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The Efficiency Index (EFFi), based on volumetric capnography, may allow for simple diagnosis and grading of COPD

Jarenbäck, Linnea LU ; Tufvesson, Ellen LU ; Ankerst, Jaro LU ; Bjermer, Leif LU and Jonson, Björn LU (2018) In International Journal of COPD 13. p.2033-2039
Abstract

Background: Spirometry, the main tool for diagnosis and follow-up of COPD, incompletely describes the disease. Based on volumetric capnography (VCap), an index was developed for the diagnosis and grading of COPD, aimed as a complement or alternative to spirometry. Methods: Nine non-smokers, 10 smokers/former smokers without COPD and 54 smokers/ former smokers with COPD were included in the study. Multiple breath washout of N2 and VCap were studied with Exhalyzer D during tidal breathing. VCap was based on signals for flow rate and CO2 and was recorded during one breath preceding N2 washout. Efficiency Index (EFFi) is the quotient between exhaled CO2 volume and the hypothetical CO2... (More)

Background: Spirometry, the main tool for diagnosis and follow-up of COPD, incompletely describes the disease. Based on volumetric capnography (VCap), an index was developed for the diagnosis and grading of COPD, aimed as a complement or alternative to spirometry. Methods: Nine non-smokers, 10 smokers/former smokers without COPD and 54 smokers/ former smokers with COPD were included in the study. Multiple breath washout of N2 and VCap were studied with Exhalyzer D during tidal breathing. VCap was based on signals for flow rate and CO2 and was recorded during one breath preceding N2 washout. Efficiency Index (EFFi) is the quotient between exhaled CO2 volume and the hypothetical CO2 volume exhaled from a completely homogeneous lung over a volume interval equal to 15% of predicted total lung capacity. Results: EFFi increased with increased Global initiative for chronic Obstructive Lung Disease (GOLD) stage and the majority of subjects in GOLD 2 and all subjects in GOLD 3 and 4 could be diagnosed as having COPD using the lower 95% confidence interval of the healthy group. EFFi also correlated with N2 washout (r=-0.73; p,0.001), forced expiratory volume in 1 second (r=0.70; p,0.001) and diffusion capacity for carbon oxide (r=0.69; p,0.001). Conclusion: EFFi measures efficiency of tidal CO2 elimination that is limited by inhomogeneity of peripheral lung function. EFFi allows diagnosis and grading of COPD and, together with FEV1, may explain limitation of physical performance. EFFi offers a simple, effortless and cost-effective complement to spirometry and might serve as an alternative in certain situations.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Carbon dioxide, Chronic obstructive pulmonary disease, Single breath, Volumetric capnography
in
International Journal of COPD
volume
13
pages
7 pages
publisher
Dove Press
external identifiers
  • scopus:85049187376
ISSN
1176-9106
DOI
10.2147/COPD.S161345
language
English
LU publication?
yes
id
424c874e-979d-4d32-b89e-81275aa7d24b
date added to LUP
2018-07-13 14:42:57
date last changed
2018-07-14 03:00:04
@article{424c874e-979d-4d32-b89e-81275aa7d24b,
  abstract     = {<p>Background: Spirometry, the main tool for diagnosis and follow-up of COPD, incompletely describes the disease. Based on volumetric capnography (VCap), an index was developed for the diagnosis and grading of COPD, aimed as a complement or alternative to spirometry. Methods: Nine non-smokers, 10 smokers/former smokers without COPD and 54 smokers/ former smokers with COPD were included in the study. Multiple breath washout of N<sub>2</sub> and VCap were studied with Exhalyzer D during tidal breathing. VCap was based on signals for flow rate and CO<sub>2</sub> and was recorded during one breath preceding N<sub>2</sub> washout. Efficiency Index (EFFi) is the quotient between exhaled CO<sub>2</sub> volume and the hypothetical CO<sub>2</sub> volume exhaled from a completely homogeneous lung over a volume interval equal to 15% of predicted total lung capacity. Results: EFFi increased with increased Global initiative for chronic Obstructive Lung Disease (GOLD) stage and the majority of subjects in GOLD 2 and all subjects in GOLD 3 and 4 could be diagnosed as having COPD using the lower 95% confidence interval of the healthy group. EFFi also correlated with N<sub>2</sub> washout (r=-0.73; p,0.001), forced expiratory volume in 1 second (r=0.70; p,0.001) and diffusion capacity for carbon oxide (r=0.69; p,0.001). Conclusion: EFFi measures efficiency of tidal CO<sub>2</sub> elimination that is limited by inhomogeneity of peripheral lung function. EFFi allows diagnosis and grading of COPD and, together with FEV<sub>1</sub>, may explain limitation of physical performance. EFFi offers a simple, effortless and cost-effective complement to spirometry and might serve as an alternative in certain situations.</p>},
  author       = {Jarenbäck, Linnea and Tufvesson, Ellen and Ankerst, Jaro and Bjermer, Leif and Jonson, Björn},
  issn         = {1176-9106},
  keyword      = {Carbon dioxide,Chronic obstructive pulmonary disease,Single breath,Volumetric capnography},
  language     = {eng},
  month        = {06},
  pages        = {2033--2039},
  publisher    = {Dove Press},
  series       = {International Journal of COPD},
  title        = {The Efficiency Index (EFFi), based on volumetric capnography, may allow for simple diagnosis and grading of COPD},
  url          = {http://dx.doi.org/10.2147/COPD.S161345},
  volume       = {13},
  year         = {2018},
}