Helium Dilution Method
The helium dilution method is a common pulmonary function test used to measure Functional
Residual Capacity (FRC), which is the volume of air remaining in the lungs at the end of a normal
exhalation. This method is based on the principle of gas dilution and is performed in a closed-
circuit system.
1. Introduction
• Purpose: To measure Functional Residual Capacity (FRC) and determine lung volumes that
cannot be directly measured through spirometry (like residual volume).
• Principle: The patient breathes in a known concentration of helium in a closed system, and the
dilution of helium allows calculation of the lung volumes. Helium is used because it is an inert
gas, meaning it doesn’t get absorbed by the body and remains in the lungs.
2. Equipment
• Closed-circuit spirometer: A spirometer that allows the patient to breathe in a closed loop.
• Helium analyzer: A device that measures the concentration of helium in the system.
• Rebreathing system: The system where the patient rebreathes air mixed with helium.
• Oxygen supply: To prevent hypoxia during the test, oxygen is provided throughout.
3. INDICATIONS
DIAGNOSTIC PURPOSE
1. To diagnose restrictive disease patterns
2. To differentiate between obstructive and restrictive disease patterns, particularly in the
presence of a reduced VC
3. To diagnose hyperinflation and gas trapping
4. To diagnose, evaluate and monitor diseases which involve the lung parenchyma
5. To aid in the interpretation of other lung function tests (eg, RV/TLC)
MONITORING/ASSESSMENT
1. To make preoperative assessments in patients with compromised lung function (known or
suspected) when the surgical procedure is known to affect lung function
2. To assess response to therapeutic interventions (eg, drugs, transplantation, radiation,
chemotherapy, lobectomy, lung-volume-reduction surgery)
4. CONTRAINDICATIONS
• No apparent absolute contraindications exist
• Unstable cardiovascular status, unstable angina, recent myocardial infarction (within one
month), or pulmonary embolism
• Haemoptysis of unknown origin / recent pneumothorax
• Thoracic, abdominal, or cerebral aneurysms
• Recent thoracic, abdominal or eye surgery
• Severe respiratory distress
• Physical limitations, cognitive impairment.
5. Procedure
1. Initial Setup:
• The spirometer is filled with a known volume of air mixed with a small concentration of helium
(usually around 10%).
• The patient is connected to the spirometer through a mouthpiece or mask.
2. Start of the Test:
• The patient is instructed to breathe normally (tidal breathing).
• At the end of a normal exhalation (at FRC), the system is closed, and the patient starts breathing
the helium-containing air mixture from the closed circuit.
3. Equilibration Phase:
• The patient continues to breathe normally for several minutes, allowing the helium to mix evenly
with the gas in the lungs.
• Since helium does not cross the alveolar-capillary membrane, its concentration will decrease as
it dilutes into the lung volumes. This process is called helium dilution.
4. End of the Test:
• Once the helium concentration in the circuit stabilizes (i.e., stops decreasing), the test is
considered complete. This usually takes 3–5 minutes.
• The final concentration of helium is measured.
4. Calculations
The FRC is calculated using the following formula based on the conservation of mass for helium:
The fundamental equation used in this technique is: C1V1=C2V2
Where:
◦ C1= initial concentration of helium in the spirometer
◦ V1 = volume of helium in the spirometer
◦ C2 = final concentration of helium after equilibration
◦ V2 = total gas volume (which includes both the lung volume and the spirometer volume)
5. Interpretation
The total gas volume V2 can be expressed as:
V2=FRC+V1
◦ Substituting for V2
Substituting this expression for V2 back into the initial equation gives:
◦ C1V1=C2(FRC+V1)
◦ This equation allows us to calculate FRC based on known values of helium concentration and
volume.
Example Calculation
Given:
◦ Initial helium concentration (C1) = 10% (0.10)
◦ Volume of gas in spirometer (V1) = 2 liters
◦ Final helium concentration (C2) = 5% (0.05)
◦ Thus, in this example, the functional residual capacity of the lungs is 2 liters.
• Normal values: FRC varies based on age, gender, and body size. For adults, normal FRC is
approximately 2.5–3.5 liters.
• Decreased FRC: Found in restrictive lung diseases (e.g., pulmonary fibrosis, obesity).
• Increased FRC: Found in obstructive lung diseases (e.g., emphysema, asthma) where air trapping
occurs.
6. Limitations and Considerations
• Inability to measure non-ventilated areas of the lung: The helium dilution method only measures
the volume of air that communicates with the airways. It cannot measure gas trapped in areas
where airflow is obstructed.
• Patient cooperation: The test requires the patient to breathe normally for several minutes, so it
may not be suitable for very young children or patients with severe respiratory distress.
• Not suitable for patients with obstructive lung disease: Because air trapping may lead to
inaccurate measurements of lung volumes.
7. Advantages and Disadvantages
Advantages:
• Non-invasive and relatively simple.
• Provides accurate measurement of FRC in healthy individuals or those with mild lung disease.
Disadvantages:
• Less accurate in patients with severe obstructive lung disease due to air trapping.
• Requires specialized equipment and patient cooperation.
