scholarly journals A MODIFICATION OF THE KROGH CARBON MONOXIDE BREATH HOLDING TECHNIQUE FOR ESTIMATING THE DIFFUSING CAPACITY OF THE LUNG; A COMPARISON WITH THREE OTHER METHODS 1

1955 ◽  
Vol 34 (9) ◽  
pp. 1417-1426 ◽  
Author(s):  
R. E. Forster ◽  
J. E. Cohn ◽  
W. A. Briscoe ◽  
W. S. Blakemore ◽  
R. L. Riley
Keyword(s):  
Carbon Monoxide ◽  
Breath Holding ◽  
Diffusing Capacity

Effect of negative intra-alveolar pressure on pulmonary diffusing capacity

1960 ◽  
Vol 15 (3) ◽  
pp. 372-376 ◽  
Author(s):  
J. E. Cotes ◽  
D. P. Snidal ◽  
R. H. Shepard
Keyword(s):  
Carbon Monoxide ◽  
Venous Pressure ◽  
Capillary Blood ◽  
Breath Holding ◽  
Diffusing Capacity ◽  
Alveolar Pressure ◽  
Holding Period ◽  
Capillary Membrane ◽  
Capillary Blood Volume ◽  
Alveolar Capillary

In one of two subjects studied in detail, using 0.1% carbon monoxide in the test gas and a 10-second breath-holding period, the alveolar capillary blood volume (Vc) was found to increase by nearly 100% when the intra-alveolar pressure was made negative during breath holding. This was accompanied by a reduction in venous pressure in the forearm. In both subjects Vc was increased on exercise. The diffusing capacity of the alveolar capillary membrane (Dm) remained relatively constant in spite of large changes in Vc. The findings suggest that stationary blood is present in some alveolar capillaries at rest. The implications of this finding and a likely mechanism for the increase in Vc with negative pressure are discussed. xsSubmitted on September 14, 1959

Studies on the Pulmonary Diffusing Capacity by the Carbon Monoxide Breath Holding Technique: I. Normal Subjects

2009 ◽  
Vol 169 (5) ◽  
pp. 583-594 ◽  
Author(s):  
Haruo Kanagami ◽  
Toshiki Katsura ◽  
Koichiro Shiroishi ◽  
Kenji Baba ◽  
Toshiaki Ebina
Keyword(s):  
Carbon Monoxide ◽  
Normal Subjects ◽  
Breath Holding ◽  
Diffusing Capacity ◽  
Pulmonary Diffusing Capacity

scholarly journals Implementing the Three-Equation Method of Measuring Single Breath Carbon Monoxide Diffusing Capacity

1996 ◽  
Vol 3 (4) ◽  
pp. 247-257 ◽  
Author(s):  
Brian L Graham ◽  
Joseph T Mink ◽  
David J Cotton
Keyword(s):  
Carbon Monoxide ◽  
Lung Volume ◽  
Equation Method ◽  
Breath Holding ◽  
Breath Hold ◽  
Diffusing Capacity ◽  
Flow Rates ◽  
Single Breath ◽  
Conventional Methods ◽  
Made In

Conventional methods of measuring the single breath diffusing capacity of the lung for carbon monoxide (DLcoSB) are based on the Krogh equation, which is valid only during breath holding. Rigid standardization is used to approximate a pure breath hold manoeuvre, but variations in performing the manoeuvre cause errors in the measurement of DLcoSB. The authors previously described a method of measuring DLcoSBusing separate equations describing carbon monoxide uptake during each phase of the manoeuvre: inhalation, breath holding and exhalation. The method is manoeuvre-independent, uses all of the exhaled alveolar gas to improve estimates of mean DLcoSBand lung volume, and is more accurate and precise than conventional methods. A slow, submaximal, more physiological single breath manoeuvre can be used to measure DLcoSBin patients who cannot achieve the flow rates and breath hold times necessary for the standardized manoeuvre. The method was initially implemented using prototype equipment but commercial systems are now available that are capable of implementing this method. The authors describe how to implement the method and discuss considerations to be made in its use.

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.

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.

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