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Original Research: COPD |

Comparison of Plethysmographic and Helium Dilution Lung Volumes: Which Is Best for COPD?

Carl R. O’Donnell, ScD, MPH; Alexander A. Bankier, MD; Leopold Stiebellehner, MD; John J. Reilly, MD, FCCP; Robert Brown, MD; Stephen H. Loring, MD
Author and Funding Information

From the Departments of Anesthesia and Critical Care (Drs O’Donnell and Loring) and Radiology (Dr Bankier), Beth Israel Deaconess Medical Center; Pulmonary and Critical Care Medicine (Dr Reilly), Brigham and Women’s Hospital; Pulmonary and Critical Care Medicine Unit and Medicine (Dr Brown), Massachusetts General Hospital; Harvard Medical School (Drs O’Donnell, Loring, Bankier, Reilly, and Brown), Boston, MA; and the Department of Pulmonology (Dr Stiebellehner), Medical University of Vienna, Vienna, Austria.

Correspondence to: Carl R. O’Donnell, ScD, MPH, Beth Israel Deaconess Medical Center, Dana 717, 330 Brookline Ave, Boston, MA 02215; e-mail: codonne1@bidmc.harvard.edu


Funding/Support: This work was supported in part by the National Heart, Lung, and Blood Institute [Grant HL-52586].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(5):1108-1115. doi:10.1378/chest.09-1504
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Background:  Theoretical considerations and limited scientific evidence suggest that whole-body plethysmography overestimates lung volume in patients with severe airflow obstruction. We sought to compare plethysmography (Pleth)-, helium dilution (He)- and CT scan-derived lung volume measurements in a sample containing many patients with severe airflow obstruction.

Methods:  We measured total lung capacity (TLC) in 132 patients at three hospitals, with monitored application of recommended techniques for Pleth and He measurements of lung volume and by thoracic CT scans obtained during breath hold at full inspiration.

Results:  Average TLC among 132 subjects was 6.18 L (± 1.69 L) by Pleth-derived TLC, 5.55 L (± 1.39 L) by He-derived TLC, and 5.31 L (± 1.47) by CT scan-derived TLC. Pleth-derived TLC was significantly greater than either He-derived TLC or CT scan-derived TLC (P ≤ .001), whereas there was no significant difference between He-derived and CT scan-derived values. When examined separately, there were significant within-subject differences in TLC by measurement technique among subjects with airflow obstruction, but not among those without airflow obstruction. Plethysmographic overestimation of TLC was greatest among subjects with FEV1 < 30% of predicted.

Conclusions:  In the setting of airflow obstruction, Pleth systematically overestimates lung volume relative to He or thoracic imaging despite adherence to current recommendations for proper measurement technique.

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