Correction of single-breath helium lung volumes in patients with airflow obstruction

Chest
N M PunjabiR A Wise

Abstract

To determine whether alveolar volume (V(A)) measured during the single-breath diffusing capacity for carbon monoxide (DCO) can be used as a substitute measure for the multiple-breath total lung capacity (TLC) in subjects with and without airways obstruction. Retrospective review of pulmonary function test (PFT) results. Pulmonary function laboratories at the Johns Hopkins Hospital (JHH) and the Johns Hopkins Asthma and Allergy Center (HAAC). Patients referred for spirometry, helium lung volumes, and Dco during a single visit between November 1993 and November 1996. JHAAC patients (n=2,477) were used to assess the relationship between V(A) and TLC. In patients with an FEV1/FVC > or = 0.70, there was good agreement between V(A) and TLC (V(A)/TLC=0.97 to 0.99). However, in patients with an FEV1/FVC <0.70, V(A) systematically underestimated TLC (V(A)/TLC=0.67 to 0.94). The degree of underestimation was related to the severity of airflow obstruction. To predict TLC using V(A) a regression equation was used to "correct" V(A) for the severity of obstruction. This equation was used to predict the multiple-breath TLC for JHH patients (n=2,892). Patients with an FEV1/FVC > or = 0.70 showed a high degree of correlation between V(A) and TL...Continue Reading

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