Regional diffusing capacity in normal lungs during a slow exhalation

1982 ◽  
Vol 52 (6) ◽  
pp. 1487-1492 ◽  
Author(s):  
N. R. MacIntyre ◽  
J. A. Nadel
Keyword(s):  
Carbon Monoxide ◽  
Lung Volume ◽  
Vital Capacity ◽  
Normal Subjects ◽  
Lower Half ◽  
Diffusing Capacity ◽  
Lung Volumes ◽  
Lower Volume ◽  
Xenon 133 ◽  
Normal Lungs

From an analysis of carbon monoxide uptake and xenon-133 distribution after two bolus inhalations of these gases, we calculated regional diffusing capacity in the upper and lower volume halves of the lungs during the middle 60% of an exhaled vital capacity in five seated normal subjects. We found that the regional diffusing capacity of the upper half of the lungs was 11.6 +/- 4.2 (mean +/- SD) ml.min-1.Torr-1 and that the regional diffusing capacity of the lower half of the lungs was 24.4 +/- 2.4 ml.min-1.Torr-1 after 25% of the vital capacity had been exhaled. These values remained relatively constant as lung volume decreased from 25 to 75% of the exhaled vital capacity. Diffusing capacity in the upper half of the lungs ranged from 9.4 to 12.4 ml.min-1.Torr-1 during exhalation, and in the lower half of the lungs from 21.0 to 28.6 ml.min-1.Torr-1 during exhalation. These results suggest that total lung diffusing capacity remains relatively constant over this midrange of lung volumes and that this occurs because the regional diffusing capacities in both the upper and lower halves of the lungs remain relatively constant.

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.

Nonlinear increases in diffusing capacity during exercise by seated and supine subjects

1981 ◽  
Vol 51 (4) ◽  
pp. 858-863 ◽  
Author(s):  
D. L. Stokes ◽  
N. R. MacIntyre ◽  
J. A. Nadel
Keyword(s):  
Carbon Monoxide ◽  
Oxygen Consumption ◽  
Healthy Subjects ◽  
Vital Capacity ◽  
Maximal Exercise ◽  
Sitting Position ◽  
Diffusing Capacity ◽  
Heavy Exercise ◽  
Lung Volumes ◽  
Rate Of Increase

To study the effects of exercise on pulmonary diffusing capacity, we measured the lungs' diffusing capacity for carbon monoxide (DLCO) during exhalation from 30 to 45% exhaled vital capacity in eight healthy subjects at rest and during exercise while both sitting and supine. We found that DLCO at these lung volumes in resting subjects was 26.3 +/- 3.2% (mean +/- SE) higher in the supine than in the sitting position (P less than 0.001). We also found that, in both positions, DLCO at these lung volumes increased significantly (P less than 0.001) with increasing exercise and approached similar values at maximal exercise. The pattern of increase in DLCO with an increase in oxygen consumption in both positions was curvilinear in that the rate of increase in DLCO during mild exercise was greater than the rate of increase in DLCO during heavy exercise (P = 0.02). Furthermore, in the supine position during exercise, it appeared that DLCO reached a physiological maximum.

Measurement of lung diffusing capacity by means of C14O in a closed system

1964 ◽  
Vol 19 (1) ◽  
pp. 59-74 ◽  
Author(s):  
Paul S⊘lvsteen
Keyword(s):  
Carbon Monoxide ◽  
Uniform Distribution ◽  
Lung Volume ◽  
Closed System ◽  
Normal Subjects ◽  
Alveolar Ventilation ◽  
Diffusing Capacity ◽  
Mathematical Equations ◽  
Experimental Findings ◽  
Better Than

