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PubMed1975

Differential pulmonary residual volume determinations with radioactive xenon.

A radioactive xenon inhalation procedure was used to determine differential residual volumes (right lung vs. left lung) in 28 normal subjects (6 of whom smoked approximately 1 package of cigarettes per day). The average right lung residual volume represented 54% of the total residual volume, whereas the average left lung residual volumerepresented 46% of the total. In addition, all of the subjects were studied by a standard helium dilution technique and found to have total lung residual comparable to the total lung residual volume as determined by the xenon technique. There was no statistical difference between the data obtained from cigarette smokers vs. nonsmokers. The noninvasive nature of the xenon technique makes this a useful procedure in determining differential residual volumes.

Adolescent↗
PubMed1997

Pressure at residual volume: a useful adjunct to standard fill cystometry.

PURPOSE: Determining the role of the bladder in incontinence and/or upper urinary tract deterioration involves the cystometrographic evaluation of detrusor compliance. Management decisions based on information provided by standard fill water cystometry assume that data reflect the physiological state of the patient but this is not always true. We report the use of pressure at residual volume as a physiological measurement to aid in the interpretation of data obtained during standard fill urodynamics. MATERIALS AND METHODS: All patients presenting to our urodynamic suite for standard cystometry between June 1994 and December 1995 underwent measurement of bladder pressure at insertion of the urodynamic catheter. Residual volume and pressure measured before draining this urine, that is pressure at residual volume, were recorded. The bladder was then filled at a rate equal to or less than 10% per minute of known or predicted capacity. When a volume equal to the residual volume had been instilled, filling pressure was recorded and the remainder of the standard urodynamic evaluation was completed. Uncooperative patients as well as those with an active infection or residual volume less than 10 ml. were excluded from further analysis. RESULTS: In 152 children pressure at residual volume was compared to filling pressure and the difference was analyzed. Filling pressure was higher than pressure at residual volume in the majority of cases. In 59 children there was a positive change (filling pressure greater than pressure at residual volume) of 5 cm. water or greater and in 13 there was a negative change (pressure at residual volume greater than filling pressure) of 5 cm. water or less. When only cases in which pressure at residual volume was greater than 5 cm. water were analyzed, 46 and 33% had a difference between filling pressure and pressure at residual volume of 5 cm. water or greater and 10 cm. water or greater, respectively. CONCLUSIONS: Pressure at residual volume is physiological, simple to determine and may provide additional information regarding storage characteristics of the bladder. In the context of the clinical history differences between pressure at residual volume and filling pressure may help to interpret standard fill cystometry data.

Adolescent↗
PubMed1984

[A new isotope technic for the determination of residual volume].

A new isotope method for the determination of the residual volume of the lungs by means of stable, non-radioactive nitrogen isotope 15N is described. Normal air is breathed in a closed system. One part of the air nitrogen is replaced by 15N labelled molecular nitrogen. 15N2 physiologically acts like normal nitrogen so that the so-called secondary effects by using He or H2 are eliminated. By combination of a spirograph and an emission spectrometric 15N analyser the residual volume can be determined and mixing curves can be obtained. The determination of the residual volume in 10 healthy persons gives a range of normal values from 19 to 31% of the total capacity. In three persons with emphysema values from 45 to 50% of the total capacity are found. The analysis of mixing curves leads to additional informations concerning the intrapulmonary gas mixing conditions in the lungs. The relative error of the residual volume determination is about 8%.

Adult↗
PubMedDate not supplied

Stopping enteral feeding for arbitrary gastric residual volume may not be physiologically sound: results of a computer simulation model.

