Global lung function initiative: Reference equations for the transfer factor for carbon monoxide (TLCO)

2016 ◽  
Author(s):  
Sanja Stanojevic ◽  
Brian Grham ◽  
Brendan Cooper ◽  
Bruce Thompson ◽  
Kim Carter ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Transfer Factor ◽  
Reference Equations

scholarly journals Effects of adopting the Global Lung Function Initiative 2017 reference equations on the interpretation of carbon monoxide transfer factor

2020 ◽  
Vol 55 (5) ◽  
pp. 1901905
Author(s):  
Danny J. Brazzale ◽  
Leigh M. Seccombe ◽  
Liam Welsh ◽  
Celia J. Lanteri ◽  
Claude S. Farah ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Transfer Factor ◽  
Teaching Hospitals ◽  
Younger Adults ◽  
Adult Females ◽  
Reference Set ◽  
Reference Equations ◽  
Lower Limit Of Normal ◽  
A Current

The recently published Global Lung Function Initiative (GLI) carbon monoxide transfer factor (TLCO) reference equations provide an opportunity to adopt a current, all-age, widely applicable reference set. The aim of this study was to document the effect of changing to GLI from commonly utilised reference equations on the interpretation of TLCO results.33 863 TLCO results (48% female, 88% Caucasian, n=930 aged <18 years) from clinical pulmonary function laboratories within three Australian teaching hospitals were analysed. The lower limit of normal (LLN) and proportion of patients with a TLCO below this value were calculated using GLI and other commonly used reference equations.The average TLCO LLN for GLI was similar or lower than the other equations, with the largest difference seen for Crapo equations (median: −1.25, IQR: −1.64, −0.86 mmol·min−1·kPa−1). These differences resulted in altered rates of reduced TLCO for GLI particularly for adults (+1.9% versus Miller to −27.6% versus Crapo), more so than for children (−0.8% versus Kim to −14.2% versus Cotes). For adults, the highest raw agreement for GLI was with Miller equations (94.7%), while for children it was with Kim equations (98.1%). Results were reclassified from abnormal to normal more frequently for younger adults, and for adult females, particularly when moving from Roca to GLI equations (30% of females versus 16% of males).The adoption of GLI TLCO reference equations in adults will result in altered interpretation depending on the equations previously used and to a greater extent in adult females. The effect on interpretation in children is less significant.

scholarly journals The impact of changing to the Global Lung Function Initiative reference equations for transfer factor in paediatrics

2020 ◽  
pp. 00412-2020
Author(s):  
Paul D. Burns ◽  
James Y. Paton
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Paediatric Patient ◽  
Transfer Factor ◽  
Reference Equations ◽  
The Difference ◽  
Predicted Values ◽  
Age Range ◽  
The Impact ◽  
Interpretation Of Results

The Global Lung Function Initiative (GLI) all age reference equations for carbon monoxide transfer factor were published in 2017 and endorsed by the ERS/ATS. In order to understand the impact of these new reference equations on the interpretation of results in children referred from haematology and oncology paediatric services, we retrospectively analysed transfer factor results from any paediatric patient referred from haematology oncology in the period 2010–2018. We examined TLCO, KCO and VA from 241 children (age range; 7–18, 130 male). The predicted values from Rosenthal and GLI were plotted against height. The difference in interpretation of results was analysed by looking at the percentage of patients <LLN for each parameter. Overall, the Rosenthal predicted values for TLCO were higher than GLI. Predicted KCO using Rosenthal was higher in all observations. In contrast, the Rosenthal predicted VA was generally lower than the GLI value. The GLI predicted values for transfer factor show considerable differences compared with currently used paediatric UK reference values, differences that will have a significant impact on interpretation of results.

