Measurement of Lung Volume by Sulfur Hexafluoride Washout during Spontaneous and Controlled Ventilation

Open Access
Publisher Website
Google Scholar
Abstract
An open circuit tracer gas washout method for measurement of lung volume in patients during anesthesia and intensive care is described and tested. The method employs a device for dispensing the tracer gas, sulfur hexafluoride (SF6), a fast SF6 analyzer, a pneumotachograph, and a computer. The dispensing device delivers SF6 into the airway in proportion to instantaneous inspiratory flow so that inspiratory SF6 concentration is held constant, usually at about 0.5%, regardless of the inspiratory flow pattern. The amount of SF6 present in the lungs at the end of a washin is calculated during washout from signals representing expired SF6 concentration and expired flow. From this, lung volume is derived. Accurate and reproducible results were obtained in lung model tests during ventilation with air, N2O in O2, and halothane in O2. Functional residual capacity (FRC) was measured both with SF6 washout and nitrogen washout in five mechanically ventilated patients. This gave the regression equation: FRCSF6 = 10 ml + 1.04 .times. FRCN2, r = 0.99. A similar close aggreement was observed for total lung capacity (TLC) and residual volume (RV) measurement in eight healthy, spontaneously breathing subjects: TLCSF6 = 91 ml + 1.01 .times. TLCN2, r = 0.99; RVSF6 = -32 ml + 0.97 .times. RVN2, r = 0.95. Comparison with body plethysmography in eight healthy, sitting subjects gave the regression equation: FRCSF6 = 180 ml + 0.96 .times. FRCbox, r = 0.99. The median (range) for the coefficient of variation at duplicate determinations in 10 anesthetized, paralyzed, and mechanically ventilated adults was 3.0% (0.2-6.6%). The corresponding figures for seven spontaneously breathing and seven manually ventilated, anesthetized children were 2.8% (0-7.6%) and 0.6% (0.2-1.9%), respectively. It is concluded that the method can be used during both spontaneous breathing and controlled ventilation.