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This Article Full Text Full Text (PDF) All Versions of this Article: 104/1/224    most recent 00582.2007v1 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 Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Van Muylem, A. Articles by Estenne, M. Search for Related Content PubMed PubMed Citation Articles by Van Muylem, A. Articles by Estenne, M.

Single-breath test in lateral decubitus reflects function of single lungs grafted for interstitial lung disease

Departments of ¹Chest Medicine and ²Radiology, Erasme University Hospital, Brussels, Belgium; the ³Department of Radiology, Medical University of Vienna, Vienna, Austria; ⁴Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and ⁵Department of Chest Medicine, Gasthuisberg Hospital, Leuven, Belgium

Submitted 31 May 2007 ; accepted in final form 29 October 2007

After single-lung transplantation (SLT) for emphysema, heterogeneity of ventilation distribution in the graft can be assessed by measuring the slope of the alveolar plateau, computed from a single-breath test, performed in lateral decubitus with this lung in the nondependent position. We tested the validity of this technique in patients with SLT for interstitial lung diseases (ILD). Twelve patients with SLT for ILD, 12 nontransplanted patients with ILD, and 10 healthy control subjects performed single-breath washouts in right and left lateral decubitus; nitrogen slope (S_N2) and the difference between SF₆ and He slopes (S_SF6-S_He) were measured between 75 and 100% of expired volume. In 10 transplant recipients, the volume of each lung was measured in both postures by computerized tomography. Slopes were unaffected by posture in normal control subjects and patients with ILD. On the other hand, S_N2 and S_SF6-S_He in transplant recipients were smaller with the graft in the nondependent than in the dependent position (0.366 ± 0.445 vs. 1.035 ± 0.498 for S_N2; 0.094 ± 0.201 vs. 0.218 ± 0.277 for S_SF6-S_He). Values of S_N2 and S_SF6-S_He obtained in the former position were similar to those obtained in normal controls, while values obtained in the latter position were similar to those obtained in nontransplanted patients with ILD. Computerized tomography studies with the graft in the nondependent position indicated that this lung contributed 82% of the volume expired below functional residual capacity. We conclude that, in patients with SLT for ILD, the slope of the alveolar plateau obtained with the graft in the nondependent position reflects heterogeneity of ventilation distribution in this lung.

lung transplantation; pulmonary fibrosis; distribution of ventilation