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

2021 ◽  
Vol 57 (3) ◽  
pp. 2000289
Author(s):  
Graham L. Hall ◽  
Nicole Filipow ◽  
Gregg Ruppel ◽  
Tolu Okitika ◽  
Bruce Thompson ◽  
...  
Keyword(s):  
Lung Function ◽  
Lung Volume ◽  
Additive Models ◽  
European Ancestry ◽  
Reference Ranges ◽  
Body Plethysmography ◽  
Lung Volumes ◽  
Reference Equations ◽  
Gas Dilution ◽  
The Impact

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.

Measurement of high lung volumes by nitrogen washout method

1994 ◽  
Vol 77 (3) ◽  
pp. 1562-1564 ◽  
Author(s):  
Y. Sivan ◽  
J. Hammer ◽  
C. J. Newth
Keyword(s):  
Lung Volume ◽  
Human Infants ◽  
Lung Volumes ◽  
Nitrogen Washout ◽  
Thoracic Gas Volume ◽  
Residual Capacity ◽  
The Difference ◽  
Gas Dilution ◽  
Spontaneously Breathing ◽  
Gas Volume

Studies on human infants suggested that thoracic gas volume (TGV) measured at end exhalation may not depict the true TGV and may differ from TGV measured from a series of higher lung volumes and corrected for the volume added. This was explained by gas trapping. If true, we should expect the discrepancy to be more pronounced when functional residual capacity (FRC) and higher lung volumes are measured by gas dilution techniques. We studied lung volumes above FRC by the nitrogen washout technique in 12 spontaneously breathing rhesus monkeys (5.0–11.3 kg wt; 42 compared measurements). Lung volumes directly measured were compared with preset lung volumes achieved by artificial inflation of the lungs above FRC with known volumes of air (100–260 ml). Measured lung volume strongly correlated with and was not significantly different from present lung volume (P = 0.05; r = 0.996). The difference between measured and preset lung volume was 0–5% in 41 of 42 cases [1 +/- 0.4% (SE)]. The direction of the difference was unpredictable; in 22 of 42 cases the measured volume was larger than the preset volume, but in 17 of 42 cases it was smaller. The difference was not affected by the volume of gas artificially inflated into the lungs. We conclude that, overall, lung volumes above FRC can be reliably measured by the nitrogen washout technique and that FRC measurements by this method reasonably reflect true FRC.

scholarly journals Stitching and switching: the impact of discontinuous lung function reference equations: Figure 1–

2012 ◽  
Vol 39 (5) ◽  
pp. 1256-1257 ◽  
Author(s):  
Jane Kirkby ◽  
Paul Aurora ◽  
Helen Spencer ◽  
Stephanie Rees ◽  
Samantha Sonnappa ◽  
...  
Keyword(s):  
Lung Function ◽  
Reference Equations ◽  
The Impact

scholarly journals Immediate Effects of Sforzesco® Bracing on Respiratory Function in Adolescents with Idiopathic Scoliosis

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1372
Author(s):  
Fabrizio Di Maria ◽  
Andrea Vescio ◽  
Alessia Caldaci ◽  
Ada Vancheri ◽  
Chiara Di Maria ◽  
...  
Keyword(s):  
Lung Function ◽  
Idiopathic Scoliosis ◽  
Lung Volume ◽  
Repeated Measures ◽  
Respiratory Function ◽  
Regression Equations ◽  
Lung Volumes ◽  
Perceived Effort ◽  
Predicted Values ◽  
The One

The thoraco-lumbar bracing is an effective management of adolescent idiopathic scoliosis (AIS). Studies have shown that brace wearing reduces lung volume. Whether or not the Sforzesco brace, frequently used in Italy, affects lung volume has not been investigated. We studied the immediate effect of Sforzesco bracing on lung volumes in 11 AIS patients (10 F, 1 M; aged 13.6 ± 1.6 yrs) mean Cobb angle 26 ± 4.49 degrees. Lung function variables and the perceived respiratory effort were recorded twice, before and 5 min after bracing. The one-way analysis of variance repeated measures, and multiple comparison tests, showed that means of unbraced variables were not significantly different from the corresponding means of predicted values, whereas means under brace were significantly lower (p < 0.05) compared to both predicted and baseline values of respiratory variables. In addition, a significant correlation (p < 0.0001) was found between unbraced and braced values, and linear regression equations were calculated. A significant but clinically unimportant increase in perceived effort was observed under the brace. In conclusion, data indicate that lung function is not impaired in moderate AIS and that wearing the Sforzesco brace causes an immediate, predictable reduction of lung volumes. Data also suggest that the respiratory discomfort during brace wearing could not be due to respiratory function defects.

