Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Lung. 2019 Oct;197(5):573-576. doi: 10.1007/s00408-019-00265-w. Epub 2019 Aug 31.
During the evaluation of potential bronchoscopic lung volume reduction (BLVR) candidates in our hospital, we frequently observe patients with a lower residual volume (RV) value compared to the value measured in their referring hospital, although both measured by body plethysmography. We explored to what degree RV and other pulmonary function measurements match between referring hospitals and our hospital. We retrospectively analyzed a total of 300 patients with severe emphysema [38% male, median age 62 years (range 38-81), median forced expiratory volume in 1 s 29% (range 14-65) of predicted, and a median of 40 packyears (range 2-125)]. We measured a median RV of 4.47 l (range 1.70-7.57), which was a median 310 ml lower than in the referring hospitals (range - 3.04 to + 1.94), P < 0.001). In conclusion, this retrospective analysis demonstrated differences in RV measurements between different hospitals in patients with severe emphysema. Overestimation of RV can lead to unnecessary referrals for BLVR and potential treatment failures. To avoid disappointment and unnecessary hospital visits, it is important that body plethysmography measurements are accurately performed by applying preferably the unlinked method in these patients.
在我院对潜在的支气管镜肺减容术（BLVR）候选者进行评估时，我们经常观察到患者的残气量（RV）值低于转诊医院测量的值，尽管这两种测量方法都是通过体描仪进行的。我们探讨了 RV 和其他肺功能测量值在转诊医院和我院之间的匹配程度。我们回顾性分析了总共 300 名患有严重肺气肿的患者[38%为男性，中位年龄 62 岁（范围 38-81），中位 1 秒用力呼气量占预计值的 29%（范围 14-65），中位吸烟指数为 40 packyears（范围 2-125）]。我们测量的 RV 中位数为 4.47 l（范围 1.70-7.57），比转诊医院低中位数 310 ml（范围-3.04 至+1.94），P<0.001）。总之，这项回顾性分析表明，严重肺气肿患者在不同医院之间 RV 测量值存在差异。RV 的高估可能导致不必要的 BLVR 转诊和潜在的治疗失败。为了避免失望和不必要的医院就诊，对于这些患者，重要的是通过应用优选的非关联方法准确地进行体描仪测量。
