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ABSTRACT: In senior subjects, diffusing capacity of the lung for carbon monoxide (Dlco) is interpreted using prediction equations derived from primarily younger adult populations. Our objectives were to provide reference equations for single-breath Dlco for a cohort of healthy, never-smoking, white, European adults between 65 and 85 years of age and to compare the predicted values of this sample with those from other studies involving middle-aged adults.
Reference equations were derived from a randomly selected sample from the general population of 431 healthy never smoker subjects aged 65 to 85 years (262 women and 169 men). Spirometry, lung volume determinations by plethysmography, and single-breath Dlco (corrected for hemoglobin) were performed following the American Thoracic Society/European Respiratory Society guidelines. Reference values and lower and upper limits of normal were derived using a piecewise polynomial model.
In addition to age, our reference equations confirmed the height and body size dependence of Dlco and diffusing capacity for alveolar volume (Dlco/Va) in older subjects. Practically all of the reference values obtained by extrapolating reference equations of middle-aged adults underestimated the true diffusing capacity of the healthy elderly volunteers. Middle-aged reference equations underestimated Dlco by 2.1% to 22.3% in women and 2.8% to 37.8% in men. In addition, Dlco/Va was overestimated up to 18% and 39.8% in women and men, respectively, whereas other equations underestimated Dlco/Va up to 22.2% and 11.9% in women and men, respectively.
These results underscore the importance of using prediction equations appropriate to the origin and age characteristics of the subjects being studied.
Chest 12/2011; 142(1):175-84. · 5.25 Impact Factor
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Chest 11/2009; 136(5 Suppl):e30. · 5.25 Impact Factor
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ABSTRACT: In elderly subjects, static lung volumes are interpreted using prediction equations derived from primarily younger adult populations.
To provide reference equations for static lung volumes for European adults 65 to 85 years of age and to compare the predicted values of this sample with those from other studies including middle-aged adults. We compare the lung volumes by plethysmography and helium dilution in elderly subjects.
Reference equations were derived from a randomly selected sample from the general population of 321 healthy never-smoker subjects 65 to 85 years of age. Spirometry and lung volume determinations by plethysmography and multibreath helium equilibration method were performed following the American Thoracic Society/European Respiratory Society recommendations. Reference values and lower and upper limits of normal were derived using a piecewise polynomial model.
Plethysmography provided higher values than the dilutional method for all lung volumes, with wide limits of agreement. In addition to height, our reference equations confirm the age- and body size dependence of lung volumes in older subjects. Practically all the estimations performed by extrapolating reference equations of middle-aged adults overpredicted the true lung volumes of our healthy elderly volunteers. Middle-aged reference equations classify subjects as being below the total lung capacity lower limit of normal between 17.9 and 62.5% of the women and between 12.5 and 42.2% of the men of the current study.
These results underscore the importance of using prediction equations appropriate to the origin, age, and height characteristics of the subjects being studied.
American Journal of Respiratory and Critical Care Medicine 10/2009; 180(11):1083-91. · 11.08 Impact Factor
