Relationship
of
in
NORMAN
Height
Healthy
G. G. HEPPER,
H. FREDERIC
to Lung
Men*
M.D.,’t
WARD
HELMHOLZ,
Rochester,
Volume
S. FOWLER,
JR.,
M.D.tt
M.D.t
and
Minnesota
The accurate
definition
of physiologic
normality
in man
is a prerequisite
to quantitation
of disease.
It has
long
been
known
that
the total
lung
volume
or a subdivision
thereof
of a person
has limited
significance
as an isolated
measurement
unless
it can be compared
to a normal
value.
Although
the ranges
of normality
of the various
subdivisions,
when
expressed
as a percentage
of the normal
total
capacity,
have
been
established,
one still
must
know
what
the
total
capacity
should
be under
normal
conditions
before
actual
values
of it and its subdivisions
can be
evaluated
in terms
of being
normal
or abnormal.
Ever since
Hutchinson’
first
reported
his extensive
study
of the vital
capacity
of man,
many
attempts
have
been
made
to define
the correlations
between
vital
capacity
(and
later,
total
capacity)
and
various
physical
measurements
in
the hope
that
it would
be possible
to predict
accurately
the normal
lung
volumes
from
certain
physical
measurements.
Hutchinson
correlated
vital
capacity
with
standing
body
height.
In addition,
stem
height,
weight,
surface
area,
circumference
and volume
of the thorax,
radiologic
lung
area or volume,
age or any combination
of these
measurements
has
been
utilized
in predicting
lung
volues.22
Most
attempts
have
been
made
at trying
to describe
a linear
correlation
between
body
build
and
lung
volume.
Good
correlations
pertained
over only
limited
ranges.
To
overcome
this,
formulas
utilizing
multiple
linear
correlations
have
been
derived.
Kelly,22
in a study
of vital
capacity
of boys
and
girls,
first
identified
the
relationship
between
vital
capacity
and
the cube
of height.
Bateman2
later
expressed
the relationship
of the total
lung
volume
and
its
subdivisions
to the third
power
of the body
height
of adults
of average
stature.
Subsequently,
Morse
and associates,21
Helliesen
and co-workers,2
and
Engstr#{246}m and
associates2
described
this
relationship
in boys
and
girls.
It is the purpose
pertains
when
the
tofore
reported.
of this
study
height
levels
to
are
determine
extended
if this
beyond
relationship
the ranges
still
here-
Methods
Measurements
of vital
capacity
and total
lung
capacity
were made
on
39 healthy
male
physicians
and
laboratory
workers
ranging
from
21 to
44 years
of age.
Older
persons
were
not included
in order
to avoid
the
well-known
effects
of age on vital
capacity.
In addition
to men of average
height,
men
were
selected
who
were
unusually
tall,
including
15 who
#{176}MayoClinic
and Mayo
a part
of the Graduate
#{176}#{176}Section
of Medicine
tSection
ttSection
of
of
Foundation,
School
of the
Rochester,
University
Minnesota.
of Minnesota.
The
Physiology
Physiology
314
Downloaded From: http://journal.publications.chestnet.org/pdfaccess.ashx?url=/data/journals/chest/21337/ on 06/18/2017
Mayo
Foundation
is
Vol.
XXXVII
LUNG
TABLE-LUNG
IN
VOLUME
VOLUMES
AND
MEN
HEALTHY
HEIGHT
OF
Ratio
ot
lung
MEN
AND
volume
height
of
315
1
liter
BOYS
cube
ti
M
R.itio
of
Tiu.il
51cm
age
in years
I ranize
(
Authors
Bateman-Birath
This report
Total
capacity
Vital
capacity
‘Predicted
as
tN is number
height
in sm.
) range
(
28
18-391
Helliesen
lot.il
C.ipaCits
Mean:
5.1).
