Comparison of two new methods for the measurement of lung volumes with two standard methods
a Department of
Respiratory Medicine, Nottingham City Hospital, Hucknall Road,
Nottingham NG5 1PB, UK, b Department of Respiratory Medicine, City General
Hospital, Newcastle Road, Stoke-on-Trent, Staffordshire ST4 6QG, UK
Correspondence to: Dr D R Baldwin.
Received 23 January 1998; Returned to authors 10 June 1998; Revised version received 29 September 1998; Accepted for publication 8 December 1998
BACKGROUND
The
two most commonly used methods for the measurement of lung volumes are
helium dilution and body plethysmography. Two methods have been
developed which are both easier and less time consuming to perform.
Mathematical modelling uses complex calculations from the flow-volume
loop to derive total lung capacity (TLC), and the nitrogen balance
technique uses nitrogen from the atmosphere to calculate lung volume in
a similar way to helium dilution. This study was designed to compare
the two new methods with the two standard methods.
METHODSSixty one
subjects were studied, 23 with normal lung function, 17 with
restrictive airway disease, and 21 with obstructive ventilatory
defects. Each subject underwent repeated measurements of TLC by each of
the four methods in random order. Reproducible values were obtained for
each method according to BTS/ARTP guidelines. Bland-Altman plots were
constructed for comparisons between the methods and paired
t tests were used to assess differences in means.
RESULTSBland-Altman
plots showed that the differences between body plethysmography and
helium dilution fell into clinically acceptable ranges (agreement
limits ±0.9 l). The agreement between mathematical modelling or the
nitrogen balance technique and helium dilution or body plethysmography
was poor (±1.8-3.4 l), especially for subjects with airflow obstruction.
CONCLUSIONSNeither of
the new methods agrees sufficiently with standard methods to be useful
in a clinical setting.
© 1999 by Thorax
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