Effect of altering breathing frequency on maximum voluntary ventilation in healthy adults

Eric V. Neufeld, Brett A. Dolezal, William Speier, Christopher B. Cooper

Compared to other pulmonary function tests, there is a lack of standardization regarding how a maximum voluntary ventilation (MVV) maneuver is performed. Specifically, little is known about the variation in breathing frequency (fR) and its potential impact on the accuracy of test results. This study examines the effect of several preselected values for fR and one self-selected fR (fRself) on MVV. Ten participants performed MVV maneuvers at various fR values, ranging from 50 to 130 breaths·min- 1 in 10 breaths·min- 1 intervals and at one fRself. Three identical trials with 2-min rest periods were conducted at each fR, and the sequence in which fR was tested was randomized. Ventilation and related parameters were measured directly by gas exchange analysis via a metabolic measurement system. A third-order polynomial regression analysis showed that MVV = - 0.0001(fR)3 + 0.0258(fR)2-1.38(fR) + 96.9 at preselected fR and increased up to approximately 100 breaths·min- 1 (r2 = 0.982, P < 0.001). Paired t-tests indicated that average MVV values obtained at all preselected fR values, but not fRself, were significantly lower than the average maximum value across all participants. A linear regression analysis revealed that tidal volume (VT) = - 2.63(MVV) + 300.4 at preselected fR (r2 = 0.846, P < 0.001); however, this inverse relationship between VT and MVV did not remain true for the self-selected fR. The VT obtained at this fR (90.9 ± 19.1% of maximum) was significantly greater than the VT associated with the most similar MVV value (at a preselected fR of 100 breaths·min- 1, 62.0 ± 10.4% of maximum; 95% confidence interval of difference: (17.5, 40.4%), P < 0.001). This study demonstrates the shortcomings of the current lack of standardization in MVV testing and establishes data-driven recommendations for optimal fR. The true MVV was obtained with a self-selected fR (mean ± SD: 69.9 ± 22.3 breaths·min- 1) or within a preselected fR range of 110-120 breaths·min- 1. Until a comprehensive reference equation is established, it is advised that MVV be measured directly using these guidelines. If an individual is unable to perform or performs the maneuver poorly at a self-selected fR, ventilating within a mandated fR range of 110-120 breaths·min- 1 may also be acceptable.