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Functional residual capacity (FRC) is the
volume Volume is a measure of occupied three-dimensional space. It is often quantified numerically using SI derived units (such as the cubic metre and litre) or by various imperial or US customary units (such as the gallon, quart, cubic inch). The def ...
of air present in the
lungs The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of th ...
at the end of passive
expiration Expiration or expiration date may refer to: Expiration Expiration may refer to: *Death *Exhalation of breath, breathing out *Expiration (options), the legal termination of an option to take an action *Shelf life, or the time after which a product ...
. At FRC, the opposing elastic recoil forces of the lungs and
chest wall The thoracic wall or chest wall is the boundary of the thoracic cavity. Structure The bony skeletal part of the thoracic wall is the rib cage, and the rest is made up of muscle, skin, and fasciae. The chest wall has 10 layers, namely (from sup ...
are in equilibrium and there is no exertion by the diaphragm or other respiratory muscles. FRC is the sum of
expiratory reserve volume Lung volumes and lung capacities refer to the volume of air in the lungs at different phases of the respiratory cycle. The average total lung capacity of an adult human male is about 6 litres of air. Tidal breathing is normal, resting breath ...
(ERV) and residual volume (RV) and measures approximately 2500 mL in a 70 kg, average-sized male (or approximately 30ml/kg). It cannot be estimated through
spirometry Spirometry (meaning ''the measuring of breath'') is the most common of the pulmonary function tests (PFTs). It measures lung function, specifically the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled. Spirometry is he ...
, since it includes the residual volume. In order to measure RV precisely, one would need to perform a test such as
nitrogen washout Nitrogen washout (or Fowler's method) is a test for measuring anatomic dead space in the lung during a respiratory cycle, as well as some parameters related to the closure of airways. Procedure A nitrogen washout can be performed with a single ...
, helium dilution or
body plethysmography A plethysmograph is an instrument for measuring changes in volume within an organ or whole body (usually resulting from fluctuations in the amount of blood or air it contains). The word is derived from the Greek "plethysmos" (increasing, enla ...
. A lowered or elevated FRC is often an indication of some form of
respiratory disease Respiratory diseases, or lung diseases, are pathological conditions affecting the organs and tissues that make gas exchange difficult in air-breathing animals. They include conditions of the respiratory tract including the trachea, bronchi, bron ...
. For instance, in
emphysema Emphysema, or pulmonary emphysema, is a lower respiratory tract disease, characterised by air-filled spaces ( pneumatoses) in the lungs, that can vary in size and may be very large. The spaces are caused by the breakdown of the walls of the alv ...
, FRC is increased, because the lungs are more compliant and the equilibrium between the inward recoil of the lungs and outward recoil of the chest wall is disturbed. As such, patients with emphysema often have noticeably broader chests due to the relatively unopposed outward recoil of the chest wall.
Total lung capacity Lung volumes and lung capacities refer to the volume of air in the lungs at different phases of the respiratory cycle. The average total lung capacity of an adult human male is about 6 litres of air. Tidal breathing is normal, resting breathin ...
also increases, largely as a result of increased functional residual capacity. In healthy humans, FRC changes with body posture. Obese patients will have a lower FRC in the supine position due to the added tissue weight opposing the outward recoil of the chest wall. Positioning plays a significant role in altering FRC. It is highest when in an upright position and decreases as one moves from upright to supine/prone or Trendelenburg position. The greatest decrease in FRC occurs when going from 60° to totally supine at 0°. There is no significant change in FRC as position changes from 0° to Trendelenburg of up to −30°. However, beyond −30°, the drop in FRC is considerable. The
helium dilution technique The helium dilution technique is the way of measuring the functional residual capacity of the lungs (the volume left in the lungs after normal expiration). This technique is a closed-circuit system where a spirometer is filled with a mixture of ...
and pulmonary plethysmograph are two common ways of measuring the functional residual capacity of the lungs. The predicted value of FRC was measured for large populations and published in several references. FRC was found to vary by a patient's age, height, and sex. Functional residual capacity is directly proportional to height and indirectly proportional with obesity. It is reduced in the setting of obesity primarily due to a reduction in chest wall compliance. The
LOINC Logical Observation Identifiers Names and Codes (LOINC) is a database and universal standard for identifying medical laboratory observations. First developed in 1994, it was created and is maintained by the Regenstrief Institute, a US nonprofit m ...
code is 19843-2 and the
SNOMED CT SNOMED CT or SNOMED Clinical Terms is a systematically organized computer-processable collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting. SNOMED CT is considered to be the m ...
concept is 65825000.


References

{{Respiratory physiology Respiratory physiology Pulmonary function testing Pulmonology