Effect of corrected GLI reference equations on carbon monoxide transfer factor interpretation

2021 ◽  
pp. 2004459
Author(s):  
Warren R. Ruehland ◽  
Celia J. Lanteri ◽  
Pam Matsas ◽  
Danny J. Brazzale
Keyword(s):  
Carbon Monoxide ◽  
Transfer Factor ◽  
Reference Equations

Childhood pneumonia, pleurisy and lung function: a cohort study from the first to sixth decade of life

Thorax ◽  
2019 ◽  
Vol 75 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Jennifer L Perret ◽  
Caroline J Lodge ◽  
Adrian J Lowe ◽  
David P Johns ◽  
Bruce R Thompson ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Lower Limit ◽  
Transfer Factor ◽  
Study Cohort ◽  
Z Score ◽  
Lung Volumes ◽  
Current Asthma ◽  
Childhood Pneumonia ◽  
Lower Limit Of Normal

IntroductionAdult spirometry following community-acquired childhood pneumonia has variably been reported as showing obstructive or non-obstructive deficits. We analysed associations between doctor-diagnosed childhood pneumonia/pleurisy and more comprehensive lung function in a middle-aged general population cohort born in 1961.MethodsData were from the prospective population-based Tasmanian Longitudinal Health Study cohort. Analysed lung function was from ages 7 years (prebronchodilator spirometry only, n=7097), 45 years (postbronchodilator spirometry, carbon monoxide transfer factor and static lung volumes, n=1220) and 53 years (postbronchodilator spirometry and transfer factor, n=2485). Parent-recalled histories of doctor-diagnosed childhood pneumonia and/or pleurisy were recorded at age 7. Multivariable linear and logistic regression were used.ResultsAt age 7, compared with no episodes, childhood pneumonia/pleurisy-ever was associated with reduced FEV1:FVC for only those with current asthma (beta-coefficient or change in z-score=−0.20 SD, 95% CI −0.38 to –0.02, p=0.028, p interaction=0.036). At age 45, for all participants, childhood pneumonia/pleurisy-ever was associated with a restrictive pattern: OR 3.02 (1.5 to 6.0), p=0.002 for spirometric restriction (FVC less than the lower limit of normal plus FEV1:FVC greater than the lower limit of normal); total lung capacity z-score −0.26 SD (95% CI −0.38 to –0.13), p<0.001; functional residual capacity −0.16 SD (−0.34 to –0.08), p=0.001; and residual volume −0.18 SD (−0.31 to –0.05), p=0.008. Reduced lung volumes were accompanied by increased carbon monoxide transfer coefficient at both time points (z-score +0.29 SD (0.11 to 0.49), p=0.001 and +0.17 SD (0.04 to 0.29), p=0.008, respectively).DiscussionFor this community-based population, doctor-diagnosed childhood pneumonia and/or pleurisy were associated with obstructed lung function at age 7 for children who had current asthma symptoms, but with evidence of ‘smaller lungs’ when in middle age.

Reference Equations for Lung Function, Lung Volumes, and Carbon Monoxide Diffusing Capacity of Healthy Never Smoking Adults Aged 18-91 Year

CHEST Journal ◽  
2011 ◽  
Vol 140 (4) ◽  
pp. 678A
Author(s):  
Pavlos Michailopoulos ◽  
Paraskevi Argiropoulou ◽  
Ioannis Kioumis ◽  
Theofilos Pechlivanidis ◽  
Dionisios Spyratos ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Diffusing Capacity ◽  
Lung Volumes ◽  
Reference Equations

scholarly journals Official ERS technical standards: Global Lung Function Initiative reference values for the carbon monoxide transfer factor for Caucasians

2017 ◽  
Vol 50 (3) ◽  
pp. 1700010 ◽  
Author(s):  
Sanja Stanojevic ◽  
Brian L. Graham ◽  
Brendan G. Cooper ◽  
Bruce R. Thompson ◽  
Kim W. Carter ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Reference Values ◽  
Transfer Factor ◽  
Technical Standards

Lung function and the response to exercise in New Guineans: role of genetic and environmental factors

1974 ◽  
Vol 268 (893) ◽  
pp. 349-361 ◽  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Transfer Factor ◽  
Respiratory Symptoms ◽  
Total Lung Capacity ◽  
Partial Regression ◽  
Lung Capacity ◽  
Ventilatory Capacity ◽  
Women And Children ◽  
Ethnic Factor

