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Clinical Investigations: COPD |

Lung Volumes in 4,774 Patients With Obstructive Lung Disease*

Brian J. Dykstra, MD; Paul D. Scanlon, MD, FCCP; Monica M. Kester, MS; Ken C. Beck, PhD; Paul L. Enright, MD
Author and Funding Information

*From the Rehoboth McKinley Clinic (Dr. Dykstra), Gallup, NM; the Mayo Clinic (Drs. Scanlon and Beck), Rochester, NY; and the University of Arizona (Ms. Kester and Dr. Enright), Tuscon, AZ.



Chest. 1999;115(1):68-74. doi:10.1378/chest.115.1.68
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Study objectives: To determine the correlates of static lung volumes in patients with airways obstruction, and to determine if static lung volumes differ between asthma and COPD.

Patients and methods: We examined the data from all of the adult patients (mean age of 69) who were referred to a pulmonary function laboratory from January 1990 through July 1994 with an FEV1/FVC ratio of < 0.70 and tested using a body plethysmograph. Correlates were determined using regression analysis.

Measurements and results: Of the 4,774 patients observed with evidence of airways obstruction, 61% were men. Self-reported diagnoses included asthma, 19%; emphysema or COPD, 23%; chronic bronchitis, 1.5%; andα 1-antiprotease deficiency, 0.6%. Fifty-six percent of the patients did not report a respiratory disease. The degree of hyperinflation, as determined by the residual volume (RV)/total lung capacity (TLC) ratio, or the RV % predicted (but not the TLC % predicted), was strongly associated with the degree of airways obstruction (the FEV1 % predicted). Patients with moderate to severe airways obstruction and high RV and TLC levels were more likely to have COPD than asthma. Of the 1,872 patients with a reduced vital capacity determined by spirometry testing, 87% had hyperinflation as defined by the RV/TLC, and 9.5% had a low TLC (with less severe airways obstruction).

Conclusion: In patients found to have airways obstruction by spirometry, the additional measurement of static lung volumes added little to the clinical interpretation.

Abbreviations: AAP = α1-antiprotease; ATS = American Thoracic Society; FRC = functional residual capacity; PF = pulmonary function; RV = residual volume; TGV = thoracic gas volume; TLC = total lung capacity; VC = vital capacity

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