Assessment of lung volumes in children and adolescents: comparison of two plethysmographic techniques

Thoracic gas volume (Vtg) can be measured with body plethysmography by either repetitive panting or one single inspiratory effort against a shutter occluding the airways. The panting technique is preferred, but may be demanding. We aimed to assess the precision of these two methods and the degree of agreement between them. Vtg and functional residual capacity (FRC) were measured in 155 subjects with a standard, commercially available plethysmograph, acting as a variable-pressure, constant-volume device when Vtg is determined. Total lung capacity (TLC) and residual lung volume (RV) were calculated subsequent to a full vital capacity manoeuvre. For non-asthmatic healthy subjects, the standard deviations (SD) of the differences between two replicate measurements of FRC, TLC and RV were respectively 0.16, 0.13 and 0.14 litres with the panting technique, and 0.18, 0.18 and 0.23 litres with the single inspiratory effort technique. In percentage of the respective lung volumes, the corresponding 1.96 SDs were 20%, 8% and 40% with the panting technique and 23%, 12% and 67% with the single inspiratory effort technique. Between the two techniques, 95% limits of agreement were 21% for FRC, 11% for TLC and 58% for RV. The variability of Vtg and FRC accounted for most of the variability of TLC and RV. In conclusion, the panting and the single inspiratory effort technique produced results that were comparable in magnitude, however with a better precision with the panting technique. The single inspiratory effort technique can be used as an alternative if the panting technique fails.