Skip to main content

Advertisement

Log in

Significant Differences in Body Plethysmography Measurements Between Hospitals in Patients Referred for Bronchoscopic Lung Volume Reduction

  • COPD
  • Published:
Lung Aims and scope Submit manuscript

Abstract

During the evaluation of potential bronchoscopic lung volume reduction (BLVR) candidates in our hospital, we frequently observe patients with a lower residual volume (RV) value compared to the value measured in their referring hospital, although both measured by body plethysmography. We explored to what degree RV and other pulmonary function measurements match between referring hospitals and our hospital. We retrospectively analyzed a total of 300 patients with severe emphysema [38% male, median age 62 years (range 38–81), median forced expiratory volume in 1 s 29% (range 14–65) of predicted, and a median of 40 packyears (range 2–125)]. We measured a median RV of 4.47 l (range 1.70–7.57), which was a median 310 ml lower than in the referring hospitals (range − 3.04 to + 1.94), P < 0.001). In conclusion, this retrospective analysis demonstrated differences in RV measurements between different hospitals in patients with severe emphysema. Overestimation of RV can lead to unnecessary referrals for BLVR and potential treatment failures. To avoid disappointment and unnecessary hospital visits, it is important that body plethysmography measurements are accurately performed by applying preferably the unlinked method in these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Klooster K, ten Hacken NH, Hartman JE, Kerstjens HA, van Rikxoort EM, Slebos DJ (2015) Endobronchial valves for emphysema without interlobar collateral ventilation. N Engl J Med 373:2325–2335

    Article  CAS  PubMed  Google Scholar 

  2. Shah PL, Herth FJ, van Geffen WH, Deslee G, Slebos DJ (2017) Lung volume reduction for emphysema. Lancet Respir Med 5:147–156

    Article  PubMed  Google Scholar 

  3. Herth FJF, Slebos DJ, Criner GJ, Shah PL (2017) Endoscopic lung volume reduction: an expert panel recommendation—update 2017. Respiration 94:380–388

    Article  PubMed  Google Scholar 

  4. Wanger J, Clausen JL, Coates A, Pedersen OF, Brusasco V, Burgos F, Casaburi R, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Hankinson J, Jensen R, Johnson D, Macintyre N, McKay R, Miller MR, Navajas D, Pellegrino R, Viegi G (2005) Standardisation of the measurement of lung volumes. Eur Respir J 26:511–522

    Article  CAS  PubMed  Google Scholar 

  5. Tantucci C, Bottone D, Borghesi A, Guerini M, Quadri F, Pini L (2016) Methods for measuring lung volumes: is there a better one? Respiration 91:273–280

    Article  CAS  PubMed  Google Scholar 

  6. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J, ATS/ERS Task Force (2005) Standardisation of spirometry. Eur Respir J 26:319–338

    Article  CAS  PubMed  Google Scholar 

  7. Hartman JE, Ten Hacken NH, Klooster K, Boezen HM, de Greef MH, Slebos DJ (2012) The minimal important difference for residual volume in patients with severe emphysema. Eur Respir J 40:1137–1141

    Article  PubMed  Google Scholar 

  8. Paton J, Beardsmore C, Laverty A, King C, Oliver C, Young D, Stocks J (2012) Discrepancies between pediatric laboratories in pulmonary function results from healthy children. Pediatr Pulmonol 47:588–596

    Article  PubMed  Google Scholar 

  9. Williams JH Jr, Bencowitz HZ (1989) Differences in plethysmographic lung volumes. Effects of linked versus unlinked spirometry. Chest 95:117–123

    Article  PubMed  Google Scholar 

  10. Criner GJ, Sue R, Wright S, Dransfield M, Rivas-Perez H, Wiese T, Sciurba FC, Shah PL, Wahidi MM, de Oliveira HG, Morrissey B, Cardoso PFG, Hays S, Majid A, Pastis N Jr, Kopas L, Vollenweider M, McFadden PM, Machuzak M, Hsia DW, Sung A, Jarad N, Kornaszewska M, Hazelrigg S, Krishna G, Armstrong B, Shargill NS, Slebos DJ, LIBERATE Study Group (2018) A Multicenter RCT of Zephyr(R) Endobronchial valve treatment in heterogeneous emphysema (LIBERATE). Am J Respir Crit Care Med. https://doi.org/10.1164/rccm.201803-0590OC

    Article  PubMed  PubMed Central  Google Scholar 

  11. Herth FJF, Slebos DJ, Criner GJ, Valipour A, Sciurba F, Shah PL (2019) Endoscopic lung volume reduction: an expert panel recommendation—update 2019. Respiration 97(6):1–10

    Article  Google Scholar 

  12. van Geffen WH, Kerstjens HA (2018) Static and dynamic hyperinflation during severe acute exacerbations of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 13:1269–1277

    Article  PubMed  PubMed Central  Google Scholar 

  13. Parker CM, Voduc N, Aaron SD, Webb KA, O'Donnell DE (2005) Physiological changes during symptom recovery from moderate exacerbations of COPD. Eur Respir J 26:420–428

    Article  CAS  PubMed  Google Scholar 

  14. Klooster K, ten Hacken NH, Hartman JE, Sciurba FC, Kerstjens HA, Slebos DJ (2015) Determining the role of dynamic hyperinflation in patients with severe chronic obstructive pulmonary disease. Respiration 90:306–313

    Article  PubMed  Google Scholar 

  15. Murphy K, Pluim JP, van Rikxoort EM, de Jong PA, de Hoop B, Gietema HA, Mets O, de Bruijne M, Lo P, Prokop M, van Ginneken B (2012) Toward automatic regional analysis of pulmonary function using inspiration and expiration thoracic CT. Med Phys 39:1650–1662

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jorrit B. A. Welling.

Ethics declarations

Conflicts of interest

JBAW, JEH, NTH, SWSA, HAMK, and KK declare that they have no competing interests. DJS is a physician advisor and investigator for PulmonX Inc., USA; Nuvaira Inc., USA; CSA Medical, USA; PneumRx/BTG, USA/UK; and FreeFlowMedical, USA, all outside the submitted work.

Ethics Approval

This retrospective analysis was part of a study which was approved by our local (University Medical Center Groningen) medical ethics committee. The study was conducted in accordance with the Declaration of Helsinki.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Welling, J.B.A., Hartman, J.E., Ten Hacken, N.H.T. et al. Significant Differences in Body Plethysmography Measurements Between Hospitals in Patients Referred for Bronchoscopic Lung Volume Reduction. Lung 197, 573–576 (2019). https://doi.org/10.1007/s00408-019-00265-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00408-019-00265-w

Keywords

Navigation