PMID: 3767126Oct 1, 1986Paper

Involuntary breath-stacking. An alternative method for vital capacity estimation in poorly cooperative subjects

The American Review of Respiratory Disease
J J MariniV Lamb

Abstract

Performed correctly, the vital capacity (VC) is a useful indicator of the mechanical properties of the thorax and of neuromuscular performance. Unfortunately, its use is often limited by impaired comprehension, altered mental status, or inability to sustain forceful effort. Our purpose was to develop a measure of VC independent of subject cooperation. We estimated the subcomponents of VC (inspiratory capacity (IC) and expiratory reserve volume (ERV], using one-way valving of an external circuit to enforce cumulation or elimination of the tidal breaths stimulated by endogenous ventilatory drive. When configured to measure IC, gas entered the chest incrementally, until tidal effort became insufficient to overcome thoracic recoil. Valve rearrangement permitted analogous estimation of ERV. We tested the validity of this method in cooperative but naive subjects by comparing the VC measured in standard fashion (VCC) to the breath-stacked estimate (VCS). Thirty normal subjects and 20 ambulatory patients with diverse causes for respiratory impairment were studied. Peak and mean values of VCS correlated strongly with the corresponding values of VCC (r greater than or equal to 0.91). The coefficient of variation for sequential V VCS dete...Continue Reading

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