A method of measuring the lung diffusing capacity (Dl) with radioactive carbon monoxide (C14O) and nonuniformity of ventilation with nonabsorbable gas in a closed system is described. Treating ventilation as a continuous phenomenon and disregarding dead space, the mathematical equations for uniform and nonuniform ventilation (two lung regions ventilated in parallel) are derived. It is proved that sooner or later the curve for carbon monoxide, plotted on semilogarithmic paper, will be rectilinear. Experiments in six normal subjects and eight patients with chronic lung disease are described. Determinations of the distribution of the ventilation and the Dl are made in separate experiments. Since the method is unreliable at high Dl values, many of the Dl estimations are performed at high oxygen tension, which reduces the apparent Dl. It is shown that the assumption of a uniform distribution of Dl to lung volume explains the experimental findings better than the assumption of a uniform distribution of Dl to alveolar ventilation. Dl was decreased in four of the eight patients. mathematics of uniform and nonuniform ventilation; distribution of lung diffusing capacity in relation to lung volume and alveolar ventilation; N2 curve for use in calculating alveolar ventilation and regional lung volumes; CO curve for use in calculating lung diffusing capacity; diffusing capacity of lung determined with a closed system Submitted on October 15, 1962

Effect of ventilation and diffusion nonuniformity on DLCO (exhaled) in a lung model

1980 ◽  
Vol 48 (4) ◽  
pp. 648-656 ◽  
Author(s):  
D. J. Cotton ◽  
B. L. Graham
Keyword(s):  
Carbon Monoxide ◽  
Lung Volume ◽  
Theoretical Basis ◽  
Normal Subjects ◽  
Lung Model ◽  
Breath Holding ◽  
Lung Region ◽  
Lung Volumes ◽  
Simultaneous Decay ◽  
And Diffusion

Recent studies have shown that diffusing capacities measured at multiple intervals during a single exhalation [DLCO(exhaled)] remained constant with lung volume in normal subjects, but decreased with decreasing lung volume in patients who may have had diffusion nonuniformity. We have examined the theoretical basis of these results by determining what factors affected DLCO(exhaled) in a computerized lung model in which diffusion in each compartment remained constant with lung volume. DLCO(exhaled) decreased with decreasing lung volume when a small lung region lacked diffusion. However, the change in DLCO(exhaled) with lung volume was also affected by nonuniform ventilation and these effects could not be eliminated by correcting the carbon monoxide decay and the simultaneous decay of helium. DLCO(exhaled) values were also influenced by the exhaled flow rate in the presence of nonuniform ventilation and/or nonuniform diffusion. However, prolonging the period of breath holding prior to exhalation reduced DLCO(exhaled) values at all lung volumes when non-uniform diffusion was simulated, but did not affect DLCO(exhaled) when only nonuniform ventilation was simulated.

scholarly journals Combined Lung Transfer of NO and CO in Patients Receiving Methotrexate or Bleomycin Therapy Compared to Normal Subjects

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Chantal Viart-Ferber ◽  
Sébastien Couraud ◽  
Frédéric Gormand ◽  
Yves Pacheco
Keyword(s):  
Nitric Oxide ◽  
Carbon Monoxide ◽  
Lung Volume ◽  
Normal Subjects ◽  
Lung Toxicity ◽  
Diffusing Capacity

The first aim of the study is to determine whether combined lung diffusing capacities of nitric oxide (TLNO) and of carbon monoxide (TLCO) are accurate in the followup of patients receiving either methotrexate (MTX) or bleomycin (BLM). The second objective is to determine whether TLCO, TLNO, KCO, and TLCO/VI% (inspiratory volume expressed as percentage of predicted value) correlate better with the diffusing capacity of the membrane (Dm) and/or capillary lung volume (Vc). TLNO and TLCO were measured in three groups: 22 “normal” subjects (N group), 17 patients receiving MTX, and 12 patients treated with BLM. TLCO, TLNO, Dm, and Vc were much lower in the MTX and BLM groups compared to those of the N one. The ratio TLNO/TLCO was higher in the BLM group compared to that of the N group and compared to that of the MTX group. KCO correlated neither with Dc nor with Vc, whereas TLCO/VI% correlated significantly with both Dm and Vc. Combined measurement of TLCO and TLNO seems to be useful in the followup of patients receiving agents inducing lung toxicity and gives a good idea of the alveolar membrane and the capillary volume.

