Effect of alveolar volume and sequential filling on the diffusing capacity of the lungs: II. Experiment

2000 ◽  
Vol 120 (3) ◽  
pp. 251-271 ◽  
Author(s):  
Nikolaos M. Tsoukias ◽  
Donald Dabdub ◽  
Archie F. Wilson ◽  
Steven C. George
Respiration ◽  
2021 ◽  
pp. 1-7
Author(s):  
Roberta Pisi ◽  
Marina Aiello ◽  
Luigino Calzetta ◽  
Annalisa Frizzelli ◽  
Veronica Alfieri ◽  
...  

<b><i>Background:</i></b> The ventilation heterogeneity (VH) is reliably assessed by the multiple-breath nitrogen washout (MBNW), which provides indices of conductive (<i>S</i><sub>cond</sub>) and acinar (<i>S</i><sub>acin</sub>) VH as well as the lung clearance index (LCI), an index of global VH. VH can be alternatively measured by the poorly communicating fraction (PCF), that is, the ratio of total lung capacity by body plethysmography to alveolar volume from the single-breath lung diffusing capacity measurement. <b><i>Objectives:</i></b> Our objective was to assess VH by PCF and MBNW in patients with asthma and with COPD and to compare PCF and MBNW parameters in both patient groups. <b><i>Method:</i></b> We studied 35 asthmatic patients and 45 patients with COPD. Each patient performed spirometry, body plethysmography, diffusing capacity, and MBNW test. <b><i>Results:</i></b> Compared to COPD patients, asthmatics showed a significantly lesser degree of airflow obstruction and lung hyperinflation. In asthmatic patients, both PCF and LCI and <i>S</i><sub>acin</sub> values were significantly lower than the corresponding ones of COPD patients. In addition, in both patient groups, PCF showed a positive correlation with LCI (<i>p</i> &#x3c; 0.05) and <i>S</i><sub>acin</sub> (<i>p</i> &#x3c; 0.05), but not with <i>S</i><sub>cond</sub>. Lastly, COPD patients with PCF &#x3e;30% were highly likely to have a value ≥2 of the mMRC dyspnea scale. <b><i>Conclusions:</i></b> These results showed that PCF, a readily measure derived from routine pulmonary function testing, can provide a comprehensive measure of both global and acinar VH in asthma and in COPD patients and can be considered as a comparable tool to the well-established MBNW technique.


2008 ◽  
Vol 104 (4) ◽  
pp. 1094-1100 ◽  
Author(s):  
Sylvia Verbanck ◽  
Daniel Schuermans ◽  
Sophie Van Malderen ◽  
Walter Vincken ◽  
Bruce Thompson

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.


1994 ◽  
Vol 76 (6) ◽  
pp. 2356-2363 ◽  
Author(s):  
H. Stam ◽  
V. Hrachovina ◽  
T. Stijnen ◽  
A. Versprille

In this study we determined reference values of total diffusing capacity of carbon monoxide (DLCO) and DLCO per liter alveolar volume (DLCO/VA) at total lung capacity (TLC) and at lung volumes below TLC in sitting position. In 55 healthy nonsmoking volunteers (20–85 yr old), we determined reference values at TLC level in which age was the only parameter. In a subgroup (n = 16) these references did not change by correction for normal variability in hemoglobin concentration. In all volunteers DLCO decreased and DLCO/VA increased with decreasing VA. The increase in DLCO/VA was linear and less in older subjects. We derived equations to calculate reference values of DLCO/VA for lung volumes at and below TLC with two methods: 1) “random coefficients linear” model, which calculates the reference values directly, and 2) a conversion method, which calculates DLCO/VA for lower VA levels from reference values at TLC. An advantage of the conversion method is the suitability of DLCO/VA reference values at TLC of other populations. A disadvantage is the greater standard deviation of these reference values compared with those obtained by the random coefficients linear method. DLCO can be found by multiplying DLCO/VA with VA.


2018 ◽  
Author(s):  
Natalie Terzikhan ◽  
Fangui Sun ◽  
Fien M. Verhamme ◽  
Hieab H.H. Adams ◽  
Daan Loth ◽  
...  

AbstractBackgroundAlthough several genome wide association studies (GWAS) have investigated the genetics of pulmonary ventilatory function, little is known about the genetic factors that influence gas exchange.AimTo investigate the heritability of, and genetic variants associated with the diffusing capacity of the lung.MethodsGWAS was performed on diffusing capacity, measured by carbon monoxide uptake (DLCO) and per alveolar volume (DLCO/VA) using the single-breath technique, in 8,372 individuals from two population-based cohort studies, the Rotterdam Study and the Framingham Heart Study. Heritability was estimated in related (n=6,246) and unrelated (n=3,286) individuals.ResultsHeritability of DLCO and DLCO/VA ranged between 23% and 28% in unrelated individuals and between 45% and 49% in related individuals. Meta-analysis identified a genetic variant in GPR126 that is significantly associated with DLCO/VA. Gene expression analysis of GPR126 in human lung tissue revealed a decreased expression in patients with COPD and subjects with decreased DLCO/VA.ConclusionDLCO and DLCO/VA are heritable traits, with a considerable proportion of variance explained by genetics. A functional variant in GPR126 gene region was significantly associated with DLCO/VA. Pulmonary GPR126 expression was decreased in patients with COPD.


2018 ◽  
Vol 52 (3) ◽  
pp. 1800647 ◽  
Author(s):  
Natalie Terzikhan ◽  
Fangui Sun ◽  
Fien M. Verhamme ◽  
Hieab H.H. Adams ◽  
Daan Loth ◽  
...  