BACKGROUND: During tube feeding, it is a common practice to check gastric residual volume frequently for indications of pathologic impairment of gastric emptying. The volume threshold standards for holding feedings are applied nonselectively, disregarding slowing of gastric emptying by nutrient-triggered intestinogastric inhibitory feedback. We developed a computer simulation model considering this feedback to test the hypothesis that gastric residual volume increases with slower gastric emptying and faster formula delivery but reaches a plateau volume (equilibrium between input and output) at volumes commonly seen in the postprandial stomach. METHODS: A computer simulation model using Microsoft Excel 4.0 calculated the cumulative gastric residual volume over time when the input volume into the stomach is 125 mL/h (endogenous secretions)+ 0 to 125 mL/h (formula delivery rate) and the output volume out of the stomach is equal to gastric emptying rates that varied between 0% and 50%/h. The model simulated nasogastric feeding with nine different rates of gastric emptying and six different rates of formula delivery. Measurements consisted of the cumulative gastric residual volume at the end of each hour for a minimum of 48 hours. RESULTS: (1) Gastric residual volumes 1.5 to 6 times the commonly applied "stop feeding" threshold volume of 150 mL are encountered at gastric emptying rates of 20% to 50%/h; (2) gastric residual volume stabilizes to a plateau of 225 to 900 mL between 3 and 13 hours after start of formula delivery at these rates; and (3) at 0% gastric emptying, gastric residual volume does not reach a plateau. CONCLUSIONS: At gastric emptying rates expected with nutrient-triggered inhibitory feedback and at formula delivery rates common in nutrition support, gastric residual volume reaches a plateau rapidly and at volumes commonly encountered in normal postprandial stomachs. On the basis of the results of this model, the current practice of stopping enteral feeding when gastric residual volume exceeds an arbitrarily selected volume threshold may not be physiologically sound. Clinical studies are needed to verify this model.

Computer Simulation↗
PubMed1987

Prognostic implications of large volume residual disease in patients with advanced stage epithelial ovarian cancer.

Thirty-two patients with Stage III or IV epithelial ovarian cancer and residual tumor volumes in excess of 2 cm in diameter after initial debulking were treated with platinum and cyclophosphamide chemotherapy. Twenty-seven patients (84%) received at least six courses of chemotherapy. Six patients developed grade 3 or 4 hematologic toxicity and one patient died with granulocytopenia and sepsis. The actuarial survival of the total group of patients was 78% at 12 months, 27% at 24 months, and 11% at 36 month. Of patients with residual disease 2-4 cm in diameter, 82% were alive 12 months after diagnosis and 46% were alive at 24 months. In contrast, patients with greater than 4 cm residual disease had a 12-month survival of 73% and a 24-month survival of only 7%. The size of residual tumor after surgery remains a very important prognostic factor in patients treated with platinum-based combination chemotherapy. Reoperation with further tumor debulking should be considered in ovarian cancer patients referred for chemotherapy with large volume residual disease to maximize response to combination chemotherapy.

Adult↗
PubMed2000

Comparison of 2 methods of managing gastric residual volumes from feeding tubes.

BACKGROUND: Research-based standards do not exist for the management of gastric residual volumes from feeding tubes. Withdrawing and returning residual volumes can lead to clogged tubes and exposes patients to possible contamination of the feeding system. However, discarding residual volumes may place patients at risk for electrolyte imbalance and may alter fluid or nutritional balance. OBJECTIVES: To investigate the effects of discarding versus returning gastric residual volumes on body weight, serum electrolyte levels, and the rate of complications associated with tube feeding. METHODS: Thirty-five subjects receiving enteral feedings were recruited from intensive care units at 3 Midwest hospitals and randomized to a discard group or a return group. Eighteen sets of usable data were obtained. RESULTS: Repeated-measures analysis of variance indicated no significant differences between the 2 groups for any of the variables. Complications related to enteral feedings were more common in the return group (n = 8), which had 2 episodes of tube clogging and 1 episode of diarrhea and nausea. None of these complications were experienced by patients in the discard group (n = 10). CONCLUSIONS: Both groups had significant numbers of complications, including a total of 15 episodes, 7 in the discard group and 8 in the return group, of feeding delays due to high gastric residual volumes. Although serum electrolyte levels did not differ significantly between the 2 groups, potassium levels tended to be lower in the discard group. Considerations for the care of critically ill patients with feeding tubes are discussed in light of these findings.

Adolescent↗
PubMedDate not supplied

[Correlation of the size of the residual volume measured by whole body plethysmography and the single breath helium dilution method].

