Lung volumes measurement using novel pressure derived method in participants with obstructive, restrictive and healthy lungs

Abstract

Background. Lung volumes can be measured by body plethysmography (BP), by inert gas dilution during a single-breath or multiple breaths and by radiographic methods based on chest roentgenogram or CT scanning. Our objective was to analyze the concordance between several methods including a new pressure-derived method (PDM) in a variety of pulmonary conditions. Methods. We recruited four groups of adult volunteers at the chronic obstructive pulmonary disease and tobacco clinic of a respiratory referral hospital: patients with lung bullae, with obstructive lung diseases, with restrictive lung diseases and healthy controls; all subjects underwent lung volume measurements according to ATS/ERS standards in random order with each method and then CT scanning. Differences among groups were estimated by Kruskal–Wallis tests. Concordance correlation coefficients (CCC) and Bland–Altman plots were performed. Results. Sixty-two patients were studied including 15 with lung bullae, 14 with obstructive lung diseases, 12 with restrictive lung disease and 21 healthy subjects. Highest concordance was obtained between BP and CT scanning (CCC 0.95, mean difference −0.35 l) and the lowest, with TLC-DLCOsb (CCC 0.65, difference −1.05 l). TLC measured by BP had a moderate concordance with the PDM (CCC = 0.91, mean difference −0.19 l). The PDM on the other hand had the lowest intra-test repeatability (2.7%) of all tested methods. Conclusions. Lung volumes measured by BP and CT had high concordance in the scenario of varied pulmonary conditions including lung bullae, restrictive and obstructive diseases. The new PDM device, had low intra-test variability, and was easy to perform, with a reasonable concordance with BP.