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In vitro and in vivo functional residual capacity comparisons between multiple-breath nitrogen washout devices

Katrina O. Tonga, Paul D. Robinson, Claude S. Farah, Greg G. King, Cindy Thamrin
ERJ Open Research 2017 3: 00011-2017; DOI: 10.1183/23120541.00011-2017
Katrina O. Tonga
1Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
2Sydney Medical School, University of Sydney, Sydney, Australia
3Dept of Respiratory Medicine, Royal North Shore Hospital, Sydney, Australia
4Dept of Respiratory Medicine, Concord Hospital, Sydney, Australia
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  • For correspondence: katrina.tonga@sydney.edu.au
Paul D. Robinson
1Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
2Sydney Medical School, University of Sydney, Sydney, Australia
5Dept of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, Australia
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  • ORCID record for Paul D. Robinson
Claude S. Farah
1Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
2Sydney Medical School, University of Sydney, Sydney, Australia
4Dept of Respiratory Medicine, Concord Hospital, Sydney, Australia
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Greg G. King
1Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
2Sydney Medical School, University of Sydney, Sydney, Australia
3Dept of Respiratory Medicine, Royal North Shore Hospital, Sydney, Australia
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Cindy Thamrin
1Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
2Sydney Medical School, University of Sydney, Sydney, Australia
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  • Article
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Figures

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  • FIGURE 1
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    FIGURE 1

    Physical lung model composed of a) a 3 L Hans Rudolph syringe, b) an attachment made from 18 flexible tubes, c) a helical mixer device inserted at the syringe entrance, and d) an adjustable syringe stopper.

  • FIGURE 2
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    FIGURE 2

    Bland–Altman plots of in vitro functional residual capacity (FRC) measurements on each device. Data are plotted as measured FRC minus lung model FRC, expressed as the absolute difference versus mean of measured and lung model FRC values. Absolute differences (circles), mean difference and upper and lower limits of agreement (mean difference±sd of differences) are shown as dashed lines. a) Woolcock in-house device; b) Exhalyzer D device; c) EasyOne Pro LAB device analysed in Version 2.01.00.09.

  • FIGURE 3
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    FIGURE 3

    Bland–Altman plots of in vivo functional residual capacity (FRC) measurements on each device. Data are plotted as body plethysmography FRC (FRCpleth) minus multiple-breath nitrogen washout (MBNW) FRC, expressed as the absolute difference versus mean of FRCpleth and MBNW FRC. Absolute differences (circles), mean difference and upper and lower limits of agreement (mean difference±sd of differences) are shown as dashed lines. a) Woolcock in-house device; b) Exhalyzer D device; c) EasyOne Pro LAB device analysed in Version 2.01.00.09.

Tables

  • Figures
  • Supplementary Materials
  • TABLE 1

    In vitro functional residual capacity (FRC) measurements on each device

    Lung model FRC volumeTrialsWIMREMndd v.2.00ndd v.2.01
    2.3192.30±0.022.39±0.021.78±0.142.16±0.04
    2.1192.10±0.022.17±0.021.72±0.122.00±0.03
    1.8191.84±0.021.88±0.021.37±0.111.72±0.03
    1.5191.53±0.031.53±0.021.25±0.051.43±0.02

    Data presented as mean±sd, unless otherwise stated. Measurements are in litres. WIMR: Woolcock in-house device; EM: Exhalyzer D device; ndd v.2.00: EasyOne Pro LAB device Version 2.00.01.05; ndd v.2.01: EasyOne Pro LAB device analysed in Version 2.01.00.09.

