Intensive Care Medicine

, Volume 33, Issue 5, pp 912–916 | Cite as

Determination of functional residual capacity by oxygen washin-washout: a validation study

  • Stefan Maisch
  • Stephan H. Boehm
  • Dieter Weismann
  • Hajo Reissmann
  • Marcus Beckmann
  • Bernd Fuellekrug
  • Andreas Meyer
  • Jochen  Schulte am Esch
Technical Note

Abstract

Objective

To validate a new system for functional residual capacity (FRC) measurements using oxygen washin/washout in spontaneously breathing humans. The system (LUFU, Drägerwerk AG, Lübeck, Germany) consists of an unmodified EVITA 4 ventilator, a side-stream paramagnetic oxygen sensor and a dedicated software.

Design

Laboratory study and measurements in spontaneously breathing volunteers.

Setting

Pulmonary function laboratory of a university hospital.

Participants

20 healthy and 15 lung diseased volunteers.

Interventions

FRC was measured by LUFU (LUFU-FRC) and by helium dilution (He-FRC); intra-thoracic gas volume (ITGV) was determined by body plethysmography. Each measurement cycle consisted of four independent LUFU-FRC determinations (step change of FiO2 from 0.21 to 0.5 and back and from 0.21 to 1.0 and back), two helium-dilution runs and two body box measurements. Repeatability and agreement between methods were determined by comparing different measurements of one technique and by comparing different techniques among each other.

Measurements and results

Repeatability of LUFU-FRC was estimated by comparing washin to washout and the different FiO2steps. The difference of the means was 3.7% at the most. Agreement between methods resulted in the following differences (mean ± standard deviation of differences) for healthy and lung-diseased volunteers, respectively: LUFU-FRC vs. He-FRC –0.40 ± 0.50 L (0.02 ± 0.95 L), LUFU-FRC vs. ITGV –0.43 ± 0.54 L (–0.18 ± 0.61 L) and He-FRC vs. ITGV –0.03 ± 0.43 L (–0.20 ± 0.98 L).

Conclusions

LUFU is a non-invasive method for the determination of FRC that requires only minor additional equipment and no modification to the ventilator. It can be used in difficult conditions such as breathing patterns with variations from breath to breath. The results of this study show that LUFU is sufficiently reliable and repeatable to warrant its clinical application.

Keywords

Oxygen washin-washout Functional residual capacity Helium dilution method Body plethysmography 

Supplementary material

134_2007_578_MOESM1_ESM.pdf (874 kb)
Electronic Supplementary Material (PDF 890K)

References

  1. 1.
    Hedenstierna G (1993) The recording of FRC: Is it of importance and can it be made simple? Intensive Care Med 19:365–366CrossRefPubMedGoogle Scholar
  2. 2.
    Larsson A, Linnarsson C, Jonmarker C, Jonson B, Larsson H, Werner O (1987) Measurement of lung volume by sulfur hexafluoride washout during spontaneous and controlled ventilation: further development of a method. Anesthesiology 67:543–550CrossRefPubMedGoogle Scholar
  3. 3.
    Saniie J, Saidel GM, Chester EH (1979) Realtime moment analysis of pulmonary nitrogen washout. J Appl Physiol 46:1184–1190CrossRefPubMedGoogle Scholar
  4. 4.
    Suter PM, Schlobohm RM (1974) Determination of functional residual capacity during mechanical ventilation. Anesthesiology 41:605–607CrossRefPubMedGoogle Scholar
  5. 5.
    Wrigge H, Sydow M, Zinserling J, Neumann P, Hinz J, Burchardi H (1998) Determination of functional residual capacity (FRC) by multibreath nitrogen washout in a lung model and in mechanically ventilated patients. Intensive Care Med 24:487–449CrossRefPubMedGoogle Scholar
  6. 6.
    Weismann D, Reissmann H, Maisch S, Füllekrug B, Schulte am Esch J (2006) Determination of functional residual capacity with an oxygen washin/washout: technical description and evaluation. J Clin Mon Comp 20:251–260CrossRefGoogle Scholar
  7. 7.
    Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310CrossRefPubMedGoogle Scholar
  8. 8.
    Hildebrand H, Islam MS, Ulmer WT (1984) Comparison between body plethysmographic measurement of the intrathoracic gas volume and oscillatory measurement of the functional residual air capacity in healthy volunteers, miners with and without obstruction of the airways and in patients not exposed to dust but with obstructive airways disease. Prax Klin Pneumol 38:217–219PubMedGoogle Scholar
  9. 9.
    Kendrick AH (1996) Comparison of methods of measuring static lung volumes. Monaldi Arch Chest Dis 51:431–439PubMedGoogle Scholar
  10. 10.
    Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC (1993) Lung volumes and forced ventilatory flows. Report of the Working Party on Standardization of Lung Function Tests. European Community for Steel and Coal. Official statement of the European Respiratory Society. Eur Respir J 6(Suppl 16):5–40CrossRefPubMedGoogle Scholar
  11. 11.
    Schaanning CG, Gulsvik A (1973) Accuracy and precision of helium dilution technique and body plethysmography in measuring lung volumes. Scand J Lab Invest 32:271–277CrossRefGoogle Scholar
  12. 12.
    Hruby J, Butler J (1975) Variability of routine pulmonary function tests. Thorax 30:548–553CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Germouty J, Charruyer-Latrille G, Boyer M, Charles A, Jaubert A, Chatelut J, Chantegreil D, Germouty C (1970) La mesure de la capacité résiduelle fonctionelle. Comparaison de trois méthodes: Spirographique, radiographique et plethysmographique chez 100 adultes normaux. Poumon 26:589–594Google Scholar
  14. 14.
    Rodenstein DO, Stanescu DC (1982) Reassessment of lung volume measurement by helium dilution and by body plethysmography in chronic airflow obstruction. Am Rev Respir Dis 126:1040–1044PubMedGoogle Scholar
  15. 15.
    Eichler W, Schumacher J, Roth-Isigkeit A, Braun J, Kuppe H, Klotz KF (2002) Automated evaluation of functional residual capacity by oxygen washout. J Clin Monit 17:195–201CrossRefGoogle Scholar
  16. 16.
    Olegard C, Söndergaard S, Houltz E, Lundin S, Stenqvist O (2005) Estimation of functional residual capacity at the bedside using standard monitoring equipment: a modified nitrogen washout/washin technique requiring a small change of the inspired oxygen fraction. Anesth Analg 101:206–212CrossRefPubMedGoogle Scholar
  17. 17.
    Stenqvist O, Olegard C, Sondergaard S, Odenstedt H, Karason S, Lundin S (2002) Monitoring functional residual capacity (FRC) by quantifying oxygen/carbon dioxide fluxes during a short apnea. Acta Anaesthesiol Scand 46:732–739CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Stefan Maisch
    • 1
  • Stephan H. Boehm
    • 1
  • Dieter Weismann
    • 2
  • Hajo Reissmann
    • 1
  • Marcus Beckmann
    • 1
  • Bernd Fuellekrug
    • 1
  • Andreas Meyer
    • 3
  • Jochen  Schulte am Esch
    • 1
  1. 1.Department of AnaesthesiologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Drägerwerk AGLübeckGermany
  3. 3.Department of PneumologyKrankenhaus St. KamillusMönchengladbachGermany

Personalised recommendations