Hysteresis in the relation between diffusing capacity of the lung and lung volume

1980 ◽  
Vol 49 (4) ◽  
pp. 566-570 ◽  
Author(s):  
S. S. Cassidy ◽  
M. Ramanathan ◽  
G. L. Rose ◽  
R. L. Johnson
Keyword(s):  
Carbon Monoxide ◽  
Functional Residual Capacity ◽  
Lung Volume ◽  
Total Lung Capacity ◽  
Breath Holding ◽  
Residual Volume ◽  
Diffusing Capacity ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Residual Capacity

The diffusing capacity of the lung for carbon monoxide (DLCO) varies directly with lung volume (VA) when measured during a breath-holding interval. DLCO measured during a slow exhalation from total lung capacity (TLC) to functional residual capacity (FRC) does not vary as VA changes. Since VA is reached by inhaling during breath holding and by exhaling during the slow exhalation maneuver, we hypothesized that the variability in the relation between DLCO and VA was due to hysteresis. To test this hypothesis, breath-holding measurements of DLCO were made at three lung volumes, both when VA was reached by inhaling from residual volume (RV) and when Va was reached by exhaling from TLC. At 72% TLC, DLCO was 22% higher when VA was reached by exhalation compared to inhalation (P < 0.02). At 52% TLC, DLCO was 19% higher when VA was reached by exhalation compared to exhalation (P < 0.005). DCLO measured during a slow exhalation fell on the exhalation limb of the CLCO/VA curve. these data indicate that there is hysteresis in DLCO with respect to lung volume.

Lung volume and effectiveness of inspiratory muscles

1993 ◽  
Vol 74 (2) ◽  
pp. 688-694 ◽  
Author(s):  
A. Brancatisano ◽  
L. A. Engel ◽  
S. H. Loring
Keyword(s):  
Lung Volume ◽  
Muscle Activity ◽  
Vital Capacity ◽  
Total Lung Capacity ◽  
Normal Subjects ◽  
Lung Volumes ◽  
Mechanical Advantage ◽  
Lung Capacity ◽  
Inspiratory Muscles ◽  
Volume Dependence

We related inspiratory muscle activity to inspiratory pressure generation (Pmus) at different lung volumes in five seated normal subjects. Integrated electromyograms were recorded from diaphragmatic crura (Edi), parasternals (PS), and lateral external intercostals (EI). At 20% increments in the vital capacity (VC) subjects relaxed and then made graded and maximal inspiratory efforts against an occluded airway. At any given level of pressure generation, Edi, PS, and EI increased with increasing lung volume. The Pmus generated at total lung capacity as a fraction of that at a low lung volume (between residual volume and 40% VC) was 0.39 +/- 0.15 (SD) for the diaphragm, 0.20 +/- 0.06 for PS, and 0.22 +/- 0.04 for the lateral EI muscles. Our results indicate a lesser volume dependence of the Pmus-EMG relationship for the diaphragm than for PS and EI muscles. This difference in muscle effectiveness with lung volume may reflect differences in length-tension and/or geometric mechanical advantage between the rib cage muscles and the diaphragm.

Breathing at low lung volumes and chest strapping: a comparison of lung mechanics

1981 ◽  
Vol 50 (3) ◽  
pp. 650-657 ◽  
Author(s):  
N. J. Douglas ◽  
G. B. Drummond ◽  
M. F. Sudlow
Keyword(s):  
Lung Volume ◽  
Maximum Flow ◽  
Normal Subjects ◽  
Lung Mechanics ◽  
Lung Volumes ◽  
Flow Rates ◽  
Recoil Pressure ◽  
Forced Expiratory Flow ◽  
Expiratory Flow ◽  
Expiratory Flow Rates

In six normal subjects forced expiratory flow rates increased progressively with increasing degrees of chest strapping. In nine normal subjects forced expiratory flow rates increased with the time spent breathing with expiratory reserve volume 0.5 liters above residual volume, the increase being significant by 30 s (P less than 0.01), and flow rates were still increasing at 2 min, the longest time the subjects could breathe at this lung volume. The increase in flow after low lung volume breathing (LLVB) was similar to that produced by strapping. The effect of LLVB was diminished by the inhalation of the atropinelike drug ipratropium. Quasistatic recoil pressures were higher following strapping and LLVB than on partial or maximal expiration, but the rise in recoil pressure was insufficient to account for all the observed increased in maximum flow. We suggest that the effects of chest strapping are due to LLVB and that both cause bronchodilatation.

