Measurement of total lung aerosol deposition as an index of lung abnormality.

Abstract

Total aerosol deposition in the lung was measured in 100 subjects with various lung conditions. The subjects consisted of 40 normals (N), 15 asymptomatic smokers (S), 10 smokers with small airway disease (SAD), 20 with chronic simple bronchitis (SB), and 15 with chronic obstructive bronchitis (COPD), and a relationship of total aerosol deposition to degree of lung abnormality was investigated. The subjects were categorized by medical history and a battery of pulmonary function tests, including spirometry, body plethysmography, and single and multiple N2 washout measurements. Subjects repeatedly breathed a monodisperse test aerosol (1.0 micron diam) from a collapsible rebreathing bag (0.5 liter volume) at a rate of 30 breaths/min, while inhaled and exhaled aerosol concentrations were continuously monitored by a laser aerosol photometer in situ and recorded on a strip-chart recorder. The number of rebreathing breaths resulting in 90% aerosol loss from the bag (N90) was determined, and percent predicted N90 values were then determined from the results of computer simulation and used as a deposition index. The percent predicted N90 values were 99.7 +/- 14, 86.5 +/- 15, 66.9 +/- 17, 51 +/- 12, and 30.9 +/- 9, respectively, for N, S, SAD, SB, and COPD. All of these values were significantly different from each other (P less than 0.05). There was no difference between male and female but percent predicted N90 values were slightly higher in young than in old normals. Percent predicted N90 values showed a strong linear correlation with spirometric measurements of forced expiratory volume in 1 s and maximum midexpiratory flow rate. However, many of the SAD and SB with normal spirometry showed abnormal N90. These results suggest that total lung aerosol deposition is a sensitive index of lung abnormality and may be of potential use for nonspecific general patient screening.