SE.
of
mean
Mean
175.9
(164-186)
11.0
(5-17)
147.6
(110-184)
31
(21-44)
31
(22-41)
180.4
164-198)
184.3
(164-206)
VCO.9
Ht3
of subjects.
and
1.177
0.141
0.027
1.138
0.147
0.021
Ht
(VC
Capacity
SE.
NT
it
me.in
NT
to
values’
capacity
Vital
cap.icitv
51cm.
Mean:
SE.
of mean
cricfhcient
variation
(
SI).
SE.
of
ciietfti.
it
I variation
0.896
28
-
28
-
-
-
1.216
0.129
0.021
TC=1.18
Vital
Mean.
observed
predicted
)
50
0.872
0.117
0.016
52
.964
.018
13.0
.968
.018
13.5
39
0.908
0.103
0.012
76
1.031
.018
10.7
1.009
.013
11.0
and
TC
in liters;
Ht
in meters).
were
6 feet (183 cm.)
or more
in height.
Determinations
of vital
capacity
only
were
done
on 37 additional
men,
including
10 professional
basketball players.
In these
last 10 men,
vital
capacity
was measured
with
the
subjects
standing;
otherwise,
measurements
were
made
in the
seated
position
and the men were not fasting.
The total
capacity
was measured
by adding
the vital capacity,
obtained
by use of a Benedict-Roth
type
of spirometer,
to the residual
volume.
The
latter
was determined
by a modification,
previously
described,27
of
Darling’s
open-circuit,
nitrogen-elimination
method.
All volumes
are expressed
at BTPS
(body
temperature,
ambient
pressure,
saturated).
Results
The
results
are
man’s232’
compilation
Vital
listed
of
in the accompanying
his and
Birath’s29
data
table,
on
Capacity
Total
/2
-
0
Hl!
along
young
with
men,
Bateand
Capacity
tlt
Si
‘978
#{149},e#{149})ol
/0
/0
-
S
S
S
S.
8
8
S
#{149}$S
S
S
#{149}
.%
5#{149}5
S
S
#{149}S
S
0%.
6
C
‘S
S.
5
0o
-J
o
0
0
0
0
000
0
080
o
800
I
.
0
0%
000
0
900
‘b
00
2L-
2
-
80
10
0
0
01.
/00
-5-
/40
/60
IW
200
HEIGHT
FIGURE
1:
Relationship
.
0
‘
/20
/
-
00
/20
/
40
I
.
/60
centimeters
of lung
volumes
to
body
height.
Downloaded From: http://journal.publications.chestnet.org/pdfaccess.ashx?url=/data/journals/chest/21337/ on 06/18/2017
I
/80
200
mean:
ent
if
) 70
316
HEPPER,
Vito!
FOWLER,
AND
Capacity
HELMHOLZ
Total
March,
1960
Capacity
(I)
-‘a
HEIGHT
FIGURE
but
on
2:
Relationship
a double
of
logarithmic
lung
centimeters
-
volumes
to
body
height.
Same
data
as
in figure
scale.
Vito!
Capacity
Total
Capacity
/0
/0
S
S
S.
5
5
1/
(1)
00
0*
-‘a
9
2
2
-
0
re,
S.,,,,
O-,,.,i..,.,.’o
#950
A-A,9uoi
9
-
90e40ol
‘93839
‘0’
X-Mo,’ol
+-m,.,v.io.io,
59000900lol
954
‘952
950
/933
950
#{163}-Bo)00’oO-B.,OO
/00
/ 50
200
HEIGHT
FIGURE
values
3:
from
Relationship
a number
of lung
of sources.
volumes
/00
-
/50
200
centimeters
and
body
height.
Downloaded From: http://journal.publications.chestnet.org/pdfaccess.ashx?url=/data/journals/chest/21337/ on 06/18/2017
Comparison
of
mean
1,
Vol.
XXXVII
LUNG
VOLUME
IN
HEALTHY
MEN
317
measurements
on boys
by Helliesen’s
group.25
The
latter
data
also are
plotted
with
the results
of this study
in figure
1 It is evident
that
lung
volume
is not a linear
function
of height.
