Validation of a two-compartment model of ventilation/perfusion distribution

Jack A. Loeppky; Arvind Caprihan; Stephen A. Altobelli; Milton V. Icenogle; Pietro Scotto; Marcos F. Vidal Melo

doi:10.1016/j.resp.2005.06.002

Validation of a two-compartment model of ventilation/perfusion distribution

Jack A. Loeppky, Arvind Caprihan, Stephen A. Altobelli, Milton V. Icenogle, Pietro Scotto, Marcos F. Vidal Melo

Research output: Contribution to journal › Article › peer-review

13 Scopus citations

Abstract

Ventilation (V̇_A) to perfusion (Q̇) heterogeneity (V̇_A/Q̇) analyses by a two-compartment lung model (2C), utilizing routine gas exchange measurements and a computer solution to account for O₂ and CO₂ measurements, were compared with multiple inert gas elimination technique (MIGET) analyses and a multi-compartment (MC) model. The 2C and MC estimates of V̇_A/Q̇ mismatch were obtained in 10 healthy subjects, 43 patients having chronic obstructive pulmonary disease (COPD) and in 14 dog experiments where hemodynamics and acid-base status were manipulated with gas mixtures, fluid loading and tilt-table stressors. MIGET comparisons with 2C were made on 6 patients and 32 measurements in healthy subjects before and after exercise at normoxia and altitude hypoxia. Statistically significant correlations for logarithmic standard deviations of V̇_A/Q̇ distributions (SD(V̇_A/Q̇)) were obtained for all 2C comparisons, with similar values between 2C and both other methods in the 1.1-1.5 range, compatible with mild to moderate COPD. 2C tended to overestimate MC and MIGET values at low and underestimate them at high SD(V̇_A/Q̇) values. SD(V̇_A/Q̇) weighted by Q̇ agreed better with MC and MIGET estimates in the normal range, whereas SD(V̇_A/Q̇) weighted by V̇A was closer to MC at higher values because the V̇_A-weighted SD(V̇_A/Q̇) is related to blood-to-gas PCO₂ differences that are elevated in disease, thereby allowing better discrimination. The 2C model accurately described functional V̇_A/Q̇ characteristics in 26 normal and bronchoconstricted dogs during non-steady state rebreathing and could be used to quantify the effect of reduced O₂ diffusing capacity in diseased lungs. These comparisons indicate that 2C adequately describes V̇_A/Q̇ mismatch and can be useful in clinical or experimental situations where other techniques are not feasible.

Original language	English (US)
Pages (from-to)	74-92
Number of pages	19
Journal	Respiratory Physiology and Neurobiology
Volume	151
Issue number	1
DOIs	https://doi.org/10.1016/j.resp.2005.06.002
State	Published - Mar 28 2006
Externally published	Yes

Keywords

Alveolar-arterial PO difference
Arterial-alveolar PCO difference
Chronic obstructive pulmonary disease
Diffusion limitation
Hypoxemia
V̇/Q̇ models

ASJC Scopus subject areas

General Neuroscience
Physiology
Pulmonary and Respiratory Medicine

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10.1016/j.resp.2005.06.002

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@article{9911e933320a43f0a95eb21e807db133,

title = "Validation of a two-compartment model of ventilation/perfusion distribution",

abstract = "Ventilation ({\.V}A) to perfusion ({\.Q}) heterogeneity ({\.V}A/{\.Q}) analyses by a two-compartment lung model (2C), utilizing routine gas exchange measurements and a computer solution to account for O2 and CO2 measurements, were compared with multiple inert gas elimination technique (MIGET) analyses and a multi-compartment (MC) model. The 2C and MC estimates of {\.V}A/{\.Q} mismatch were obtained in 10 healthy subjects, 43 patients having chronic obstructive pulmonary disease (COPD) and in 14 dog experiments where hemodynamics and acid-base status were manipulated with gas mixtures, fluid loading and tilt-table stressors. MIGET comparisons with 2C were made on 6 patients and 32 measurements in healthy subjects before and after exercise at normoxia and altitude hypoxia. Statistically significant correlations for logarithmic standard deviations of {\.V}A/{\.Q} distributions (SD({\.V}A/{\.Q})) were obtained for all 2C comparisons, with similar values between 2C and both other methods in the 1.1-1.5 range, compatible with mild to moderate COPD. 2C tended to overestimate MC and MIGET values at low and underestimate them at high SD({\.V}A/{\.Q}) values. SD({\.V}A/{\.Q}) weighted by {\.Q} agreed better with MC and MIGET estimates in the normal range, whereas SD({\.V}A/{\.Q}) weighted by {\.V}A was closer to MC at higher values because the {\.V}A-weighted SD({\.V}A/{\.Q}) is related to blood-to-gas PCO2 differences that are elevated in disease, thereby allowing better discrimination. The 2C model accurately described functional {\.V}A/{\.Q} characteristics in 26 normal and bronchoconstricted dogs during non-steady state rebreathing and could be used to quantify the effect of reduced O2 diffusing capacity in diseased lungs. These comparisons indicate that 2C adequately describes {\.V}A/{\.Q} mismatch and can be useful in clinical or experimental situations where other techniques are not feasible.",

