Vital capacity & expiratory reserve volume were significantly lower in active smokers as compared to non-smokers. Conclusions : Our findings suggest a significant reduction in indices of lung functions of adolescents exposed to paternal smoke.

Long-term Prognosis and Physiologic Status of Patients Requiring Ventilatory Support Secondary to Chest wall Disorders / 결핵및호흡기질환

BACKGROUND: Chest wall deformities such as kyphoscoliosis, thoracoplasty, and fibrothorax cause ventilatory insufficiency that can lead to chronic respiratory failure, with recurrent fatal acute respiratory failure(ARF). This study evaluated the frequency and outcome of ARF, the physiologic status, and the long-term prognosis of these patients. METHODS: Twenty-nine patients with chest wall disorders, who experienced the first requirement of ventilatory support from ARF were examined. The mortality and recurrence rate of ARF, the pulmonary functions with arterial blood gas analysis, the efficacy of home oxygen therapy, and the long-term survival rate were investigated. RESULTS: 1) The mortality of the first ARF was 24.1%. ARF recurred more than once in 72.7% of the remaining 22 patients, and overall rate of successful weaning was 73.2%. 2) Twenty-two patients who recovered from the first ARF showed a restrictive ventilatory impairment with a mean FVC and TLC of 37.2% and 62.4 % of predicted value, respectively, and a mean PaCO2 of 57mmHg. Among the parameters of pulmonaty functions. the FVC(p=0.01) and VC(p=0.02) showed a significant correlation with the PaCO2 level. 3) There were no significant differences between the patients treated with conservative medical treatment only and those with additional home oxygen therapy due to significant hypoxemia in the patients with recurrent ARF and the mortality. 4) The 1, 3, 5-year survival rates were 75%, 66%, and 57%, respectively, in the 20 patients who had recovered from the first ARF, excluding the two patients managed by non-invasive nocturnal ventilatory support. CONCLUSION: These results suggest that active ventilatory support should be provided to patients with ARF and chest wall disorders. However, considering recurrent ARF and weak effect of home oxygen therapy, non-invasive domiciliary ventilation is recommended in those patients with these conditions to achieve a better long-term prognosis.