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Comparison of plethysmographic and helium dilution lung volumes: which is best for COPD? 2010

Carl R O'Donnell, and Alexander A Bankier, and Leopold Stiebellehner, and John J Reilly, and Robert Brown, and Stephen H Loring
ScD, Beth Israel Deaconess Medical Center, Dana 717, 330 Brookline Ave, Boston, MA 02215, USA. codonne1@bidmc.harvard.edu

BACKGROUND Theoretical considerations and limited scientific evidence suggest that whole-body plethysmography overestimates lung volume in patients with severe airflow obstruction. We sought to compare plethysmography (Pleth)-, helium dilution (He)- and CT scan-derived lung volume measurements in a sample containing many patients with severe airflow obstruction. METHODS We measured total lung capacity (TLC) in 132 patients at three hospitals, with monitored application of recommended techniques for Pleth and He measurements of lung volume and by thoracic CT scans obtained during breath hold at full inspiration. RESULTS Average TLC among 132 subjects was 6.18 L (+/- 1.69 L) by Pleth-derived TLC, 5.55 L (+/- 1.39 L) by He-derived TLC, and 5.31 L (+/- 1.47) by CT scan-derived TLC. Pleth-derived TLC was significantly greater than either He-derived TLC or CT scan-derived TLC (P < or = .001), whereas there was no significant difference between He-derived and CT scan-derived values. When examined separately, there were significant within-subject differences in TLC by measurement technique among subjects with airflow obstruction, but not among those without airflow obstruction. Plethysmographic overestimation of TLC was greatest among subjects with FEV(1) < 30% of predicted. CONCLUSIONS In the setting of airflow obstruction, Pleth systematically overestimates lung volume relative to He or thoracic imaging despite adherence to current recommendations for proper measurement technique.

UI MeSH Term Description Entries
D007201 Indicator Dilution Techniques Methods for assessing flow through a system by injection of a known quantity of an indicator, such as a dye, radionuclide, or chilled liquid, into the system and monitoring its concentration over time at a specific point in the system. (From Dorland, 28th ed) Dilution Techniques,Dilution Technics,Indicator Dilution Technics,Dilution Technic,Dilution Technic, Indicator,Dilution Technics, Indicator,Dilution Technique,Dilution Technique, Indicator,Dilution Techniques, Indicator,Indicator Dilution Technic,Indicator Dilution Technique,Technic, Dilution,Technic, Indicator Dilution,Technics, Dilution,Technics, Indicator Dilution,Technique, Dilution,Technique, Indicator Dilution,Techniques, Dilution,Techniques, Indicator Dilution
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D008176 Lung Volume Measurements Measurement of the amount of air that the lungs may contain at various points in the respiratory cycle. Lung Capacities,Lung Volumes,Capacity, Lung,Lung Capacity,Lung Volume,Lung Volume Measurement,Measurement, Lung Volume,Volume, Lung
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009929 Organ Size The measurement of an organ in volume, mass, or heaviness. Organ Volume,Organ Weight,Size, Organ,Weight, Organ
D010993 Plethysmography, Whole Body Measurement of the volume of gas in the lungs, including that which is trapped in poorly communicating air spaces. It is of particular use in chronic obstructive pulmonary disease and emphysema. (Segen, Dictionary of Modern Medicine, 1992) Whole Body Plethysmography,Body Plethysmographies, Whole,Body Plethysmography, Whole,Plethysmographies, Whole Body,Whole Body Plethysmographies
D012129 Respiratory Function Tests Measurement of the various processes involved in the act of respiration: inspiration, expiration, oxygen and carbon dioxide exchange, lung volume and compliance, etc. Lung Function Tests,Pulmonary Function Tests,Function Test, Pulmonary,Function Tests, Pulmonary,Pulmonary Function Test,Test, Pulmonary Function,Tests, Pulmonary Function,Function Test, Lung,Function Test, Respiratory,Function Tests, Lung,Function Tests, Respiratory,Lung Function Test,Respiratory Function Test,Test, Lung Function,Test, Respiratory Function,Tests, Lung Function,Tests, Respiratory Function
D005260 Female Females
D005541 Forced Expiratory Volume Measure of the maximum amount of air that can be expelled in a given number of seconds during a FORCED VITAL CAPACITY determination . It is usually given as FEV followed by a subscript indicating the number of seconds over which the measurement is made, although it is sometimes given as a percentage of forced vital capacity. Forced Vital Capacity, Timed,Timed Vital Capacity,Vital Capacity, Timed,FEVt,Capacities, Timed Vital,Capacity, Timed Vital,Expiratory Volume, Forced,Expiratory Volumes, Forced,Forced Expiratory Volumes,Timed Vital Capacities,Vital Capacities, Timed,Volume, Forced Expiratory,Volumes, Forced Expiratory

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