Figure
2 shows
the same
data
on a double
logarithmic
scale.
The
straight
lines
represent
the mean
values
calculated
by Bateman
for men
of heights
ranging
from
164 to
186 cm.
The
same
relationship
evidently
applies
almost
equally
well
from
about
110 to 205 cm. of height.
Data
on male
subjects
reported
previously
by others
are summarizc.J
in figure
3. We have
calculated
the
average
volumes
for each
range
of height
of 5 cm.;
all were
corrected
to BTPS
and
for the effect
of the recumbent
position
when
necessary.
Since
the study
of Aslett’s
group’5
included
men
up to 63 years
of age,
their
data
on vital
capacity
were
omitted
and only
data
for total
lung
volume
were
used.
.
It is evident
that
our data
for men
of average
height
coincide
with
those
of previous
studies
and
that
the cube
of height
also
applies
to
lung volumes
of men taller
than
6 feet (183 cm.).
We have
calculated
the variation
of our measurements
and
those
of
Helliesen
and
co-workers
from
values
estimated
from
Bateman’s
prediction
formula
(see table).
The mean
values
differ
by only
a few per
cent,
and
the coefficients
of variation
of 10 to 13 per cent
are similar
to Bateman’s
values.
Figure
plotted
values
mulas
When
subjects,
linear
above
4 presents
our average
values
for each 5-cm.
segment
of height,
on an arithmetic
scale.
This
permits
a comparison
with
the
predicted
by several
of the
more
widely
used
and
recent
forthat
predict
vital
capacity
as a linear
function
of height.’5’30’
age was also
a variable
in the formula,
the average
age of our
namely
31 years,
was used.
It is apparent
that
even
the best
formula
predicts
values
that
are too small
as height
increases
the
average
and
too large
in the
shorter
height
range
of the
8
(I,,
>I-
c:34
C.,)
0
/20
/40
FIGURE
4:
Measured
/80
/60
HEIGHT
vital
capacities
-
200
centimeters
and
various
prediction
formulas.
Downloaded From: http://journal.publications.chestnet.org/pdfaccess.ashx?url=/data/journals/chest/21337/ on 06/18/2017
318
pediatric
for adults
HEPPER,
age. It should
and were
not
FOWLER,
be stated
considered
AND
that
as
HELMHOLZ
all these
necessarily
March,
formulas
applying
were
to
1960
designed
children.
Comment
Of
the various
measurements
of body
build,
height
generally
has been
found
to be
the
single
measurement
with
which
lung
volumes
can
be correlated
best.
Previous
studies
describing
lung
volumes
as a linear
function
of height
dealt
for the most
part
with
persons
of a limited
height
range
; over such
limited
ranges,
the correlation
may
be satisfactory.
However,
the
correlation
is not satisfactory
when
the height
range
is extended.
It appears
reasonable
that
a better
correlation
should
exist
between
lung
volumes
and
the third
power
of height
than
with
the first
power
of height,
since
the body
is
three-dimensional.
This
has been
pointed
out several
times
in the literature,
but its
use has not been
widely
adopted.
Although
the relationship
between
lung
volumes
and
the cube
of height
is similar
for a range
between
120 and 206 cm., there
are data
to
indicate
that
equations
having
the
same
coefficients
or exponent
or both
may
not
apply
to newborns
and
infants.
Anthropometric
studies
show
that
the ratio
of actual
body
volume
to the
cube
of body
height
in infants
is almost
twice
that
in adults,22
which
is a reflection
of the
relatively
large
trunk
and
head
of the newborn.
Other
anatomic
studies
show
that
the ventilatory
portions
of the lung
lag behind
in development,
and
the
adult
ratio
of ventilatory
to nonventilatory
tissue
is established
at
about
3 years.33’34
The
functional
residual
capacity
of newborns
has been
determined
by Berglund
and Karlberg;33
on the basis
of the relationship
to metabolic
rate,
it was
considerably
smaller
than
in adults.