1. Information on respiratory symptoms and, in most instances, the ventilatory capacity (forced expiratory volume and forced vital capacity) were obtained on 2026 men, women and children comprising the total population of 12 villages situated at 2000 m in the Eastern Highlands and 1736 coastal people on Karkar Island. On selected healthy adults measurements were made of the total lung capacity and its subdivisions, the transfer factor for the lungs for carbon monoxide (151 subjects aged 20-63 years) and the ventilation and the cardiac frequency during submaximal exercise (132 subjects aged 17-34 years). The transfer factor was standardized to a haemoglobin concentration of 14.6 g/100 ml and alveolar capillary oxygen tension of 14.7 kPa (110 Torr). 2. The ventilatory capacity was reduced by the presence of respiratory symptoms or a loose cough but not by smoking local tobacco (Brus). For subjects with apparently healthy lungs and after allowing for the effects of age and of stature, the ventilatory capacity of the highland men, women and children was similar to that of representative Europeans. The coastal people had lower values including lower partial regression coefficients on age. The total lung capacity, its subdivisions and the transfer factor for the adult highlanders were larger than for the coastal people; the values were similar to or larger than for Europeans. The values for the coastal people resembled those for people of Indian, African and Chinese descent living in the tropics. The partial regression coefficient of transfer factor on age in the New Guineans was more negative than in the Europeans. 3. For the healthy young adults, analysis of the lung function data in relation to those for exercise point to the differences between the groups being due to the combined effects of an ethnic factor plus differences in the level of physical activity. The lung volumes, ventilatory capacity and ventilation during exercise are the resultant of both effects. The exercise tidal volume is a function of the ethnic factor but not the level of activity, while the reverse is true of the lung transfer factor for carbon monoxide.

AB0796 THE EVALUATION OF LUNG DIAGNOSTIC PROCEDURE AT THE ONSET OF INFLAMMATORY RHEUMATIC DISEASES WITH INTERSTITIAL LUNG DISEASE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1422.3-1423
Author(s):  
T. Hoffmann ◽  
P. Oelzner ◽  
F. Marcus ◽  
M. Förster ◽  
J. Böttcher ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Interstitial Lung Disease ◽  
Lung Function ◽  
Lung Disease ◽  
Sensitivity And Specificity ◽  
Lung Function Test ◽  
Inflammatory Rheumatic Diseases ◽  
X Ray ◽  
Function Test ◽  
Chest X Ray

Background:Interstitial lung disease (ILD) in inflammatory rheumatic diseases (IRD) is associated with increased mortality. Moreover, the lung is one of the most effected organs on IRD. Consequently, screening methods were required to the detect ILD in IRD.Objectives:The objective of the following study is to evaluate the diagnostic value of lung function test, chest x-ray and HR-CT of the lung in the detection of ILD at the onset of IRD.Methods:The study is designed as a case-control study and includes 126 patients with a newly diagnosed IRD. It was matched by gender, age and the performance of lung function test and chest x-ray. The sensitivity and specificity were verified by crosstabs and receiver operating characteristic (ROC) curve analysis. The study cohort was divided in two groups (ILD group: n = 63 and control group: n = 63). If possible, all patients received a lung function test and optional a chest x-ray. Patients with pathological findings in the screening tests (chest x-ray or reduced diffusing capacity for carbon monoxide (DLCO) < 80 %) maintained a high-resolution computer tomography (HR-CT) of the lung. Additionally, an immunological bronchioalveolar lavage was performed in the ILD group as gold standard for the detection of ILD.Results:The DLCO (< 80 %) revealed a sensitivity of 83.6 % and specificity of 45.8 % for the detection of ILD. Other examined parameter of lung function test showed no sufficient sensitivity as screening test (FVC = Forced Vital Capacity, FEV1 = Forced Expiratory Volume in 1 second, TLC = Total Lung Capacity, TLCO = Transfer factor of the Lung for carbon monoxide). Also, a combination of different parameter did not increase the sensitivity. The sensitivity and specificity of chest x-ray for the verification of ILD was 64.2 % versus 73.6 %. The combination of DLCO (< 80 %) and chest x-ray showed a sensitivity with 95.2 % and specificity with 38.7 %. The highest sensitivity (95.2 %) and specificity (77.4 %) was observed for the combination of DLCO (< 80 %) and HR-CT of the lung.Conclusion:The study highlighted that a reduced DLCO in lung function test is associated with a lung involvement in IRD. DLCO represented a potential screening parameter for lung manifestation in IRD. Especially patients with suspected vasculitis should receive an additional chest x-ray. Based on the high sensitivity of DLCO in combination with chest x-ray or HR-CT for the detection of ILD in IRD, all patients with a reduced DLCO (< 80%) should obtained an imaging of the lung.Disclosure of Interests:None declared

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