scholarly journals THE LUNG VOLUME IN HEART DISEASE

1923 ◽  
Vol 38 (4) ◽  
pp. 445-476 ◽  
Author(s):  
Carl A. L. Binger
Keyword(s):  
Heart Disease ◽  
Lung Volume ◽  
Vital Capacity ◽  
Lung Volumes ◽  
Total Lung Volume ◽  
Surface Areas ◽  
Normal Individuals ◽  
The Absolute ◽  
Total Capacity ◽  
Residual Air

The lung volumes in a group of individuals suffering from chronic cardiac disease have been studied by a method which is applicable to patients suffering from dyspnea. In a number of instances the same patients were investigated during various stages of decompensation and compensation. The values found have been compared with those determined in a group of normal subjects. Lung volumes have been considered from three points of view: (1) relative lung volumes or subdivisions of total lung volume expressed as percentage of total lung volume; (2) the absolute lung volumes of patients with heart disease have been compared with lung volumes calculated for normal individuals having similar surface areas or chest measurements; and (3) in individual cases absolute lung volumes have been measured in various stages of compensation and decompensation. (1) In patients with heart disease it has been observed that the vital capacity forms a portion of the total lung volume relatively smaller than in normal individuals, and that the mid-capacity and residual air form relatively larger portions. When the patient progresses from the compensated to the decompensated state these changes become more pronounced. (2) When the absolute lung volumes determined for patients are compared with volumes of the same sort, as calculated for normal individuals of the same surface areas and chest measurements, the following differences are found. The vital capacities are always smaller in the patients and the volumes of residual air are always larger. There is a tendency for middle capacity and total capacity to be smaller, though, when the patients are in a compensated state, these volumes may approximate normal. (3) When decompensation occurs the absolute lung volumes undergo changes as follows: (a) vital capacity, mid-capacity, and total capacity decrease in volume; and (b) the residual air may either increase or decrease according to the severity of the state of decompensation. The significance of these changes has been discussed and an explanation offered for the occurrence of a residual air of normal volume in patients with heart disease. It results from a combination of two tendencies working in opposite directions: one to increase the residual air—stiffness of the lungs (Lungenstarre); the other to decrease it—distended capillaries (Lungenschwellung), edema, round cell infiltration.

Lung volume specificity of inspiratory muscle training

1994 ◽  
Vol 77 (2) ◽  
pp. 789-794 ◽  
Author(s):  
G. E. Tzelepis ◽  
D. L. Vega ◽  
M. E. Cohen ◽  
F. D. McCool
Keyword(s):  
Lung Volume ◽  
Vital Capacity ◽  
Inspiratory Muscle ◽  
Control Group ◽  
Residual Volume ◽  
Maximal Inspiratory Pressure ◽  
Muscle Training ◽  
Inspiratory Capacity ◽  
Lung Volumes ◽  
Before And After

We examined the extent to which training-related increases of inspiratory muscle (IM) strength are limited to the lung volume (VL) at which the training occurs. IM strength training consisted of performing repeated static maximum inspiratory maneuvers. Three groups of normal volunteers performed these maneuvers at one of three lung volumes: residual volume (RV), relaxation volume (Vrel), or Vrel plus one-half of inspiratory capacity (Vrel + 1/2IC). A control group did not train. We constructed maximal inspiratory pressure-VL curves before and after a 6-wk training period. For each group, we found that the greatest improvements in strength occurred at the volume at which the subjects trained and were significantly greater for those who trained at low (36% for RV and 26% for Vrel) than at high volumes (13% for Vrel + 1/2IC). Smaller increments in strength were noted at volumes adjacent to the training volume. The range of vital capacity (VC) over which strength was increased was greater for those who trained at low (70% of VC) than at high VL (20% of VC). We conclude that the greatest improvements in IM strength are specific to the VL at which training occurs. However, the increase in strength, as well as the range of volume over which strength is increased, is greater for those who trained at the lower VL.

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