A new noninvasive method for measurement of dynamic lung compliance from fluctuations on photoplethysmography in respiration

Lung compliance is important in interstitial lung disease (ILD). However, the measurement requires placement of an esophageal pressure probe and is therefore not done in routine clinic practice. This study was performed to develop and verify a new noninvasive method for estimation of dynamic lung compliance (Cdyn) with a photoplethysmograph (PPG) of pulse wave represented as the changes of absorbance of green LED for hemoglobin and to examine its usefulness. A system for measuring Cdyn in combination with changes in estimated pleural pressure (Ppl) from the fluctuations on PPG with respiration and lung volume measured simultaneously by spirometry was developed and verified to show correspondence with the estimated Ppl and the esophageal pressure (Pes), estimated Cdyn, and Cdyn measured with an esophageal balloon. Furthermore, the estimated percentage of predicted Cdyn (%Cdyn) was compared among healthy subjects (HS) ( = 33) and patients with chronic obstructive pulmonary disease (COPD) ( = 31) and ILD ( = 30). Both estimated Ppl and Cdyn were significantly correlated with Pes ( = 0.89) and measured Cdyn (r = 0.63), respectively. The estimated %Cdyn in ILD showed significantly lower values than those in HS and COPD. The estimated %Cdyn was significantly related to percentage of predicted vital capacity (VC) ( = 0.57, < 0.01) and percentage of predicted diffusion capacity of carbon monoxide (Dl ) ( = 0.50, < 0.01) in patients with ILD. These findings suggested that the newly developed noninvasive and convenient method for Cdyn estimation using a combination of PPG and spirometry may be useful for the assessment of lung fibrosis in ILD. Our newly developed method for measuring dynamic lung compliance (Cdyn) in combination with changes in estimated intrathoracic pressure from fluctuations on photoplethysmography with respiration and lung volume measured simultaneously by spirometry showed good linear regression between the estimated Cdyn and the Cdyn measured with an esophageal balloon, and the estimated percentage of predicted Cdyn (%Cdyn) showed significantly lower values in patients with interstitial lung disease (ILD) than in healthy subjects and chronic obstructive pulmonary disease (COPD) patients and significant correlations with vital capacity and lung diffusion capacity.