HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Travaline, J. M. Articles by Criner, G. J. Search for Related Content PubMed PubMed Citation Articles by Travaline, J. M. Articles by Criner, G. J.

Quantitation of Regional Ventilation During the Washout Phase of Lung Scintigraphy^*

Measurement in Patients With Severe COPD Before and After Bilateral Lung Volume Reduction Surgery

^* From the Division of Pulmonary and Critical Care Medicine (Drs. Travaline and Criner), Department of Diagnostic Imaging (Drs. Maurer, Charkes, and Urbain), and Cardiothoracic Surgery (Dr. Furukawa), Temple University School of Medicine, Philadelphia, PA.

Correspondence to: John M. Travaline, MD, FCCP, Pulmonary and Critical Care, Temple University School of Medicine, 3401 North Broad St, Philadelphia, PA 19140; e-mail: trav{at}astro.ocis.temple.edu

Study objectives: We sought to investigate the effect of lung volume reduction surgery (LVRS) on regional lung ventilation.

Design: Retrospective analysis of routinely acquired data before and after LVRS.

Setting: Large, urban, university medical center.

Patients: Twenty-nine patients with severe emphysema.

Intervention: Bilateral LVRS.

Measurements and results: ¹³³Xe washout curves during lung scintigraphy exhibit a biphasic pattern (the first component of the washout curve [m_r] corresponds to an initial rapid phase in washout that reflects larger airways emptying, and the second component [m_s] reflects a slower phase of washout that is attributed to gas elimination via smaller airways). We analyzed six standardized regions of the lung (upper, mid, and lower zones of the right and left lung), and calculated m_r and m_s for each lung region. The mean (± SE) baseline FEV₁ was 0.69 ± 0.04 L, total lung capacity (TLC) was 139 ± 4% predicted, and the residual volume (RV)/TLC ratio was 65 ± 2%. The mean improvement in FEV₁ 3 months post-LVRS was 38%. Post-LVRS, m_r and m_s increased in 79 and 74 lung regions, respectively, and there was no relationship with respect to lung regions that had or had not been operated on. The increase in m_s, however, significantly correlated with the increase in FEV₁ (r = 0.66; p < 0.0001) and the decrease in RV/TLC (r = -0.67; p < 0.0001). An increase in m_s also correlated with a decrease in PaCO₂ (r = -0.39; p = 0.03), but m_r showed no relationship with any parameter.

Conclusions: Small airways ventilation in lung regions that had and had not been operated on is associated with a greater improvement in lung mechanics following LVRS.

Key Words: emphysema • lung scintigraphy • lung volume reduction surgery • ventilation

This article has been cited by other articles:

				D. A. Torigian, W. B. Gefter, J. D. Affuso, K. Emami, and L. Dougherty Application of an Optical Flow Method to Inspiratory and Expiratory Lung MDCT to Assess Regional Air Trapping: A Feasibility Study Am. J. Roentgenol., March 1, 2007; 188(3): W276 - W280. [Abstract] [Full Text] [PDF]