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

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.

III. PULMONARY DIFFUSION

PEDIATRICS ◽  
1965 ◽  
Vol 35 (1) ◽  
pp. 185-193
Author(s):  
George R. DeMuth ◽  
William F. Howatt
Keyword(s):  
Carbon Monoxide ◽  
Body Size ◽  
Longitudinal Data ◽  
Surface Area ◽  
Residual Variance ◽  
Normal Variation ◽  
Diffusing Capacity ◽  
Healthy Individuals ◽  
Lung Volumes ◽  
Mean Values

1. Equations describing the normal variation and changes with size of the diffusing capacity (rebreathing technique) for boys and girls have been obtained from 230 observations on 139 children. 2. The use of covariance analysis on the longitudinal data reduces the residual variance by about half, indicating that in children the diffusing capacity for carbon monoxide, Dco, grows along growth lines. This aids in finding significant deviations from the predicted in children who are followed with repeated examinations. 3. The Dco increases with growth in a manner very similar to that of the lung volumes, not only in respect to height, but also in respect to age, weight, and surface area. The ratio Dco/TLC expresses a relationship which does not vary with body size, age, or sex in these healthy individuals. Although boys and girls have the same mean values, the correlation between each individual's values from the two series is significant for boys but not for girls. 4. The constancy of the Dco/TLC during growth supports the hypothesis that the lung grows between the ages of 5 and 18 years by the addition of new air spaces rather than by enlarging the pre-existing ones.

Prädiktoren für Progression und Mortalität bei Patienten mit RA-assoziierter ILD

2021 ◽  
pp. 1-3
Author(s):  
Nicolas Carlos Kahn
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Lung Disease ◽  
Pulmonary Function Tests ◽  
Diffusing Capacity ◽  
Radiological Progression ◽  
Cox Regression Analysis ◽  
Factors Associated ◽  
Disease Modifying

<b>Objectives:</b> To describe a prospective cohort of patients with rheumatoid arthritis associated with interstitial lung disease (RA-ILD) and identify risk factors associated with disease progression and mortality in this cohort. <b>Patients and methods:</b> We performed a multicenter, prospective, observational study of patients with RA-ILD receiving disease-modifying antirheumatic drugs (DMARDs) between 2015 and 2020. The patients were assessed using high-resolution computed tomography and pulmonary function tests at baseline and at 60 months. The main endpoint was «Progression to ILD at the end of follow-up» in terms of the following outcomes: (1) improvement (i.e., improvement in forced vital capacity (FVC) ≥10% or diffusing capacity of the lungs for carbon monoxide (DLCO) ≥15% and absence of radiological progression); (2) nonprogression (stabilization or improvement in FVC ≤10% or diffusing capacity of the lungs for carbon monoxide (DLCO) &#x3c;15% and absence of radiological progression); (3) progression (worsening of FVC &#x3e;10% or DLCO &#x3e;15% and radiological progression); or (4) death. We recorded demographic and clinical characteristics, lung function, and the incidence of adverse events. A Cox regression analysis was performed to identify factors associated with the worsening of ILD. <b>Results:</b> After 60 months, lung disease had stabilized in 66 patients (56.9%), improved in 9 (7.8%), and worsened in 23 (19.8%). Eighteen patients (15.5%) died, with a mean survival of 71.8 (1.9) months after diagnosis of ILD. The Cox multivariate analysis revealed the independent predictors of worsening of RA-ILD to be usual interstitial pneumonia (hazard ratio (HR), 2.6 (95%CI, 1.0–6.7)), FVC &#x3c;80% (HR, 3.8 (95%CI, 1.5–6.7)), anticitrullinated protein antibody titers (HR, 2.8 (95%CI, 1.1–6.8)), smoking (HR, 2.5 (95%CI, 1.1–6.2)), and treatment with abatacept, tocilizumab, or rituximab (HR, 0.4 (95%CI, 0.2–0.8)). During follow-up, 79 patients (68%) experienced an adverse event, mostly infection (61%). Infection was fatal in 10/18 patients (55.5%) during follow-up. <b>Conclusions:</b> Lung function is stable in most patients with RA-ILD receiving treatment with disease-modifying anti-rheumatic drugs (DMARDs), although one-third worsened or died. Identifying factors associated with worsening in RA-ILD is important for clinical management.