Reference Equations for Lung Function, Lung Volumes, and Carbon Monoxide Diffusing Capacity of Healthy Never Smoking Adults Aged 18-91 Year

CHEST Journal ◽  
2011 ◽  
Vol 140 (4) ◽  
pp. 678A
Author(s):  
Pavlos Michailopoulos ◽  
Paraskevi Argiropoulou ◽  
Ioannis Kioumis ◽  
Theofilos Pechlivanidis ◽  
Dionisios Spyratos ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Diffusing Capacity ◽  
Lung Volumes ◽  
Reference Equations

scholarly journals Nonlinearity of respiratory mechanics during bronchoconstriction in mice with airway inflammation

2002 ◽  
Vol 92 (5) ◽  
pp. 1802-1807 ◽  
Author(s):  
Scott Wagers ◽  
Lennart Lundblad ◽  
Henrique T. Moriya ◽  
Jason H. T. Bates ◽  
Charles G. Irvin
Keyword(s):  
Respiratory System ◽  
Lung Volume ◽  
Respiratory Mechanics ◽  
Equation Of Motion ◽  
Model Fit ◽  
Airway Closure ◽  
Lung Volumes ◽  
Mechanically Ventilated ◽  
Respiratory System Resistance ◽  
The Impact

Respiratory system resistance (R) and elastance (E) are commonly estimated by fitting the linear equation of motion P = EV + RV˙ + P0 ( Eq. 1 ) to measurements of respiratory pressure (P), lung volume (V), and flow (V˙). However, the respiratory system is unlikely to behave linearly under many circumstances. We determined the importance of respiratory system nonlinearities in two groups of mechanically ventilated Balb/c mice [controls and mice with allergically inflamed airways (ova/ova)], by assessing the impact of the addition of nonlinear terms (E2V2 and R2V˙‖V˙‖) on the goodness of model fit seen with Eq. 1 . Significant improvement in fit (51.85 ± 4.19%) was only seen in the ova/ova mice during bronchoconstriction when the E2V2alone was added. An improvement was also observed with addition of the E2V2 term in mice with both low and high lung volumes ventilated at baseline, suggesting a volume-dependent nonlinearity of E. We speculate that airway closure in the constricted ova/ova mice accentuated the volume-dependent nonlinearity by decreasing lung volume and overdistending the remaining lung.

scholarly journals Impact of lung volume changes on perfusion estimates derived by Electrical Impedance Tomography

2019 ◽  
Vol 5 (1) ◽  
pp. 199-202
Author(s):  
Sabine Krueger-Ziolek ◽  
Bo Gong ◽  
Bernhard Laufer ◽  
Knut Moeller
Keyword(s):  
Observational Study ◽  
Electrical Impedance Tomography ◽  
Lung Volume ◽  
Electrical Impedance ◽  
Region Of Interest ◽  
Intrathoracic Pressure ◽  
Breath Holding ◽  
Impedance Tomography ◽  
Lung Volumes ◽  
The Impact

AbstractElectrical Impedance Tomography (EIT), an imaging technique which operates non-invasively and without radiation exposure, provides information about ventilation- and cardiac-synchronous (pulsatile) changes in the lung. It is well known, that perfusion within the thorax is influenced by lung volume or intrathoracic pressure. In this observational study, it shall be investigated if this phenomenon can be monitored by EIT. Therefore, the impact of the amount of air within the lung on the pulsatile EIT signal was evaluated by carrying out EIT measurements with a spontaneously breathing lung healthy subject holding the breath at three different inspiratory and three various expiratory volume levels during normal tidal breathing. For EIT data analysis, a region of interest was defined by including lung tissue and excluding the heart region. The EIT data revealed, that the shape and the amplitude of the pulsatile EIT signal (evaluated per heartbeat) during the phases of breath holding were dependent on the enclosed lung volume. For lung volumes > 4 L, the amplitude of the pulsatile EIT signal increased with rising inspiratory level and the shape remained almost unchanged. For lung volumes < 4 L, a change in shape was visible but the amplitude remained more or less the same with decreasing expiratory level. Since the results of this observational study show that the pulsatile EIT signal is influenced by the lung volume, it might be used in future to draw conclusions of cardiacpulmonary interactions or intrathoracic pressure states, benefitting the treatment of intensive care patients.