The value of residual volume, intrathoracic gas volume, functional residual capacity and total lung capacity obtained by the method of body plethysmography and helium dilution method was correlated by single-breath diffusing capacity. These parameters were correlated in 22 patients who had had complete functional diagnostics of the lung: spirometry, flow volume curve, body plethysmography and single-breath diffusing capacity. All findings were within normal limits, which was a condition for selection of patients for our group. Statistically significant differences (p = 0.01) of t-test were established between residual volumes by the plethysmographic and helium dilution method of single-breath diffusing capacity. The residual volume obtained by body plethysmography showed higher values for 526 ml, or 30%. The intrathoracic gas volume showed higher values for 682 ml, or 17%. Inspite of the fact that values of RV obtained by two methods had statistically significant differences, they were still within normal limits, if presented as percent of the predicted value.

Adult↗
PubMed2001

New prediction equation for residual volume in Japanese male and female young adults.

BACKGROUND: The purpose of this study was to establish a convenient prediction equation for residual volume for Japanese male and female young adults after comparisons in reliability and validity with previous equations widely used in studies of body composition with Japanese subjects. METHODS: The subjects were healthy Japanese, 110 males aged 18 to 27 years and 82 females aged 18 to 22 years. Measured residual volume (MRV) was measured with a nitrogen washout technique and each predicted residual volume (PRV) was predicted using a prediction equation. Multiple regression analysis on all possible selections was applied to determine a suitable and convenient prediction equation for residual volume. RESULTS: Intra-class correlation coefficient and a coefficient of Cronbach in MRV exceeded 0.9, indicating high reliability. Pearson s correlation coefficients between MRV and each PRV for males and females ranged from 0.225 to 0.327 and - 0.485 to 0.507, respectively. Multiple correlation coefficient adjusted for degrees of freedom applying the one variables of height was 0.592 for males and 0.670 for females. CONCLUSIONS: Considering the practicability of measurement, prediction equations for residual volume with height in Japanese male and female young adults have been proposed. The new prediction equations (PRVnew) are as follows: male: PRVnew= 32.16 yen height (cm) - 4113.70 (Radj= 0.592, SE= 247.13 ml); female: PRVnew = 34.03 yen height (cm) - 4407.78 (Radj= 0.670, SE= 195.74 ml).

Adolescent↗
PubMed1993

Changes in residual volume relative to vital capacity and total lung capacity after arthrodesis of the spine in patients who have adolescent idiopathic scoliosis.

We evaluated pulmonary functions before correction and again after a mean follow-up of three years in thirty-five patients who had adolescent idiopathic scoliosis. The mean age (and standard deviation) at the time of correction was 13.7 +/- 1.8 years, and at the time of follow-up it was 17.1 +/- 2.5 years. The findings in the patients were compared with those in matched normal control subjects. With the exception of forced vital capacity, all of the determinations of absolute pulmonary volume increased postoperatively, but the increases were not all proportional. When the preoperative and follow-up determinations were expressed as percentages of the predicted pulmonary volumes (on the basis of age) to eliminate any effects of the difference in age, there was no change in total lung capacity, but vital capacity and forced vital capacity were significantly reduced. In addition, there was a significant increase in residual volume. Of the mean increase in total lung capacity after correction of the scoliosis, 82 per cent was due to an increase in residual volume and 18 per cent, to an increase in vital capacity. However, in control subjects age-matched at the time of follow-up, the increase in vital capacity contributed 69 per cent of the mean increase in total lung capacity, a very marked difference from the findings in the patients who had scoliosis. In addition, two pulmonary-volume ratios--residual volume to vital capacity and residual volume to total lung capacity--increased in a highly significant fashion (Mann-Whitney test, p < 0.001) after arthrodesis of the spine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Gastric residual volume in infants and children following a 3-hour fast.