Assessment of Global Lung Function Initiative (GLI) reference equations for diffusing capacity in relation to respiratory burden in the Swedish CArdioPulmonary bioImage Study (SCAPIS)

2020 ◽  
Vol 56 (2) ◽  
pp. 1901995 ◽  
Author(s):  
Andrei Malinovschi ◽  
Xingwu Zhou ◽  
Björn Bake ◽  
Göran Bergström ◽  
Anders Blomberg ◽  
...  
Keyword(s):  
Lung Function ◽  
Reference Values ◽  
Airflow Limitation ◽  
Diffusing Capacity ◽  
High Resolution Computed Tomography ◽  
Swedish Population ◽  
Reference Equations ◽  
Lms Method ◽  
Never Smokers ◽  
Lower Limit Of Normal

The Global Lung Function Initiative (GLI) has recently published international reference values for diffusing capacity of the lung for carbon monoxide (DLCO). Lower limit of normal (LLN), i.e. the 5th percentile, usually defines impaired DLCO. We examined if the GLI LLN for DLCO differs from the LLN in a Swedish population of healthy, never-smoking individuals and how any such differences affect identification of subjects with respiratory burden.Spirometry, DLCO, chest high-resolution computed tomography (HRCT) and questionnaires were obtained from the first 15 040 participants, aged 50–64 years, of the Swedish CArdioPulmonary bioImage Study (SCAPIS). Both GLI reference values and the lambda-mu-sigma (LMS) method were used to define the LLN in asymptomatic never-smokers without respiratory disease (n=4903, of which 2329 were women).Both the median and LLN for DLCO from SCAPIS were above the median and LLN from the GLI (p<0.05). The prevalence of DLCO <GLI LLN (and also <SCAPIS LLN) was 3.9%, while the prevalence of DLCO >GLI LLN but <SCAPIS LLN was 5.7%. Subjects with DLCO >GLI LLN but <SCAPIS LLN (n=860) had more emphysema (14.3% versus 4.5%, p<0.001), chronic airflow limitation (8.5% versus 3.9%, p<0.001) and chronic bronchitis (8.3% versus 4.4%, p<0.01) than subjects (n=13 600) with normal DLCO (>GLI LLN and >SCAPIS LLN). No differences were found with regard to physician-diagnosed asthma.The GLI LLN for DLCO is lower than the estimated LLN in healthy, never-smoking, middle-aged Swedish adults. Individuals with DLCO above the GLI LLN but below the SCAPIS LLN had, to a larger extent, an increased respiratory burden. This suggests clinical implications for choosing an adequate LLN for studied populations.

Carbon Monoxide Diffusing Capacity, Other Indices of Lung Function, and Respiratory Symptoms in a General Population Sample

1990 ◽  
Vol 141 (4_pt_1) ◽  
pp. 1033-1039 ◽  
Author(s):  
Giovanni Viegi ◽  
Paolo Paoletti ◽  
Renato Prediletto ◽  
Francesco di Pede ◽  
Laura Carrozzi ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
General Population ◽  
Respiratory Symptoms ◽  
Population Sample ◽  
General Population Sample ◽  
Diffusing Capacity

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

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.

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.

New reference equations: What changes in diffusing capacity for carbon monoxide interpretation?

2020 ◽  
Author(s):  
Tânia Duarte ◽  
Mafalda Silva ◽  
Catarina Rijo ◽  
Susana Sousa ◽  
Paula Duarte
Keyword(s):  
Carbon Monoxide ◽  
Diffusing Capacity ◽  
Reference Equations
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