Measurement of lung volumes from supine portable chest radiographs

1979 ◽  
Vol 47 (6) ◽  
pp. 1332-1335 ◽  
Author(s):  
A. L. Ries ◽  
J. L. Clausen ◽  
P. J. Friedman
Keyword(s):  
Lung Volume ◽  
Chest Radiographs ◽  
Lung Field ◽  
Regression Equations ◽  
Lung Volumes ◽  
Magnification Factors ◽  
Portable Chest ◽  
Radiographic Magnification ◽  
Helium Dilution ◽  
Gas Dilution

Lung volumes in supine nonambulatory patients are physiological parameters often difficult to measure with current techniques (plethysmograph, gas dilution). Existing radiographic methods for measuring lung volumes require standard upright chest radiographs. Accordingly, in 31 normal supine adults, we determined helium-dilution functional residual and total lung capacities and measured planimetric lung field areas (LFA) from corresponding portable anteroposterior and lateral radiographs. Low radiation dose methods, which delivered less than 10% of that from standard portable X-ray technique, were utilized. Correlation between lung volume and radiographic LFA was highly significant (r = 0.96, SEE = 10.6%). Multiple-step regressions using height and chest diameter correction factors reduced variance, but weight and radiographic magnification factors did not. In 17 additional subjects studied for validation, the regression equations accurately predicted radiographic lung volume. Thus, this technique can provide accurate and rapid measurement of lung volume in studies involving supine patients.

scholarly journals The impact of changing to the Global Lung Function Initiative reference equations for transfer factor in paediatrics

2020 ◽  
pp. 00412-2020
Author(s):  
Paul D. Burns ◽  
James Y. Paton
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Paediatric Patient ◽  
Transfer Factor ◽  
Reference Equations ◽  
The Difference ◽  
Predicted Values ◽  
Age Range ◽  
The Impact ◽  
Interpretation Of Results

The Global Lung Function Initiative (GLI) all age reference equations for carbon monoxide transfer factor were published in 2017 and endorsed by the ERS/ATS. In order to understand the impact of these new reference equations on the interpretation of results in children referred from haematology and oncology paediatric services, we retrospectively analysed transfer factor results from any paediatric patient referred from haematology oncology in the period 2010–2018. We examined TLCO, KCO and VA from 241 children (age range; 7–18, 130 male). The predicted values from Rosenthal and GLI were plotted against height. The difference in interpretation of results was analysed by looking at the percentage of patients <LLN for each parameter. Overall, the Rosenthal predicted values for TLCO were higher than GLI. Predicted KCO using Rosenthal was higher in all observations. In contrast, the Rosenthal predicted VA was generally lower than the GLI value. The GLI predicted values for transfer factor show considerable differences compared with currently used paediatric UK reference values, differences that will have a significant impact on interpretation of results.

scholarly journals Can the single-breath helium dilution method predict lung volumes as measured by whole-body plethysmography?

2013 ◽  
Vol 39 (6) ◽  
pp. 675-685 ◽  
Author(s):  
Patrícia Chaves Coertjens ◽  
Marli Maria Knorst ◽  
Anelise Dumke ◽  
Adriane Schmidt Pasqualoto ◽  
João Riboldi ◽  
...  
Keyword(s):  
Lung Function ◽  
Whole Body ◽  
Normal Lung ◽  
Regression Equations ◽  
Body Plethysmography ◽  
Lung Volumes ◽  
Single Breath ◽  
Normal Lung Function ◽  
Helium Dilution ◽  
Whole Body Plethysmography

