Measurement of single breath-hold carbon monoxide diffusing capacity in healthy infants and toddlers

The aim of this study was to determine reference equations for the combined measurement of diffusing capacity of the lung for carbon monoxide (CO) and nitric oxide (NO) (DLCONO). In addition, we wanted to appeal for consensus regarding methodology of the measurement including calculation of diffusing capacity of the alveolo-capillary membrane (Dm) and pulmonary capillary volume (Vc).DLCONO was measured in 282 healthy individuals aged 18–97 years using the single-breath technique and a breath-hold time of 5 s (true apnoea period). The following values were used: 1) specific conductance of nitric oxide (θNO)=4.5 mLNO·mLblood−1·min−1·mmHg−1; 2) ratio of diffusing capacity of the membrane for NO and CO (DmNO/DmCO)=1.97; and 3) 1/red cell CO conductance (1/θCO)=(1.30+0.0041·mean capillary oxygen pressure)·(14.6/Hb concentration in g·dL−1).Reference equations were established for the outcomes of DLCONO, including DLCO and DLNO and the calculated values Dm and Vc. Independent variables were age, sex, height and age squared.By providing new reference equations and by appealing for consensus regarding the methodology, we hope to provide a basis for future studies and clinical use of this novel and interesting method.

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Implementing the Three-Equation Method of Measuring Single Breath Carbon Monoxide Diffusing Capacity

Canadian Respiratory Journal ◽

10.1155/1996/567450 ◽

1996 ◽

Vol 3 (4) ◽

pp. 247-257 ◽

Cited By ~ 11

Author(s):

Brian L Graham ◽

Joseph T Mink ◽

David J Cotton

Keyword(s):

Carbon Monoxide ◽

Lung Volume ◽

Equation Method ◽

Breath Holding ◽

Breath Hold ◽

Diffusing Capacity ◽

Flow Rates ◽

Single Breath ◽

Conventional Methods ◽

Made In

Conventional methods of measuring the single breath diffusing capacity of the lung for carbon monoxide (DLcoSB) are based on the Krogh equation, which is valid only during breath holding. Rigid standardization is used to approximate a pure breath hold manoeuvre, but variations in performing the manoeuvre cause errors in the measurement of DLcoSB. The authors previously described a method of measuring DLcoSBusing separate equations describing carbon monoxide uptake during each phase of the manoeuvre: inhalation, breath holding and exhalation. The method is manoeuvre-independent, uses all of the exhaled alveolar gas to improve estimates of mean DLcoSBand lung volume, and is more accurate and precise than conventional methods. A slow, submaximal, more physiological single breath manoeuvre can be used to measure DLcoSBin patients who cannot achieve the flow rates and breath hold times necessary for the standardized manoeuvre. The method was initially implemented using prototype equipment but commercial systems are now available that are capable of implementing this method. The authors describe how to implement the method and discuss considerations to be made in its use.

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Measurement of xenon diffusing capacity in the rat lung by hyperpolarized129Xe MRI and dynamic spectroscopy in a single breath-hold

Magnetic Resonance in Medicine ◽

10.1002/mrm.20943 ◽

2006 ◽

Vol 56 (2) ◽

pp. 255-264 ◽

Cited By ~ 45

Author(s):

Nishard Abdeen ◽

Albert Cross ◽

Gregory Cron ◽

Steven White ◽

Thomas Rand ◽

...

Keyword(s):

Breath Hold ◽

Diffusing Capacity ◽

Rat Lung ◽

Single Breath ◽

Single Breath Hold

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Liver fat quantitation at 3T using a single breath hold multi-echo sequence

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren ◽

10.1055/s-0029-1246595 ◽

2010 ◽

Vol 182 (01) ◽

Author(s):

MK Ivancevic ◽

J Smink ◽

HK Hussain ◽

TL Chenevert

Keyword(s):

Liver Fat ◽

Breath Hold ◽

Single Breath ◽

Single Breath Hold

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Genauigkeit von Single-Breath-Hold vs. Non-Breath-Hold Compressed-Sensing Kardio-MRT Datensätzen für die LV-Volumetrie

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren ◽

10.1055/s-0035-1550809 ◽

2015 ◽

Vol 187 (S 01) ◽

Author(s):

S Sudarski ◽

H Haubenreisser ◽

C Dösch ◽

S Haneder ◽

T Henzler ◽

...

Keyword(s):

Compressed Sensing ◽

Breath Hold ◽

Single Breath ◽

Single Breath Hold

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The effect of conductive ventilation heterogeneity on diffusing capacity measurement

Journal of Applied Physiology ◽

10.1152/japplphysiol.00917.2007 ◽

2008 ◽

Vol 104 (4) ◽

pp. 1094-1100 ◽

Cited By ~ 9

Author(s):

Sylvia Verbanck ◽

Daniel Schuermans ◽

Sophie Van Malderen ◽

Walter Vincken ◽

Bruce Thompson

Keyword(s):

Carbon Monoxide ◽

Vital Capacity ◽

Experimental Situation ◽

Normal Subjects ◽

Diffusing Capacity ◽

Capacity Measurement ◽

Alveolar Volume ◽

Estimation Errors ◽

Single Breath ◽

Ventilation Heterogeneity

It has long been assumed that the ventilation heterogeneity associated with lung disease could, in itself, affect the measurement of carbon monoxide transfer factor. The aim of this study was to investigate the potential estimation errors of carbon monoxide diffusing capacity (DlCO) measurement that are specifically due to conductive ventilation heterogeneity, i.e., due to a combination of ventilation heterogeneity and flow asynchrony between lung units larger than acini. We induced conductive airway ventilation heterogeneity in 35 never-smoker normal subjects by histamine provocation and related the resulting changes in conductive ventilation heterogeneity (derived from the multiple-breath washout test) to corresponding changes in diffusing capacity, alveolar volume, and inspired vital capacity (derived from the single-breath DlCO method). Average conductive ventilation heterogeneity doubled ( P < 0.001), whereas DlCO decreased by 6% ( P < 0.001), with no correlation between individual data ( P > 0.1). Average inspired vital capacity and alveolar volume both decreased significantly by, respectively, 6 and 3%, and the individual changes in alveolar volume and in conductive ventilation heterogeneity were correlated ( r = −0.46; P = 0.006). These findings can be brought in agreement with recent modeling work, where specific ventilation heterogeneity resulting from different distributions of either inspired volume or end-expiratory lung volume have been shown to affect DlCO estimation errors in opposite ways. Even in the presence of flow asynchrony, these errors appear to largely cancel out in our experimental situation of histamine-induced conductive ventilation heterogeneity. Finally, we also predicted which alternative combination of specific ventilation heterogeneity and flow asynchrony could affect DlCO estimate in a more substantial fashion in diseased lungs, irrespective of any diffusion-dependent effects.

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