The effect of a 3-hour versus a 10-hour preoperative fasting interval on the gastric residual volume and gastric pH of pediatric patients was evaluated. Forty-four healthy infants, 1 month to 5 years of age, were randomly assigned to one of two groups. The 3-hour nil per os (NPO) group consisted of 19 infants kept NPO for 3 hours following ingestion of up to 4 ounces of 5% dextrose in water (D5W). The control group consisted of 25 infants who remained NPO an average of 10 hours prior to surgery. Gastric residual volume was calculated using the dye-dilution technique. After the dye marker was injected into the stomach, complete aspiration of the stomach (including the volume of dye marker plus residual gastric contents) was attempted as another method to measure gastric residual volume. There were no significant differences in gastric residual volume between the 3-hour and the 10-hour NPO groups using either the dye-dilution or aspiration methods. However, there were significant differences between the two measuring techniques. Gastric residual volume was significantly greater in volume when measured by the dye-dilution technique than it was when measured by the aspiration technique in both the 10-hour (p less than 0.009) and the 3-hour (p less than 0.0009) NPO groups. Complete aspiration of a known volume of fluid injected through the orogastric tube was not possible in 23 of the 44 (52.4%) infants. Mean gastric pH was less than 2.0 in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Weight↗
PubMed1996

The value of symptom score, quality of life score, maximal urinary flow rate, residual volume and prostate size for the diagnosis of obstructive benign prostatic hyperplasia: a urodynamic analysis.

PURPOSE: We investigated which linear combination of scores for symptoms, quality of life, maximum urinary flow rate, residual volume and prostate size best discriminated men with prostatism who do and do not have obstruction. MATERIALS AND METHODS: Mandatory and recommended tests were performed in 196 men older than 50 years with prostatism. Schäfer's obstruction grade was estimated by urodynamic studies. Relative residual volume was defined as residual volume divided by cystometric capacity (times 100%). Correlation coefficients among the different parameters were estimated. Obstruction grade was correlated with linear weighted combinations of the parameters. RESULTS: Of the men 79% appeared to have obstruction. The formula, prostate size (cm.3) -3 x maximum urinary flow rate (ml. per second) + 1/4 of relative residual volume (%), correlated almost maximally with obstruction grade. Including quality of life score or symptom score in this expression had a negative outcome on the correlation. Calculation of this expression resulted in the bladder outlet obstruction number. In more than 50% of the men the bladder outlet obstruction number was greater than -2 and more than 90% had obstruction. In 25% of all men the bladder outlet obstruction number was greater than 13 and more than 95% had obstruction. CONCLUSIONS: Bladder outlet obstruction number may be calculated with an easy to use expression composed of prostate size, maximum urinary flow and relative residual volume. In 50% of the men with prostatism bladder outlet obstruction number will diagnose obstruction with a reliability of more than 90%.

Aged↗
PubMed1988

Residual volume as a tool in body fat prediction.

Possible methods of estimating residual volume for the prediction of body fat have been compared in young and healthy adults, with particular reference to the potential of a rapid helium equilibration method. In the first experiment, 5 women and 5 men performed nitrogen elimination, oxygen dilution and helium equilibration tests; scores for the helium test were higher than for the other two methods, but lay between the predictions made by Bass in 1964 and by Wilmore in 1969 and the values predicted by the equation of Goldman and Becklake in 1959. However, estimates of body density and body fat, based on residual volumes obtained from the prediction equations, did not differ significantly from those obtained directly by helium equilibration. A second experiment compared the helium and the oxygen techniques in 18 men and 18 women, with similar results. A final experiment compared the simple helium equilibration procedure with vital capacity and anthropometric predictions also suited to large scale determinations of body composition. It is concluded that the rapid helium equilibration procedure provides a fast and convenient procedure for the residual volume component of a body fat estimation. However, further study of the adequacy of equilibration is needed in older subjects and in patients with chronic chest disease.

Adipose Tissue↗
PubMed1979

[Reference values of the residual volume for the rvo2-method (author's transl)].

Residual volume and the relative RV/TLC (total lung capacity) were measured in 632 men and 191 women aged 15 to 70 years. The residual volume showed a significant correlation to age and body height, but not to the relative body weight (Broca-Index). The values of RV/TLC showed a correlation to age and Broca-Index, but not to the body height. The regression formular to calculate the normal range are given; they comply with the data of other authors.

Adolescent↗
PubMed1976

Determinants of regional distribution of a bolus inhaled from residual volume.