If the
functional
residual
capacity
I liters)
equalled
0.5 times
the cube
of the height
(meters)
, it
would
be 62.5 ml. in an infant
50 cm. in length.
This
is less than
the value
of about
95 ml. that
was observed
for a
3.5-kg.
infant.
The
older
literature
stated
that
athletes
and people
indulging
in strenuous
physical
labor
tend
to have
larger
vital
capacities2.
However,
other
studies36’37
do not support
this
concept,
while
one study3’
indicated
that
the vital
capacity
increases
after
much
skin
diving.
For
the
10 tall
(193 to 206 cm.)
professional
athletes
in our study,
the
mean
ratio
of measured
to predicted
vital
capacity
was 0.94, using
the same
formula
as for nonathletes
(see
table)
.
One
well-proportioned,
28-year-old
athlete,
200 cm.
tall and
weighing
105 kg., had
a vital
capacity
of 8.76 liters,
which
to our knowledge
is the largest
recorded
value
in the literature.
SUMMARY
Measurements
of vital
capacity
and
total
lung
men
of heights
up to 206 cm.
(81 inches)
, extending
and
men
of average
height.
In the
range
between
volumes
are
closely
related
to the
third
power
of
prediction
formula
of Bateman,
relating volume
to
over greater ranges of height than
are other
linear
for estimating
the normal
lung volumes
from
height.
ACKNOWLEDGMENT:
Schmelzer,
Henrietta
The
Cranston,
authors
Darlene
gratefully
Timmerman,
capacity
were
made
on healthy
previous
measurements
on boys
120 and
206 cm. of height,
lung
height,
as shown
by others.
The
the cube of height, is applicable
equations
in current
clinical
use
acknowledge
Darlene
the
Smith
assistance
and Jean
of Rita
Frank.
RESUMEN
Se llevaron a cabo las medidas
de la capacidad
vital y de la capacidad
pulmonar
total de hombres
de estatura hast de 206 cms. (81 pulgdas)
adem#{225}s
de las medidas
de
jOvenes y hombres
adultos de estatura
media.
Entre
las estaturas de 120 a 206 cms.,
los volUmenes
est#{225}n
en relaciOn estrecha
con la tercera potencia
de la altura como
otros
lo han mostrado.
La fOrmula
para
la predicciOn
de Bateman
relacionado
el volumen
al cabo
de la
altura
es aplicable
a las estaturs myores
m#{225}s
que otrs ecuaciones
lineales en el uso
clinico corriente para valuar los vol#{252}meuesnormales
del pulmOn
de acuerdo
con la
estatura.
RESUME
Des m#{233}sures de la capacit#{233} vitale
et de la capacit#{233} respiratoire
totale
furent
faites
sur des individus
sains
dont
la taille allait jusqu’#{224}
2 m.06.
Ii s’agit
donc
d’une
extension
des mesures
ant#{233}rieures
qui portaient
sur des garcons
et des hommes
de taille
moyenne.
Dans
la
limite
comprise
entr
Im.20
t
2m.06,
les
volumes
respiratoires
sont
#{233}troitement
lies au tiers
de la taille,
comme
d’autres
l’ont
montr#{233}. La mormule
de
Bateman,
liant le volume
respiratoire au cube de la hauteur,
est applicable
sur de
plus grandes
#{233}chelles
de taille
que
ne le sont
les equations
lin#{233}aires dans
l’emploi
clinique courant
pour
#{233}valuer les
volumes
respiratoires
normaux
d’apr#{232}s la taille.