Although several genome-wide association studies (GWAS) have investigated the genetics of pulmonary ventilatory function, little is known about the genetic factors that influence gas exchange. The aim of the study was to investigate the heritability of, and genetic variants associated with the diffusing capacity of the lung.GWAS was performed on diffusing capacity of the lung measured by carbon monoxide uptake (DLCO) and per alveolar volume (VA) using the single-breath technique, in 8372 individuals from two population-based cohort studies, the Rotterdam Study and the Framingham Heart Study. Heritability was estimated in related (n=6246) and unrelated (n=3286) individuals.Heritability of DLCO and DLCO/VA ranged between 23% and 28% in unrelated individuals and between 45% and 49% in related individuals. Meta-analysis identified a genetic variant in ADGRG6 that is significantly associated with DLCO/VA. Gene expression analysis of ADGRG6 in human lung tissue revealed a decreased expression in patients with chronic obstructive pulmonary disease (COPD) and subjects with decreased DLCO/VA.DLCO and DLCO/VA are heritable traits, with a considerable proportion of variance explained by genetics. A functional variant in ADGRG6 gene region was significantly associated with DLCO/VA. Pulmonary ADGRG6 expression was decreased in patients with COPD.


Respiration ◽  
1987 ◽  
Vol 52 (3) ◽  
pp. 163-170 ◽  
Author(s):  
Nicolás González Mangado ◽  
Maria J. Avilés Inglés ◽  
Germán Peces-Barba ◽  
Mariano Arévalo González ◽  
Fernando Lahoz Navarro

1963 ◽  
Vol 41 (1) ◽  
pp. 1283-1292
Author(s):  
Edith Rosenberg

The single breath diffusing capacity for CO, DL, and the permeability of the lungs, K, were measured in six male and two female medical students at various lung volumes. The subjects rested 15 minutes before each test and the expired alveolar volume as well as breath-holding time and inspired volume were recorded on a spirogram. The test gas used consisted of 0.3% CO, 0.3% SF6, 20% O2, and the balance N2. The sample of alveolar gas expired after breath-holding was analyzed for CO and SF6 on a vapor fractometer using a 2-meter molecular sieve column. DL varied with the surface area of the subjects as well as with the alveolar volume at which the test was performed. K, on the other hand, was independent of the size of the subjects and decreased towards a constant value as lung volume became large. K should, therefore, be more reproducible than DL. The average permeability of the eight subjects used in this study was 0.0715 ml CO per second per ml of alveolar volume. In every experiment, alveolar volumes were also calculated from the SF6 dilution. These values, VD, were compared to alveolar volumes calculated from the maximum lung volumes, VA. For the males there was no measurable difference between alveolar volumes calculated by these two methods when 2 liters or more of test gas were inspired. It is suggested that the replacement of the measurement of DL in pulmonary function laboratories by an evaluation of K and VD may transform the single breath diffusing capacity test into a useful diagnostic tool.


1962 ◽  
Vol 17 (2) ◽  
pp. 259-262 ◽  
Author(s):  
Joseph C. Ross ◽  
Glen D. Ley ◽  
Ronald F. Coburn ◽  
J. L. Eller ◽  
Robert E. Forster

Previous investigations of the effect of inflation of a pressure suit on pulmonary diffusing capacity (DL) have been reported from our two laboratories, one (Indianapolis) finding an increase and the other (Philadelphia) finding no change. The present investigation was carried out in Philadelphia, using some of the same subjects and pressure suits in order to reconcile the contradictory results. The earlier contradictory results were confirmed. The pressure suit used in the investigations at Philadelphia ( suit P)covered the entire body below the nipples, whereas the suit used in the investigations at Indianapolis( suit I) extended cephalad only as far as the costal margin. When suit P was inflated in the present study, DL again did not increase significantly in two subjects. However, when the upper part of the suit was folded down so that the thoracic cage was not covered, inflation of the suit did produce a significant increase in DL. Inflation of suit P when it covered the chest made it difficult for a subject not to perform a Valsalva maneuver during breath holding and caused more decrease in alveolar volume (Va) than when it was inflated in the folded-down position. In two subjects studied, we found no difference in air trapping with inflation of suit P in the two positions. The discrepancy between the results of the two earlier studies appears to have resulted from the different construction of the two pressure suits used. We conclude that pressure suit inflation in man will produce an increase in DL, presumably by means of pulmonary congestion. Submitted on September 22, 1961


1965 ◽  
Vol 20 (1) ◽  
pp. 113-116 ◽  
Author(s):  
Denise Jouasset-Strieder ◽  
John M. Cahill ◽  
John J. Byrne ◽  
Edward A. Gaensler

The CO diffusing capacity (Dl) was measured by the single-breath method in eight anesthetized dogs. Pulmonary capillary blood volume (Vc) and membrane diffusing capacity (Dm) were determined in six animals by the method of Roughton and Forster. The studies were repeated after anemia had been induced by replacing whole blood with plasma. Large dogs were selected with a mean body weight of 29 kg and a mean alveolar volume of 2,020 ml (STPD) during tests. The mean arterial blood Hb decreased from 14.3 to 6.6 g/100 ml, the mean Dl from 27 to 12 ml/min mm Hg, and the mean Dm from 100 to 47 ml/min mm Hg. Vc averaged 67 ml in the control state and was not significantly changed during anemia. Reductions in Dl and Dm during anemia were proportional to the fall in blood Hb. Both Dl and Dm in all dogs, normal and anemic, were proportional to the volume of red blood cells in the lung capillaries (Vrbc). These results suggest that Vrbc might be an estimate of the useful area of the alveolar-capillary membrane while Dm/Vrbc should vary with changes in its thickness. The latter was not altered by anemia. alveolar capillary membrane; pulmonary membrane; diffusing capacity; pulmonary capillary RBC volume; pulmonary diffusion pathway; carbon monoxide Submitted on March 2, 1964


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