Dataset Information

Quantification of single-breath underestimation of lung volume in emphysema.

ABSTRACT: The extent to which a single breath measurement represents available gas dilutional as well as compressible thoracic volume in emphysema patients has not been quantified. We therefore measured single breath (TLCSB) and rebreathe helium dilution (TLCRB), and plethysmographic lung volume (TLCpleth), in fifty-five outpatients with clinical and radiographic emphysema, and in twenty-one normal controls. Among emphysema patients, TLCSB increasingly underestimated both TLCpleth and TLCRB as FEV1% predicted decreased (p for interaction=0.001 for both) by a mean of 1.7 l for TLCRB (p<0.001) and 2.2l for TLCpleth (p<0.001). In contrast, TLCRB underestimated TLCpleth by a mean of 0.5l (p<0.001) regardless of FEV1% (p for interaction=0.25). TLCSB, TLCRB, and TLCpleth showed strong agreement among normal subjects. We conclude that TLCSB underestimates available gas dilutional and compressible lung volume as physiologic emphysema severity increases. In contrast, TLCRB and TLCpleth show closer agreement which is unaffected by physiologic emphysema severity.

SUBMITTER: Milite F

PROVIDER: S-EPMC2759678 | biostudies-literature | 2009 Feb

REPOSITORIES: biostudies-literature

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Quantification of single-breath underestimation of lung volume in emphysema.

Milite Fulvia F Lederer David J DJ Weingarten Jeremy A JA Fani Pauline P Mooney Anne M AM Basner Robert C RC

Respiratory physiology & neurobiology 20081225 2-3

The extent to which a single breath measurement represents available gas dilutional as well as compressible thoracic volume in emphysema patients has not been quantified. We therefore measured single breath (TLCSB) and rebreathe helium dilution (TLCRB), and plethysmographic lung volume (TLCpleth), in fifty-five outpatients with clinical and radiographic emphysema, and in twenty-one normal controls. Among emphysema patients, TLCSB increasingly underestimated both TLCpleth and TLCRB as FEV1% predi ...[more]

PMID: 19150417

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Project description:Bronchoscopic lung volume reduction (BLVR) offers alternative novel treatments for patients with emphysema. Comprehensive evidence for comparing different BLVR remains unclear. To estimate the effects of different BLVR on patients with emphysema. PubMed, EMBASE, Cochrane Library, and Web of Science databases from January 2001 to August 2017 were searched. Randomized clinical trials evaluated effects of BLVR on patients with emphysema. The relevant information was extracted from the published reports with a predefined data extraction sheet, and the risk of bias was assessed with the Cochrane risk of bias tools. Pair-wise metaanalyses were made using the random-effects model. A random-effects network meta-analysis was applied within a Bayesian framework. The quality of evidence contributing to primary outcomes was assessed using the GRADE framework. 13 trials were deemed eligible, including 1993 participants. The quality of evidence was rated as moderate in most comparisons. Medical care (MC)was associated with the lowest adverse events compared with intrabronchial valve (IBV)(-2.5,[-4.70 to -0.29]), endobronchial valve (EBV) (-1.73, [-2.37 to -1.09]), lung volume reduction coils (LVRC) (-0.76, [-1.24 to -0.28]), emphysematous lung sealant (ELS) (-1.53, [-2.66 to -0.39]), and airway bypass(-1.57, [-3.74 to 0.61]). Adverse events in LVRC were lower compared with ELS (-0.77,[-2.00 to 0.47]). Bronchoscopic thermal vapor ablation (BTVA) showed significant improvement in FEV1 compared with MC (0.99, [0.37 to 1.62]), IBV (1.25, [0.25 to 2.25]), and LVRC (0.72, [0.03 to 1.40] ). Six? minute walking distance (6 MWD) in ELS was significantly improved compared with other four BLVR, sham control, and MC (-1.96 to 1.99). Interestingly, MC showed less improvement in FEV1 and 6MWDcompared with EBV (-0.45, [-0.69 to -0.20] and -0.39, [-0.71 to -0.07], respectively). The mortality in MC and EBV was lower compared with LVRC alone (-0.38, [-1.16 to 0.41] and -0.50, [-1.68 to 0.68], respectively). BTVA and EBV led to significant changes in St George's respiratory questionnaire (SGRQ) compared with MC alone (-0.74, [-1.43 to -0.05] and 0.44, [0.11 to 0.78], respectively). BLVR offered a clear advantage for patients with emphysema. EBV had noticeable beneficial effects on the improvement of forced expiratory volume 1, 6MWD and SGRQ, and was associated with lower mortality compared with MC in different strategies of BLVR.

Dataset Information

Quantification of single-breath underestimation of lung volume in emphysema.

Publications

Quantification of single-breath underestimation of lung volume in emphysema.

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