-Original-

A Possible, Non-Invasive Method of Measuring Dynamic Lung Compliance in Patients with Interstitial Lung Disease Using Photoplethysmography

Kenichiro Atsumi¹, Yoshinobu Saito¹, Toru Tanaka¹, Takeru Kashiwada¹, Hiroki Hayashi¹, Koichiro Kamio¹, Masahiro Seike¹, Rie Osaki², Kazuhiro Sakai², Shinya Kurosawa², Akihiko Gemma¹ and Arata Azuma¹

¹Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
²DENSO Corporation

Background: Measuring lung compliance is useful for evaluating progression of interstitial lung disease (ILD), because reduced lung compliance due to fibrosis progression is the main cause of decreased vital capacity. However, because insertion of a balloon into the esophagus is invasive, lung compliance is rarely measured. A recently developed method uses fingertip photoplethysmography to estimate intrathoracic pressure. This method non-invasively measures lung dynamic compliance (Cdyn) by simultaneously measuring tidal volume. We evaluated the efficacy of this method in assessing ILD.
Methods: This single-center, cross-sectional, observational study evaluated the efficacy of this method in patients with ILD and healthy controls. The primary outcome was estimated Cdyn (eCdyn), as determined with this method. We also evaluated baseline characteristics that are potential confounding factors for eCdyn.
Results: Median eCdyn was significantly lower in the ILD group (n = 14) than in the control group (n = 49) (0.122 vs. 0.183; P = 0.011). In univariate regression analysis, eCdyn was significantly correlated with height, weight, forced vital capacity, forced expiratory volume in 1 second, diffusing capacity for carbon monoxide, and usual interstitial pneumonia. In multivariate regression analysis, weight (β = 0.49, P = 0.011) and usual interstitial pneumonia (β = 0.52, P = 0.007) were significantly correlated with eCdyn.
Conclusions: Using photoplethysmography, we noted a significant reduction in Cdyn in patients with ILD. This novel non-invasive method is a promising tool for evaluating fibrosis progression in ILD.

J Nippon Med Sch 2021; 88: 326-334

Keywords
lung compliance, photoplethysmography, respiratory function tests, pulse wave analysis, interstitial lung disease

Correspondence to
Yoshinobu Saito, MD, PhD, Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
yo-saito@nms.ac.jp

Received, March 11, 2020
Accepted, September 11, 2020