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

Jarenbäck, Linnea; Ankerst, Jaro; Bjermer, Leif; Tufvesson, Ellen

doi:10.1155/2013/782052

Cited by 38 publications

(28 citation statements)

References 19 publications

(19 reference statements)

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“…However, the guideline does not make a clear recommendation on which specific technique is the best to use, especially in COPD patients, that lung volumes measured by WBP and MBHD are always not consistent. Consistent with other studies, our study found that TLC%pred, RV%pred and RV/TLC measured in COPD patients by WBP were significantly higher than those measured by MBHD method891119. Coertjens et al found that in 93 COPD patients (29 mild/moderate, 29 severe, 35 very severe), the differences of TLC between the WBP and MBHD method ranged from 30.5% of the predicted value to 38.2% of the predicted value, which is similar to our finding8.…”

Section: Discussionsupporting

confidence: 92%

“…As previous mentioned, underestimation of lung volume by MBHD is associated with the degree of gas trapping. Our findings align with Jarenback et al 19 in that with single breath or multiple breath helium dilution methods, the helium dilution-derived TLC did not increase based on GOLD classifications. Moreover, O’Donnell et al found FEV 1 %pred <30% is an independent factor for ΔTLC >1L, which also indicates that the difference of lung volumes measured by different methods maybe associated with airflow limitation9.…”

Section: Discussionsupporting

confidence: 92%

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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: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

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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“…We have previously shown that baseline impulse oscillometry (IOS) parameters seem to be more affected in moderate-to-severe COPD patients, while volume and diffusion parameters are more affected in severe and very severe COPD patients. In addition, we showed that the lung function parameters are widely spread in Global Initiative for chronic Obstructive Lung Disease (GOLD) stage 2 2. Post hoc investigations of this study identified break points (BPs) in the linear relationship between forced expiratory volume in 1 second (FEV 1 ) percent predicted (%p) and advanced lung function parameters, identifying a change in the lung function pattern when FEV 1 %p drops below 65 3.…”

Section: Introductionmentioning

confidence: 79%

Bronchodilator response of advanced lung function parameters depending on COPD severity

Jarenbäck

Eriksson

Peterson

et al. 2016

COPD

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BackgroundCOPD is defined as partly irreversible airflow obstruction. The response pattern of bronchodilators has not been followed in advanced lung function parameters.PurposeThe aim of this study was to investigate bronchodilator response pattern in advanced lung function parameters in a continuous fashion along forced expiratory volume in 1 second (FEV1) percent predicted (%p) in COPD patients and controls.Patients and methodsEighty-one smokers/ex-smokers (41 controls and 40 COPD) performed spirometry, body plethysmography, impulse oscillometry and single-breath helium dilution carbon monoxide diffusion at baseline, after salbutamol inhalation and then after an additional inhalation of ipratropium.ResultsMost pulmonary function parameters showed a linear increase in response to decreased FEV1%p. The subjects were divided into groups of FEV1%p <65 and >65, and the findings from continuous analysis were verified. The exceptions to this linear response were inspiratory capacity (IC), forced vital capacity (FVC), FEV1/FVC and expiratory resistance (Rex), which showed a segmented response relationship to FEV1%p. IC and FVC, with break points (BP) of 57 and 58 FEV1%p respectively, showed no response above, but an incresed slope below the BP. In addition, in patients with FEV1%p <65 and >65, response of FEV1%p did not correlate to response of volume parameters.ConclusionResponse of several advanced lung function parameters differs depending on patients’ baseline FEV1%p, and specifically response of volume parameters is most pronounced in COPD patients with FEV1%p <65. Volume and resistance responses do not follow the flow response measured with FEV1 and may thus be used as a complement to FEV1 reversibility to identify flow, volume and resistance responders.

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“…Lowering of FEV% measures the degree of airflow obstruction, predominantly in large and intermediate airways, but provides no explanation of the underlying pathophysiology 11. It is therefore generally accepted that FEV 1 by itself cannot describe the complexity of COPD and that FEV 1 alone cannot be used for optimal assessment and management of the disease 7,12…”

Section: Introductionmentioning

confidence: 99%

Identifying the heterogeneity of COPD by V/P SPECT: a new tool for improving the diagnosis of parenchymal defects and grading the severity of small airways disease

Bajc¹,

Chen²,

Wang³

et al. 2017

COPD

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IntroductionAirway obstruction and possible concomitant pulmonary diseases in COPD cannot be identified conventionally with any single diagnostic tool. We aimed to diagnose and grade COPD severity and identify pulmonary comorbidities associated with COPD with ventilation/perfusion single-photon emission computed tomography (V/P SPECT) using Technegas as the functional ventilation imaging agent.Methods94 COPD patients (aged 43–86 years, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I–IV) were examined with V/P SPECT and spirometry. Ventilation and perfusion defects were analyzed blindly according to the European guidelines. Penetration grade of Technegas in V SPECT measured the degree of obstructive small airways disease. Total preserved lung function and penetration grade of Technegas in V SPECT were assessed by V/P SPECT and compared to GOLD stages and spirometry.ResultsSigns of small airway obstruction in the ventilation SPECT images were found in 92 patients. Emphysema was identified in 81 patients. Two patients had no signs of COPD, but both of them had a pulmonary embolism, and in one of them we also suspected a lung tumor. The penetration grade of Technegas in V SPECT and total preserved lung function correlated significantly to GOLD stages (r=0.63 and −0.60, respectively, P<0.0001). V/P SPECT identified pulmonary embolism in 30 patients (32%). A pattern typical for heart failure was present in 26 patients (28%). Parenchymal changes typical for pneumonia or lung tumor were present in several cases.ConclusionV/P SPECT, using Technegas as the functional ventilation imaging agent, is a new tool to diagnose COPD and to grade its severity. Additionally, it revealed heterogeneity of COPD caused by pulmonary comorbidities. The characteristics of these comorbidities suggest their significant impact in clarifying symptoms, and also their influence on the prognosis.

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

Cited by 38 publications

References 19 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

Bronchodilator response of advanced lung function parameters depending on COPD severity

Identifying the heterogeneity of COPD by V/P SPECT: a new tool for improving the diagnosis of parenchymal defects and grading the severity of small airways disease

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