A pilot comparison of helium dilution and plethysmographic lung volumes to assess the impact of a long-acting bronchodilator on lung hyperinflation in COPD

Cazzola, Mario; Rogliani, Paola; Curradi, Giacomo; Segreti, Andrea; Ciaprini, Chiara; Pezzuto, Gabriella; Saltini, Cesare

doi:10.1016/j.pupt.2009.05.005

Cited by 12 publications

(12 citation statements)

References 15 publications

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“…For example, some studies found that an increase of RV/TLC was an independent risk factor of all-cause mortality and frequent exacerbations in COPD population1415. Lung volume is also very sensitive to bronchodilators and lung-volume reduction surgery, and better associated with patient-centered outcomes such as dyspnea and exercise tolerance161718. Washko et al found that preoperative RV/TLC ratio but not FEV 1 is predictive of postoperative outcomes after lung-volume reduction surgery16.…”

Section: Discussionmentioning

confidence: 99%

The measurement of lung volumes using body plethysmography and helium dilution methods in COPD patients: a correlation and diagnosis analysis

Tang

Zhang

Feng

et al. 2016

Sci Rep

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Chronic obstructive pulmonary disease (COPD) is a chronic airway disease characterized by persistent airflow limitation. Moreover, lung hyperinflation evaluated by lung volumes is also the key pathophysiologic process during COPD progression. Nevertheless, there is still no preferred method to evaluate lung volumes. For this study, we recruited 170 patients with stable COPD to assess lung volumes stratified by airflow limitation severity. Lung volumes including residual volume (RV) and total lung capacity (TLC) were determined by both body plethysmography and helium dilution methods. The discrepancies between these two methods were recorded as ΔRV%pred, ΔTLC%pred, and ΔRV/TLC. We found that ΔRV%pred, ΔTLC%pred, and ΔRV/TLC increased significantly with the severity of COPD. The differences of lung capacity between these two methods were negatively correlated with FEV1%pred, and diffusing capacity for carbon monoxide (DLCO%pred). Moreover, the receiver operating characteristic (ROC) for ΔTLC%pred to distinguish severe COPD from non-severe COPD had an area under curve (AUC) of 0.886. The differences of lung volume parameters measured by body plethysmography and helium dilution methods were associated with airflow limitation and can effectively differentiate COPD severity, which may be a supportive method to assess the lung function of stable COPD patients.

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Section: Discussionmentioning

confidence: 99%

The measurement of lung volumes using body plethysmography and helium dilution methods in COPD patients: a correlation and diagnosis analysis

Tang

Zhang

Feng

et al. 2016

Sci Rep

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“…When lung volumes are used to make therapeutic/clinical decisions, the method by which those volumes are derived may need to be considered. 32,51 CT scanning provides an option to body plethysmography or gas dilution for measuring lung volumes. 52 However, it is more expensive than any of the conventional methods.…”

Section: Does It Make Any Difference How You Measure Lung Volumes?mentioning

confidence: 99%

What Is the Clinical Value of Lung Volumes?

Ruppel

2012

Respir Care

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Lung volumes are considered part of a complete pulmonary function test, but their value for enhancing clinical decision making is unknown. Unlike spirometry and diffusing capacity of the lung for carbon monoxide (D LCO ), which do contribute to confirming or excluding a diagnosis, there are few clear indications when lung volumes are discriminatory. Confirming "restriction" when vital capacity (VC) or FVC is reduced is perhaps the most important. A restrictive pattern can have many etiologies, and clinicians often use VC or FVC as a primary index of lung volume. This makes "physiologic" sense because, in healthy subjects, and in patients with true restriction, VC comprises most of the total lung capacity (TLC). Mixed obstruction-restriction and the nonspecific pattern (ie, reduced FVC and FEV 1 , normal FEV 1 /FVC and TLC) require measuring TLC to confirm the underlying physiology. In obesity, VC and TLC may remain within normal limits, but functional residual capacity (FRC) can exponentially decrease. Increased lung volumes, particularly residual volume (RV), are commonly observed in airway obstruction. TLC may be normal, but is frequently increased in the late stages of COPD. Hyperinflation and air-trapping are terms commonly used to reflect these changes, but are not well standardized. The variability of lung volumes related to degree of obstruction suggests that measuring gas-trapping may be needed to monitor therapy. Changes in inspiratory capacity, RV, or FRC may be important gauges of response to bronchodilators or other hyperinflation-reducing therapies. How lung volumes are measured may be important, especially in patients who have moderate or severe airway obstruction. Body plethysmography is often considered more accurate than gas dilution methods in the presence of obstruction. However, the differences between techniques are not completely understood. Newer approaches such as computed tomography, although not suitable for routine testing, may help to delineate the true underlying physiology.

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“…However, the helium dilution method is known to underestimate lung volumes, while body plethysmography measures increased lung volumes in obstructive patients [6]. After administration of tiotropium for two weeks in obstructive patients with hyperinflation, lung volumes such as residual volume (RV) and functional residual capacity (FRC) measured with body plethysmography decreased, while RV and FRC measured by helium dilution method increased [7]. …”

Section: Introductionmentioning

confidence: 99%

Flow-Volume Parameters in COPD Related to Extended Measurements of Lung Volume, Diffusion, and Resistance

et al. 2013

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Classification of COPD into different GOLD stages is based on forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) but has shown to be of limited value. The aim of the study was to relate spirometry values to more advanced measures of lung function in COPD patients compared to healthy smokers. The lung function of 65 COPD patients and 34 healthy smokers was investigated using flow-volume spirometry, body plethysmography, single breath helium dilution with CO-diffusion, and impulse oscillometry. All lung function parameters, measured by body plethysmography, CO-diffusion, and impulse oscillometry, were increasingly affected through increasing GOLD stage but did not correlate with FEV1 within any GOLD stage. In contrast, they correlated fairly well with FVC%p, FEV1/FVC, and inspiratory capacity. Residual volume (RV) measured by body plethysmography increased through GOLD stages, while RV measured by helium dilution decreased. The difference between these RV provided valuable additional information and correlated with most other lung function parameters measured by body plethysmography and CO-diffusion. Airway resistance measured by body plethysmography and impulse oscillometry correlated within COPD stages. Different lung function parameters are of importance in COPD, and a thorough patient characterization is important to understand the disease.

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A pilot comparison of helium dilution and plethysmographic lung volumes to assess the impact of a long-acting bronchodilator on lung hyperinflation in COPD

Abstract: , et al.. A pilot comparison of helium dilution and plethysmographic lung volumes to assess the impact of a longacting bronchodilator on lung hyperinflation in COPD.

Cited by 12 publications

References 15 publications

The measurement of lung volumes using body plethysmography and helium dilution methods in COPD patients: a correlation and diagnosis analysis

The measurement of lung volumes using body plethysmography and helium dilution methods in COPD patients: a correlation and diagnosis analysis

What Is the Clinical Value of Lung Volumes?

Flow-Volume Parameters in COPD Related to Extended Measurements of Lung Volume, Diffusion, and Resistance

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