The volume of lung at residual volume (RV) which fails to receive an inhaled tracer bolus (EXV) was quantitated in 13 normals by comparison of a scintigram of the distribution of a tracer bolus inhaled from RV (BORV) with a scintigram at RV of lung equilibrated with the tracer (EQRV). EXV was found in the dependent lung in the erect position in all subjects but also occurred to a lesser degree at the apex in 11 of 13 subjects. Basal EXV ranged from 1 to 7% of TLC, and unlike apical EXV increased with age (r= 0.91, P less than 0.01). EXV in the decubitus position shifted largely to the dependent lung with none remaining in the original erect apical and basal locations, demonstrating that gravity determined EXV location. Nitrous oxide, which is highly diffusible, failed in four subjects to carry the tracer to basal EXV even though perfusion was documented to persist to this area, implying basal EXV airways were closed, not narrowed. In one of the four subjects apical EXV was readily definable. Nitrous oxide carried tracer into this region, implying patent apical EXV airways.

Adolescent↗
PubMed1978

Effects of age on regional residual volume.

Forty-one normal non-smokers between the ages of 20 and 80 were studied to determine if the increased residual volume, known to occur with aging, results from increased residual volume throughout, or only in specific regions of the lung. The subjects were dividied into groups consisting of 20-29, 30-39, 40-49, 50-69, and 70+ yr. Measurements of regional residual volume to regional total lung capacity ratio (RVr/TLCr) were made using zenon-133 and a multidetector analysis system in which five zones (from top to bottom) were analyzed in each lung. Closing volume was also measured. The subjects were in the sitting position for all studies. The results showed regardless of age, the RVr/TLCr was higher at the top than at the bottom of the lung. In addition, the ratio of upper to lower RVr/TLCr was not significantly different between any of the age groups. The results can be explained if airways throughout the lung close at higher volumes as age increases, or if altered emptying sequences within regions occur due to retarded emptying of highly compliant lung regions.

Adult↗
PubMed1993

Validity of the forced rebreathing method in the measurement of residual volume in patients with airflow limitation.

The validity of the forced rebreathing method (FRM) in the measurement of residual volume (RVn) was assessed in two groups (28 and 12) of patients with significant airflow limitation. The mean FEV1% FVC% were 48.28%, SD = 8.91% and 54.3%, SD = 0.23% respectively. Patients performed at least 30 forced rebreathings into a bag and bottle system at about 28 breaths per minute. RVn per breath was regressed on breath and gas dilution was considered complete at the breath number where the regression line deviated from the nitrogen washout curve. Residual volume computed four breaths after the breath number where the regression line deviated from the curve were compared with results derived from helium dilution (RVHe), mouth (RVmo) and oesophageal (RVOeS) pressure changes in the body plethysmograph. The mean RVn was similar to RVHe (P > 0.98) and correlated well with RVHe (r = 0.908, P < 0.001). RVn and RVHe were significantly smaller than RVmo and RVoes (P < 0.001). The difference between RVn and RVmo was smaller than the difference with RVoes. RVmo was larger than RVoes (P < 0.001) and correlated well with RVoes (r = 0.939, P < 0.001). It is concluded that the FRM can be used with reasonable accuracy to measure residual volume in patients with airflow limitation, and has advantages over the plethysmographic and conventional helium dilution methods.

Adult↗
PubMed1981

Comparison of hydrostatic weighing at residual volume and total lung capacity.

Hydrostatic weighing (HW) was performed at both residual volume (RV) and total lung capacity (TLC) (both measured on land) to determine if underwater weighting at extreme lung volumes affected the measurement of body density. Subjects were 72 middle-aged males (mean age = 43.4 yr) and 51 middle-aged females (mean age = 40.2 yr). Subjects were first assessed for underwater weight at RV for at least 10 trials. Subjects were than instructed to inspire maximally and hold their breath underwater for as long as they could. Three trials at TLC were used for assessment of underwater weight. Forced vital capacity and residual volume (oxygen dilution) were determined separately on land. Small but statistically significant differences in body density (Db) were observed with the use of RV (1.0354 g/ml for men and 1.0196 g/ml for women) vs TLC (1.0367 g/ml for men and 1.0221 g/ml for women) (p less than 0.05). Percent fat values for the RV and TLD data differed by only 0.5% for men and 0.9% for women. Results indicated that the difference between percent fat determination by HW at RV and TLC, was negligible. It was concluded that HW at TLC may be the method of choice for subjects who are uncomfortable with performing the technique of underwater weighing at RV.

Adipose Tissue↗