Abstract
PurposeTo evaluate the concordance between the value of the actual maximum voluntary ventilation (MVV) and the estimated value by multiplying the forced expiratory volume in the first second (FEV1) and a different value established in the literature.MethodsA retrospective study was conducted with healthy subjects and patients with stable chronic obstructive pulmonary disease (COPD). Five prediction formulas MVV were used for the comparison with the MVV values. Agreement between MVV measured and MVV obtained from five prediction equations were studied. FEV1 values were used to estimate MVV. Correlation and agreement analysis of the values was performed in two groups using the Pearson test and the Bland–Altman method; these groups were one group with 207 healthy subjects and the second group with 83 patients diagnosed with COPD, respectively.ResultsWe recruited 207 healthy subjects (105 women, age 47 ± 17 years) and 83 COPD patients (age 66 ± 6 years; 29 GOLD II, 30 GOLD III, and 24 GOLD IV) for the study. All prediction equations presented a significant correlation with the MVV value (from 0.38 to 0.86, p < 0.05) except for the GOLD II subgroup, which had a poor agreement with measured MVV. In healthy subjects, the mean difference of the value of bias (and limits of agreement) varied between -3.9% (-32.8 to 24.9%), and 27% (-1.4 to 55.3%). In COPD patients, the mean difference of value of bias (and limits of agreement) varied between -4.4% (-49.4 to 40.6%), and 26.3% (-18.3 to 70.9%). The results were similar in the subgroup analysis.ConclusionThe equations to estimate the value of MVV present a good degree of correlation with the real value of MVV, but they also show a poor concordance. For this reason, we should not use the estimated results as a replacement for the real value of MVV.
Highlights
The maximal voluntary ventilation (MVV) is the largest amount of air that a person can inhale and exhale during a 12to 15-s interval with maximal voluntary effort (Neder et al, 1999)
For Student’s t test, only Equation 4 showed no significant differences with the direct measured MVV value
The results of all equations were significantly correlated with the measured MVV values
Summary
The maximal voluntary ventilation (MVV) is the largest amount of air that a person can inhale and exhale during a 12to 15-s interval with maximal voluntary effort (Neder et al, 1999) This maneuver was used to provide information about the functioning of the inspiratory pump and chest wall and is used to evaluate maximum ventilatory capacity (Colwell and Bhatia, 2017) and respiratory muscle endurance, but the last ERS statement on respiratory muscle tests does not recommend its use for these purposes because mechanical aspects of the chest wall and lung tissue can affect the MVV value (Laveneziana et al, 2019). From a technical point of view, the mobilized volume is extrapolated to the volume of air that would be moved in 60 s in order to avoid prolonged hyperventilation (Neufeld et al, 2018), and the result is expressed in liters/minute with an accuracy of ±10% (±15 L/min; ATS/ACCP, 2003)
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