Official ERS technical standard: Global Lung Function Initiative reference values for static lung volumes in individuals of European ancestry

Abstract

BackgroundMeasurement of lung volumes across the life course is critical to the diagnosis and management of lung disease. The aim of the study was to use the Global Lung Function Initiative methodology to develop all-age multi-ethnic reference equations for lung volume indices determined using body plethysmography and gas dilution techniques.MethodsStatic lung volume data from body plethysmography and gas dilution techniques from individual, healthy participants were collated. Reference equations were derived using the LMS (lambda-mu-sigma) method and the generalised additive models of location shape and scale programme in R. The impact of measurement technique, equipment type and being overweight or obese on the derived lung volume reference ranges was assessed.ResultsData from 17 centres were submitted and reference equations were derived from 7190 observations from participants of European ancestry between the ages of 5 and 80 years. Data from non-European ancestry populations were insufficient to develop multi-ethnic equations. Measurements of functional residual capacity (FRC) collected using plethysmography and dilution techniques showed physiologically insignificant differences and were combined. Sex-specific reference equations including height and age were developed for total lung capacity (TLC), FRC, residual volume (RV), inspiratory capacity, vital capacity, expiratory reserve volume and RV/TLC. The derived equations were similar to previously published equations for FRC and TLC, with closer agreement during childhood and adolescence than in adulthood.ConclusionsGlobal Lung Function Initiative reference equations for lung volumes provide a generalisable standard for reporting and interpretation of lung volumes measurements in individuals of European ancestry.

Normative reference equations of airway dynamics assessed by whole‐body plethysmography during spontaneous breathing evaluated in infants, children, and adults

“…An extension of the so‐called LMS (lambda, mu, sigma) method (Cole & Green, 1992 ; Cole et al, 2009 ) was applied. Prediction models using LMS‐statistics have been formulated for spirometric parameters (Quanjer, Stanojevic, et al, 2012 ), the carbon monoxide transfer factor (Stanojevic et al, 2017 ), and static lung volumes in individuals of European ancestry (Hall et al, 2021 ). However, there is a striking dearth of normative reference values availability measuring parameters of airway dynamics computed throughout the whole respiratory cycle during spontaneous breathing at rest such as the effective specific airway resistance (sR eff ), its reciprocal value, the effective specific airway conductance (sG eff ), and the specific aerodynamic work of breathing at rest (sWOB).…”

Sex and gender in respiratory physiology

“…Supported by the European Respiratory Society, the European Respiratory Society Global Lung Function Initiative (GLI) has developed sex-specific reference equations, with age and height being independent and significant predictors, for spirometry [64], carbon monoxide transfer factor [65] and static lung volumes [66]. It is interesting to notice that the authors never comment on differences induced by sex.…”

Putting lung function reference equations into context

“…Brigitte M. Borg 1,2 , Bruce R. Thompson 3 1 Respiratory Medicine, The Alfred, Melbourne, Australia. 2 School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.…”

“…2 School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. 3 School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.…”