    • TABLE 2

      Differences in in vitro functional residual capacity (FRC) measurements from the lung model functional residual capacity for four different lung volumes

      Lung model FRC volumeSubjectsWIMREMndd v.2.00ndd v.2.01
      AbsoluteRelativeAbsoluteRelativeAbsoluteRelativeAbsoluteRelative
      2.319−0.01±0.02−0.2±0.8%0.07±0.023.3±1.0%−0.54±0.14−23.4±6.1%−0.15±0.04−6.3±1.7%
      2.119−0.01±0.02−0.43±0.9%0.06±0.022.9±0.9%−0.39±0.12−18.5±5.7%−0.11±0.03−5.2±1.5%
      1.8190.03±0.021.6±1.4%0.07±0.023.7±1.0%−0.44±0.11−24.1±6.4%−0.09±0.03−4.7±1.6%
      1.5190.02±0.031.7±13.1%0.02±0.021.1±1.3%−0.26±0.05−17.1±3.0%−0.08±0.02−5.0±1.2%

      Data presented as mean±sd, unless otherwise stated. Absolute measurements are in litres. WIMR: Woolcock in-house device; EM: Exhalyzer D device; ndd v.2.00: EasyOne Pro LAB device Version 2.00.01.05; ndd v.2.01: EasyOne Pro LAB device analysed in Version 2.01.00.09.

      • TABLE 3

        Subject demographics and standard lung function measurements

        All subjectsControlsAsthmatics
        Subjects n29209
        Males/females n12/178/124/5
        Age years37±1236±1237±13
        Height cm172±12174±12.5168±10
        BMI kg·m−224.1±3.6323.9±3.4824.6±4.10
        Smoking history pack-years2.5±3.22.75±3.310.70±0.00
        FEV1 L3.66±0.933.75±0.933.47±0.95
        FVC L4.75±1.174.77±1.164.71±1.25
        FEV1/FVC0.77±0.060.79±0.050.74±0.08
        TLC L6.51±1.386.55±1.416.42±1.41
        FRCpleth L3.44±0.773.49±0.783.34±0.80

        Data presented as mean±sd unless otherwise stated. BMI: body mass index; FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; TLC: total lung capacity; FRCpleth: functional residual capacity measured using body plethysmography.

        • TABLE 4

          Differences in in vivo functional residual capacity (FRC) measurements from body plethysmography FRC on each device

          Subjects nWIMREMndd v2.00ndd v2.01
          AbsoluteRelativeAbsoluteRelativeAbsoluteRelativeAbsoluteRelative
          Controls20−0.13±0.46#−3.3±13.0%0.17±0.414.7±11.8%−0.73±0.36−20.6±8.9%−0.36±0.32−10.1±8.4%
          Asthmatics9−0.24±0.45−6.8±13.8%0.01±0.390.12±12.0%−0.73±0.59−20.7±15.3%−0.42±0.57−11.2±15.8%
          All subjects29−0.17±0.45−4.4±13.1%0.12±0.403.3±11.8%−0.73±0.43−20.6±11%−0.38±0.40−10.5±10.9%

          Data presented as mean±sd, unless otherwise stated. Absolute measurements are in litres. WIMR: Woolcock in-house device; EM: Exhalyzer D device; ndd v.2.00: EasyOne Pro LAB device Version 2.00.01.05; ndd v.2.01: EasyOne Pro LAB device analysed in Version 2.01.00.09. #: missing data for one subject.

          Supplementary Materials

          • Figures
          • Tables
          • Supplementary Material

            Please note: supplementary material is not edited by the Editorial Office, and is uploaded as it has been supplied by the author.

            Description of MBNW devices 00011-2017_supp

          • Supplementary Material

            G.G. King 00011-2017_King

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          In vitro and in vivo functional residual capacity comparisons between multiple-breath nitrogen washout devices
          Katrina O. Tonga, Paul D. Robinson, Claude S. Farah, Greg G. King, Cindy Thamrin
          ERJ Open Research Oct 2017, 3 (4) 00011-2017; DOI: 10.1183/23120541.00011-2017

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          In vitro and in vivo functional residual capacity comparisons between multiple-breath nitrogen washout devices
          Katrina O. Tonga, Paul D. Robinson, Claude S. Farah, Greg G. King, Cindy Thamrin
          ERJ Open Research Oct 2017, 3 (4) 00011-2017; DOI: 10.1183/23120541.00011-2017
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