改变呼吸频率对健康成年人最大自主通气量的影响。

Effect of altering breathing frequency on maximum voluntary ventilation in healthy adults.

机构信息

Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 37-131 CHS Building, Los Angeles, CA, 90095, USA.

Medical Imaging Informatics, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

出版信息

BMC Pulm Med. 2018 May 24;18(1):89. doi: 10.1186/s12890-018-0650-4.

DOI:10.1186/s12890-018-0650-4

PMID:29793460

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5968560/

Abstract

BACKGROUND

Compared to other pulmonary function tests, there is a lack of standardization regarding how a maximum voluntary ventilation (MVV) maneuver is performed. Specifically, little is known about the variation in breathing frequency (f) and its potential impact on the accuracy of test results. This study examines the effect of several preselected values for f and one self-selected f (f) on MVV.

METHODS

Ten participants performed MVV maneuvers at various f values, ranging from 50 to 130 breaths·min in 10 breaths·min intervals and at one f. Three identical trials with 2-min rest periods were conducted at each f, and the sequence in which f was tested was randomized. Ventilation and related parameters were measured directly by gas exchange analysis via a metabolic measurement system.

RESULTS

A third-order polynomial regression analysis showed that MVV = - 0.0001(f) + 0.0258(f)-1.38(f) + 96.9 at preselected f and increased up to approximately 100 breaths·min (r = 0.982, P < 0.001). Paired t-tests indicated that average MVV values obtained at all preselected f values, but not f, were significantly lower than the average maximum value across all participants. A linear regression analysis revealed that tidal volume (V) = - 2.63(MVV) + 300.4 at preselected f (r = 0.846, P < 0.001); however, this inverse relationship between V and MVV did not remain true for the self-selected f. The V obtained at this f (90.9 ± 19.1% of maximum) was significantly greater than the V associated with the most similar MVV value (at a preselected f of 100 breaths·min, 62.0 ± 10.4% of maximum; 95% confidence interval of difference: (17.5, 40.4%), P < 0.001).

CONCLUSIONS

This study demonstrates the shortcomings of the current lack of standardization in MVV testing and establishes data-driven recommendations for optimal f. The true MVV was obtained with a self-selected f (mean ± SD: 69.9 ± 22.3 breaths·min) or within a preselected f range of 110-120 breaths·min. Until a comprehensive reference equation is established, it is advised that MVV be measured directly using these guidelines. If an individual is unable to perform or performs the maneuver poorly at a self-selected f, ventilating within a mandated f range of 110-120 breaths·min may also be acceptable.

摘要

背景

与其他肺功能测试相比，最大自主通气量（MVV）测试的操作缺乏标准化。具体来说，人们对呼吸频率（f）的变化以及其对测试结果准确性的潜在影响知之甚少。本研究探讨了几种预选 f 值和一个自选 f（f）对 MVV 的影响。

方法

10 名参与者在不同的 f 值下进行 MVV 测试，f 值范围为 50-130 次/min，间隔 10 次/min，同时进行一次 f 测试。每个 f 值下进行三次相同的试验，每次试验之间有 2 分钟的休息时间，f 值的测试顺序是随机的。通气和相关参数通过代谢测量系统直接通过气体交换分析进行测量。

结果

三阶多项式回归分析表明，在预选 f 时，MVV =-0.0001（f）+0.0258（f）-1.38（f）+96.9，在预选 f 时增加到约 100 次/min（r=0.982，P<0.001）。配对 t 检验表明，所有预选 f 值下的平均 MVV 值，但不是 f 值，均显著低于所有参与者的平均最大值。线性回归分析表明，在预选 f 时，潮气量（V）=-2.63（MVV）+300.4（r=0.846，P<0.001）；然而，这种 V 和 MVV 之间的反比关系并不适用于自选 f。在这个 f 值下获得的 V（90.9±19.1%的最大值）明显大于与最相似的 MVV 值相关的 V（在预选 f 值为 100 次/min 时，为 62.0±10.4%的最大值；95%置信区间的差异：（17.5，40.4%），P<0.001）。

结论

本研究表明 MVV 测试目前缺乏标准化的缺点，并为最佳 f 值建立了数据驱动的建议。通过自选 f（平均±SD：69.9±22.3 次/min）或预选 f 范围 110-120 次/min 可获得真实的 MVV。在建立全面的参考方程之前，建议使用这些指南直接测量 MVV。如果个体无法进行自选 f 的操作或操作不佳，在规定的 110-120 次/min 的 f 范围内通气也可能是可以接受的。