Effect of Blood Transfusion on the Carbon Monoxide Transfer Factor of the Lung in Man

1978 ◽  
Vol 54 (6) ◽  
pp. 627-631 ◽  
Author(s):  
Elizabeth H. Clark ◽  
R. L. Woods ◽  
J. M. B. Hughes
Keyword(s):  
Carbon Monoxide ◽  
Transfer Factor ◽  
Haemoglobin Concentration ◽  
Blood Transfusions ◽  
Alveolar Volume ◽  
Single Breath ◽  
The Mean ◽  
Haematological Disorders ◽  
Predicted Values ◽  
Normal Lungs

1. Ten studies were performed on nine patients with haematological disorders but with normal lungs, who required intermittent blood transfusions. The transfer factor for carbon monoxide and uptake of carbon monoxide per unit lung volume (KCO) were measured with the single breath technique before and at various intervals after transfusion. 2. The mean haemoglobin concentration increased from 7·7 to 11·1 g/dl. 3. The TLCO increased according to a formula based on the Roughton & Forster (1957) diffusion equations, TLCO (standardized) = TLCO (observed). (10·2 + Hb)/1·7 Hb, where haemoglobin (Hb) is expressed as g/dl. 4. The correlation between measured and predicted values was slightly better if changes in alveolar volume were taken into account, by using the KCO value.

The Effect of Human Pregnancy on the Pulmonary Transfer Factor for Carbon Monoxide as Measured by the Single-Breath Method

1977 ◽  
Vol 53 (3) ◽  
pp. 271-276 ◽  
Author(s):  
J. A. Milne ◽  
R. J. Mills ◽  
J. R. T. Coutts ◽  
M. C. Macnaughton ◽  
F. Moran ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Transfer Factor ◽  
Post Partum ◽  
Previous History ◽  
Haemoglobin Concentration ◽  
First Trimester ◽  
Alveolar Volume ◽  
Single Breath ◽  
Pregnant State ◽  
Single Breath Method

1. The pulmonary transfer factor for carbon monoxide was measured by the single-breath method in 21 pregnant women with no previous history of cardiac or respiratory disease. Measurements were made at monthly intervals throughout pregnancy and once post partum. 2. The transfer factor was higher in the first trimester of pregnancy than in the non-pregnant state. There was a fall in the transfer factor during pregnancy until 26 weeks gestation, after which no further decrease was observed. 3. The changes in transfer factor were not explained by alterations in haemoglobin concentration or alveolar volume. 4. Simultaneous serial estimations of plasma 17β-oestradiol were performed in all the subjects. There was no obvious direct relation between changes in the concentration of this hormone and transfer factor measurements.

Serial Estimations of Carbon Monoxide Diffusing Capacity in Intrapulmonary Haemorrhage

1981 ◽  
Vol 60 (5) ◽  
pp. 507-512 ◽  
Author(s):  
A. P. Greening ◽  
J. M. B. Hughes
Keyword(s):  
Carbon Monoxide ◽  
Haemoglobin Concentration ◽  
Diffusing Capacity ◽  
Clinical Context ◽  
Alveolar Volume ◽  
X Ray ◽  
Single Breath ◽  
Patients At Risk ◽  
Chest X Ray ◽  
Baseline Values

1. Serial estimations of the diffusing capacity for carbon monoxide, with a standard single-breath technique, were used to assist the monitoring of disease activity in patients at risk from intrapulmonary haemorrhage. 2. A reversible rise in diffusing capacity for carbon monoxide per unit alveolar volume (DLco/VA) of 50% or more above baseline values was detected on 61 occasions and in the diffusing capacity for carbon monoxide (DLco) alone on 45 occasions in 39 patients. 3. Concurrent with these rises in DLco/VA or DLco, two or more traditional indicators of intrapulmonary haemorrhage (haemoptysis, abrupt fall in haemoglobin concentration, chest X-ray opacities) were found on 47 occasions. 4. In the appropriate clinical context, acute reversible rises in DLco/VA or DLco reflect active intrapulmonary haemorrhage.

The effect of conductive ventilation heterogeneity on diffusing capacity measurement

2008 ◽  
Vol 104 (4) ◽  
pp. 1094-1100 ◽  
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.

Single Breath Carbon Monoxide Diffusing Capacity (Transfer Factor): Reply

1988 ◽  
Vol 138 (4) ◽  
pp. 1084-1085 ◽  
Author(s):  
Robert O. Crapo ◽  
Reed M. Gardner ◽  
Steven L. Berlin
Keyword(s):  
Carbon Monoxide ◽  
Transfer Factor ◽  
Diffusing Capacity ◽  
Single Breath
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