Single and multiple breath nitrogen wash-out--closing volume and volume of trapped gas for detection of early airway obstruction.

Thirty-eight patients with varying degrees of peripheral airway involvement were studied by flow-volume curves and two nitrogen wash-out techniques in an on-site study. Closing capacity (CC), closing volume in percentage of vital capacity (CV%), slope of the alveolar plateau (phase III), volume of trapped gas (VTG), and maximum expiratory flow at 50 and 75% of vital capacity (MEF50, MEF25) were determined and correlation analyses were performed. A biphasic or exponential correlation was noted between the degree of airway closure and VTG with rapidly increasing VTG at high CC. Although there were correlations between spirometry and the two nitrogen wash-out techniques, a large scatter precluded the use of the flow-volume variables to predict CC, CV% and VTG. The coefficient of variation was lower for the measurements of CV% than for the recording of VTG. Since the single breath nitrogen wash-out technique is also technically simpler it is recommended prior to the multiple breath technique.