OBJECTIVE: To compare TLC and RV values obtained by the single-breath helium dilution (SBHD) method with those obtained by whole-body plethysmography (WBP) in patients with normal lung function, patients with obstructive lung disease (OLD), and patients with restrictive lung disease (RLD), varying in severity, and to devise equations to estimate the SBHD results.METHODS: This was a retrospective cross-sectional study involving 169 individuals, of whom 93 and 49 presented with OLD and RLD, respectively, the remaining 27 having normal lung function. All patients underwent spirometry and lung volume measurement by both methods.RESULTS: TLC and RV were higher by WBP than by SBHD. The discrepancy between the methods was more pronounced in the OLD group, correlating with the severity of airflow obstruction. In the OLD group, the correlation coefficient of the comparison between the two methods was 0.57 and 0.56 for TLC and RV, respectively (p < 0.001 for both). We used regression equations, adjusted for the groups studied, in order to predict the WBP values of TLC and RV, using the corresponding SBHD values. It was possible to create regression equations to predict differences in TLC and RV between the two methods only for the OLD group. The TLC and RV equations were, respectively, ∆TLCWBP-SBHD in L = 5.264 − 0.060 × FEV1/FVC (r2= 0.33; adjusted r2 = 0.32) and ∆RVWBP-SBHD in L = 4.862 − 0.055 × FEV1/FVC (r2= 0.31; adjusted r2 = 0.30).CONCLUSIONS: The correction of TLC and RV results obtained by SBHD can improve the accuracy of this method for assessing lung volumes in patients with OLD. However, additional studies are needed in order to validate these equations.

scholarly journals A randomised controlled study of Bronchoscopic Lung Volume Reduction with endobronchial valves for patients with Heterogeneous emphysema and Intact interlobar Fissures: the BeLieVeR-HIFi study

2015 ◽  
Vol 2 (5) ◽  
pp. 1-34 ◽  
Author(s):  
Zaid Zoumot ◽  
Claire Davey ◽  
Simon Jordan ◽  
William H McNulty ◽  
Denis H Carr ◽  
...  
Keyword(s):  
Lung Function ◽  
Lung Volume ◽  
Cycle Ergometry ◽  
Volume Reduction ◽  
Gas Transfer ◽  
Lung Volume Reduction ◽  
Lung Volumes ◽  
End Point ◽  
Endobronchial Valve ◽  
Valve Placement

BackgroundDespite optimal therapy many patients with emphysema remain significantly breathless and limited. Bronchoscopic lung volume reduction (BLVR), using valves placed to allow air to leave but not enter the worst-affected areas of the lung, has been proposed as a way to improve lung function in these patients, but response is variable because interlobar collateral ventilation prevents the devices from working. Based on retrospective analysis of clinical trials, patients with heterogeneous emphysema and intact interlobar fissures are most likely to benefit.ObjectivesTo establish whether or not it is possible to identify patients prospectively who will reliably benefit from endobronchial valve placement.DesignProspective, randomised, parallel-group, double-blind, sham-controlled trial.SettingThe study was performed at a single specialist centre.ParticipantsAdult patients with heterogeneous emphysema and a target lobe with intact interlobar fissures were eligible if they had significant gas trapping (total lung capacity > 100% predicted, residual volume > 150% predicted), breathlessness [Medical Research Council (MRC) dyspnoea score of ≥ 3] and exercise limitation (6-minute walk distance of < 450 m). Participants were on optimised pharmacotherapy and were non-smokers.InterventionsStudy participants were randomised to either unilateral lobar endobronchial valve placement aiming to achieve lobar atelectasis or bronchoscopy and ‘sham’ valve placement.Main outcome measuresThe primary end point was improvement in forced expiratory volume in 1 second (FEV1) in the treatment arm compared with the control arm measured 90 days post procedure. Secondary end points were change in lung volumes, gas transfer, exercise capacity (both walking and endurance cycle ergometry) and health-related quality of life.ResultsIn total, 50 patients were recruited, 25 to each arm; 62% were male and mean (standard deviation) FEV1% predicted was 31.7% (10.2%). The primary end point of the study was met as FEV1increased by 24.8% [95% confidence interval (CI) 8.0% to 41.5%] in the treatment arm and by 3.9% (95% CI 0.7% to 7.1%) in the control arm [between-group difference 20.9% (95% CI 4.3% to 37.5%);p = 0.033]. There were both statistically and clinically significant improvements in lung volumes and carbon monoxide gas transfer as well as endurance time and dynamic hyperinflation during cycle ergometry. Two deaths occurred in the treatment arm and one control patient was unable to attend for follow-up assessment because of a prolonged pneumothorax. Two pneumothoraces occurred in the treatment arm.ConclusionsWith appropriate selection of patients through a multidisciplinary team it is possible to produce a significant improvement in lung function through lobar occlusion with endobronchial valves in heterogeneous emphysema. Prospective trials are needed to compare the effect of BLVR with surgical approaches in terms of magnitude and duration of benefit.Trial registrationCurrent Controlled Trials ISRCTN04761234.FundingThis project was funded by the Efficacy and Mechanism Evaluation (EME) programme, a MRC and NIHR partnership.

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