ZUSAMMENFASSUNG
Es wurden
genommen
Messungen
bei
gesunden
der Vitalkapazit#{228}t
M#{228}nnern mit
einer
und
des
gesamten
KOrpergrOsse
bis
zu
Downloaded From: http://journal.publications.chestnet.org/pdfaccess.ashx?url=/data/journals/chest/21337/ on 06/18/2017
Lungenvolumen
vor206 cm in Erweite-
Vol.
rung
LUNG
XXXVII
vorausgegangener
VOLUME
IN
Untersuchungen
HEALTHY
an
Knaben
MEN
und
319
M#{228}nnern
mit
durchschnitt-
licher
K#{246}rpergrOsse.
Bei Werten
zwischen
120 und
206 cm KOrpergrosse
liegen,
wie
auch
von andered
Seite
gezeigt
worden
ist, die Lungenvoluminas
dicht
bei der dritten
Potenz
der
KOrperbrOsse.
Die
Sollwertsbestimmungsformel
von
Batemann,
die das
Volumen
in Beziehung
setzen
zur Kubikzahl
der KOrperbrOsse,
lassen
sich
f#{252}r
einen
gr#{246}sseren Bereich
von KOrpergrOssen
verwenden
als andere
lineare
Gleichungen,
die
meist
bei
klinischem
Gebrauch
verwandt
werden
zur
Bestimmung
der
normalen
Lungenvolumina
aus der KOrpergrOsse.
REFERENCES
1 Hutchinson,
tions:
ease
John:
With
by the
“On
the
a View
of
Spirometer,”
Capacity
2 Peabody,
F. W., and Wentworth,
Vital
Capacity
of the
Lungs
443, 1917.
3 Lundsgaard,
Between
1918.
of
Establishing
Tr. Med.-Chir.
Christen,
Thorax
Size
and
and
Lungs
and
and
London
J. A. : “Clinical
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and
Van
Lung
the
a Precise
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6
7 Edwards,
the Vital
8 Rogers,
Med.,
W. L. : “The
31:342, 1923.
9 Hewlett,
Students,”
10 Stewart,
ease,”
A. W.,
Arch.
Am.
11 Christie,
Special
12 Bowen,
Med.,
13
and
Green,
Hyman:
22:202,
1921.
D. J., and Wilson,
Capacity
Measurements
and
mt.
and
of
Jackson,
N.
Med.,
29:515,
R. : “The
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15 Aslett,
visions
N. L.,
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E. A., Hart,
in Normal
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of
F.
Studies
1952.
W.
19
20
21
Ferris,
B.
G.,
Jr.;
Capacity
1952.
and
W.:
With
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E., King,
R. M.,
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Yamada,
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in
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mt.
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I. Relation
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27:65,
of
the
of
Med.,
Lungs
of
With
Stem
Height,”
Vital
Capacity
in
a Group
the
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of
of
Physical
Children
Various
25:306,
Children,”
to
Total
and
Vital
Vital
1922.
Pulmonary
and
Comroe,
50 Years
and
McDonald,
I.:
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J. L., and
Gallagher,
Male
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and
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mt.
and
and
1939.
“The
III.
4:113,
Its
Its
J.
Total
Subdi-
Total
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Correlation
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Standards
for
Capacity,”
“Maximum
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Lung
Tho-
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Maximum
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Jap.
J. Physiol.,
Arc/i.
Dis-
J. H. Jr.:
“Pulmonary
Older,”
J. Appl.
Phys-
“Normal
Breathing
J. R.:
Adolescents,”
and
of Age on the
37:662,
1938.
J.: “The
Lung
Volume
London,
s. B. 126:502,
S. S.,
Women
College
Capacity
J. A. H., and
Arnott,
W. M.:
Study
in Physiological
Norms.
Brit.
J. Prey.
& Social
Med.,
Latch,
and
mt.
Measurements,”
H. V.: “The
Effect
Am. Rev.
Tuberc.,
McMichael,
Roy.
Soc.,
of
Capacity,”
Radiological
in
Arch.
in Health
of Normal
Med.,
30:34,
Obesity
“Studies
“Vital
Healthy
Capacity
Capacity
and
Mary
C., and
Gas-Mixing,
Vital Capacity
VI.
Lungs,”
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