keywords = "Alveolar-arterial PO difference, Arterial-alveolar PCO difference, Chronic obstructive pulmonary disease, Diffusion limitation, Hypoxemia, {\.V}/{\.Q} models",

author = "Loeppky, {Jack A.} and Arvind Caprihan and Altobelli, {Stephen A.} and Icenogle, {Milton V.} and Pietro Scotto and {Vidal Melo}, {Marcos F.}",

year = "2006",

month = mar,

day = "28",

doi = "10.1016/j.resp.2005.06.002",

language = "English (US)",

volume = "151",

pages = "74--92",

journal = "Respiratory Physiology and Neurobiology",

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T1 - Validation of a two-compartment model of ventilation/perfusion distribution

AU - Loeppky, Jack A.

AU - Caprihan, Arvind

AU - Altobelli, Stephen A.

AU - Icenogle, Milton V.

AU - Scotto, Pietro

AU - Vidal Melo, Marcos F.

PY - 2006/3/28

Y1 - 2006/3/28

N2 - Ventilation (V̇A) to perfusion (Q̇) heterogeneity (V̇A/Q̇) analyses by a two-compartment lung model (2C), utilizing routine gas exchange measurements and a computer solution to account for O2 and CO2 measurements, were compared with multiple inert gas elimination technique (MIGET) analyses and a multi-compartment (MC) model. The 2C and MC estimates of V̇A/Q̇ mismatch were obtained in 10 healthy subjects, 43 patients having chronic obstructive pulmonary disease (COPD) and in 14 dog experiments where hemodynamics and acid-base status were manipulated with gas mixtures, fluid loading and tilt-table stressors. MIGET comparisons with 2C were made on 6 patients and 32 measurements in healthy subjects before and after exercise at normoxia and altitude hypoxia. Statistically significant correlations for logarithmic standard deviations of V̇A/Q̇ distributions (SD(V̇A/Q̇)) were obtained for all 2C comparisons, with similar values between 2C and both other methods in the 1.1-1.5 range, compatible with mild to moderate COPD. 2C tended to overestimate MC and MIGET values at low and underestimate them at high SD(V̇A/Q̇) values. SD(V̇A/Q̇) weighted by Q̇ agreed better with MC and MIGET estimates in the normal range, whereas SD(V̇A/Q̇) weighted by V̇A was closer to MC at higher values because the V̇A-weighted SD(V̇A/Q̇) is related to blood-to-gas PCO2 differences that are elevated in disease, thereby allowing better discrimination. The 2C model accurately described functional V̇A/Q̇ characteristics in 26 normal and bronchoconstricted dogs during non-steady state rebreathing and could be used to quantify the effect of reduced O2 diffusing capacity in diseased lungs. These comparisons indicate that 2C adequately describes V̇A/Q̇ mismatch and can be useful in clinical or experimental situations where other techniques are not feasible.

AB - Ventilation (V̇A) to perfusion (Q̇) heterogeneity (V̇A/Q̇) analyses by a two-compartment lung model (2C), utilizing routine gas exchange measurements and a computer solution to account for O2 and CO2 measurements, were compared with multiple inert gas elimination technique (MIGET) analyses and a multi-compartment (MC) model. The 2C and MC estimates of V̇A/Q̇ mismatch were obtained in 10 healthy subjects, 43 patients having chronic obstructive pulmonary disease (COPD) and in 14 dog experiments where hemodynamics and acid-base status were manipulated with gas mixtures, fluid loading and tilt-table stressors. MIGET comparisons with 2C were made on 6 patients and 32 measurements in healthy subjects before and after exercise at normoxia and altitude hypoxia. Statistically significant correlations for logarithmic standard deviations of V̇A/Q̇ distributions (SD(V̇A/Q̇)) were obtained for all 2C comparisons, with similar values between 2C and both other methods in the 1.1-1.5 range, compatible with mild to moderate COPD. 2C tended to overestimate MC and MIGET values at low and underestimate them at high SD(V̇A/Q̇) values. SD(V̇A/Q̇) weighted by Q̇ agreed better with MC and MIGET estimates in the normal range, whereas SD(V̇A/Q̇) weighted by V̇A was closer to MC at higher values because the V̇A-weighted SD(V̇A/Q̇) is related to blood-to-gas PCO2 differences that are elevated in disease, thereby allowing better discrimination. The 2C model accurately described functional V̇A/Q̇ characteristics in 26 normal and bronchoconstricted dogs during non-steady state rebreathing and could be used to quantify the effect of reduced O2 diffusing capacity in diseased lungs. These comparisons indicate that 2C adequately describes V̇A/Q̇ mismatch and can be useful in clinical or experimental situations where other techniques are not feasible.

KW - Alveolar-arterial PO difference

KW - Arterial-alveolar PCO difference

KW - Chronic obstructive pulmonary disease

KW - Diffusion limitation

KW - Hypoxemia

KW - V̇/Q̇ models

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Validation of a two-compartment model of ventilation/perfusion distribution

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Keywords

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