S78 Estimating residual volume and predicting presence or absence of significant hyperinflation from spirometry data: validating two described equations

Dawson, Silvina Ponce; Macfarlane, David P.; Carlin, C

doi:10.1136/thorax-2019-btsabstracts2019.84

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“…In addition to the RV/TLC ratio, several other parameters, somewhat arbitrarily, are used to rate trapped air and hyperinflation [7], and various approaches have been proposed for their estimation from spirometry, obviating the need for body plethysmography, gas dilution or further techniques [29]. RV % pred can be estimated to detect hyperinflation [30] using two equations published previously [31,32]. Although it appeared that measurement of static lung volumes had little incremental value compared to spirometry regarding the differentiation between asthma and COPD [33], there are other data underlining the value of such measurements.…”

Section: Discussionmentioning

confidence: 99%

Prediction of air trapping or pulmonary hyperinflation by forced spirometry in COPD patients: results from COSYCONET

Alter

Orszag²,

Kellerer

et al. 2020

ERJ Open Res

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BackgroundAir trapping and lung hyperinflation are major determinants of prognosis and response to therapy in chronic obstructive pulmonary disease (COPD). They are often determined by body plethysmography, which has limited availability, and so the question arises as to what extent they can be estimated via spirometry.MethodsWe used data from visits 1–5 of the COPD cohort COSYCONET. Predictive parameters were derived from visit 1 data, while visit 2–5 data was used to assess reproducibility. Pooled data then yielded prediction models including sex, age, height, and body mass index as covariates. Hyperinflation was defined as ratio of residual volume (RV) to total lung capacity (TLC) above the upper limit of normal. (ClinicalTrials.gov identifier: NCT01245933).ResultsVisit 1 data from 1988 patients (Global Initiative for Chronic Obstructive Lung Disease grades 1–4, n=187, 847, 766, 188, respectively) were available for analysis (n=1231 males, 757 females; mean±sd age 65.1±8.4 years; forced expiratory volume in 1 s (FEV1) 53.1±18.4 % predicted (% pred); forced vital capacity (FVC) 78.8±18.8 % pred; RV/TLC 0.547±0.107). In total, 7157 datasets were analysed. Among measures of hyperinflation, RV/TLC showed the closest relationship to FEV1 % pred and FVC % pred, which were sufficient for prediction. Their relationship to RV/TLC could be depicted in nomograms. Even when neglecting covariates, hyperinflation was predicted by FEV1 % pred, FVC % pred or their combination with an area under the curve of 0.870, 0.864 and 0.889, respectively.ConclusionsThe degree of air trapping/hyperinflation in terms of RV/TLC can be estimated in a simple manner from forced spirometry, with an accuracy sufficient for inferring the presence of hyperinflation. This may be useful for clinical settings, where body plethysmography is not available.

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