In vitro validation of an ultrasonic flowmeter in order to measure the functional residual capacity in newborns

Abstract

Ultrasonic transit-time airflow meters (UFM) allow simultaneous measurements of volume flow V′(t) and molar mass MM(t) of the breathing gas in the mainstream. Consequently, by using a suitable tracer gas the functional residual capacity (FRC) of the lungs can be measured by a gas wash-in/wash-out technique. The aim of this study was to investigate the in vitro accuracy of a multiple-breath wash-in/wash-out technique for FRC measurements using 4% sulphur hexafluoride (SF6) in air. V′(t) and MM(t) were measured with a Spiroson SCIENTIFIC flowmeter (ECO Medics, CH) with 1.3 ml dead space. Linearity of airflow and MM were tested using different tidal volumes (VT and breathing gases with different O2 and SF6 concentrations. To determine the accuracy of FRC measurements SF6 wash-in and wash-out curves from four mechanical lung models (FRC of 22, 53, 102 and 153 ml) were evaluated by the Spiroson. For each model five measurements were performed with a physiological VT/FRC ratio of 0.3 and constant respiratory rate of 30 min−1. The error of measured VT (range 4–60 ml) was <2.5%. There was a strong correlation between the measured and calculated MM of different breathing gases (r = 0.989), and the measuring accuracy was better than 1%. The measured FRC of the four models were 20.3, 49.7, 104.3 and 153.4 ml with a coefficient of variation of 16.5%, 4.5%, 4.9% and 3%. Accordingly, for FRC < 100 ml the in vitro accuracy was better than 8% and for FRC > 100 ml better than 2.5%. The determination of FRC by MM measurements using the UFM is a simple and cost-effective alternative to conventionally used gas analysers with an acceptable accuracy for many clinical purposes.