Contribution of multiple inert gas elimination technique to pulmonary medicine. 1. Principles and information content of the multiple inert gas elimination technique.

This introductory review summarises four different aspects of the multiple inert gas elimination technique (MIGET). Firstly, the historical background that facilitated, in the mid 1970s, the development of the MIGET as a tool to obtain more information about the entire spectrum of VA/Q distribution in the lung by measuring the exchange of six gases of different solubility in trace concentrations. Its principle is based on the observation that the retention (or excretion) of any gas is dependent on the solubility (lambda) of that gas and the VA/Q distribution. A second major aspect is the analysis of the information content and limitations of the technique. During the last 15 years a substantial amount of clinical research using the MIGET has been generated by several groups around the world. The technique has been shown to be adequate in understanding the mechanisms of hypoxaemia in different forms of pulmonary disease and the effects of therapeutic interventions, but also in separately determining the quantitative role of each extrapulmonary factor on systemic arterial PO2 when they change between two conditions of MIGET measurement. This information will be extensively reviewed in the forthcoming articles of this series. Next, the different modalities of the MIGET, practical considerations involved in the measurements and the guidelines for quality control have been indicated. Finally, a section has been devoted to the analysis of available data in healthy subjects under different conditions. The lack of systematic information on the VA/Q distributions of older healthy subjects is emphasised, since it will be required to fully understand the changes brought about by diseases that affect the older population.