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      Flow-Volume Parameters in COPD Related to Extended Measurements of Lung Volume, Diffusion, and Resistance

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          Abstract

          Classification of COPD into different GOLD stages is based on forced expiratory volume in 1 s (FEV 1) and forced vital capacity (FVC) but has shown to be of limited value. The aim of the study was to relate spirometry values to more advanced measures of lung function in COPD patients compared to healthy smokers. The lung function of 65 COPD patients and 34 healthy smokers was investigated using flow-volume spirometry, body plethysmography, single breath helium dilution with CO-diffusion, and impulse oscillometry. All lung function parameters, measured by body plethysmography, CO-diffusion, and impulse oscillometry, were increasingly affected through increasing GOLD stage but did not correlate with FEV 1 within any GOLD stage. In contrast, they correlated fairly well with FVC%p, FEV 1/FVC, and inspiratory capacity. Residual volume (RV) measured by body plethysmography increased through GOLD stages, while RV measured by helium dilution decreased. The difference between these RV provided valuable additional information and correlated with most other lung function parameters measured by body plethysmography and CO-diffusion. Airway resistance measured by body plethysmography and impulse oscillometry correlated within COPD stages. Different lung function parameters are of importance in COPD, and a thorough patient characterization is important to understand the disease.

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          Most cited references22

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          Standardisation of spirometry

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            Reference spirometric values using techniques and equipment that meet ATS recommendations.

            Forced expiratory volumes and flows were measured in 251 healthy nonsmoking men and women using techniques and equipment that meet American Thoracic Society (ATS) recommendations. Linear regression equations using height and age alone predict spirometric parameters as well as more complex equations using additional variables. Single values for 95% confidence intervals are acceptable and should replace the commonly used method of subtracting 20% to determine the lower limit of normal for a predicted value. Our study produced predicted values for forced vital capacity and forced expiratory volume in one second that were almost identical to those predicted by Morris and associates (1) when the data from their study were modified to be compatible with the back extrapolation technique recommended by the ATS. The study of Morris and colleagues was performed at sea level in rural subjects, whereas ours was performed at an altitude of 1,400 m in urban subjects. Either the present study or the study of Morris and co-workers, modified to back extrapolation, could be recommended for predicting normal values.
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              Standardisation of spirometry

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                Author and article information

                Journal
                Pulm Med
                Pulm Med
                PM
                Pulmonary Medicine
                Hindawi Publishing Corporation
                2090-1836
                2090-1844
                2013
                13 June 2013
                : 2013
                : 782052
                Affiliations
                Department of Clinical Sciences, Respiratory Medicine and Allergology, Lund University, 221 84 Lund, Sweden
                Author notes

                Academic Editor: S. L. Johnston

                Author information
                https://orcid.org/0000-0001-5555-5773
                https://orcid.org/0000-0002-3441-8099
                Article
                10.1155/2013/782052
                3697409
                23844288
                a921ec75-3bd4-4093-b4bd-e419393323ce
                Copyright © 2013 Linnea Jarenbäck et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 7 February 2013
                : 30 April 2013
                : 7 May 2013
                Categories
                Clinical Study

                Respiratory medicine
                Respiratory medicine

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