Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Pulmonary Diffusing Capacity”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,369 records · Page 76Linked to original sources

[Obstructive pulmonary emphysema. Evolution of various parameters of pulmonary function and its correlation].

A follow-up study was carried on in a series of 20 patients with chronic obstructive pulmonary disease. The parameters analyzed were forced expiratory volume in the first second (FEV1), maximum voluntary ventilation (MVV), forced expiratory flow (FEF), vital capacity (VC), and diffusing capacity of lung (DL). Considering the importance of the parameter changes observed, each of these parameters were divided in three groups. The period of observation was of two and a half years in 9 patients, and between two years and seven months to four years in 11 patients. The follow-up was characterized by stability of the parameters in cases with the greatest degree of changes, and a definite deterioration of the parameter values in patients with minor degree of basal changes. It was observed an excellent correlation between FEV1 and MVV and FEF. As to CV and DL, the relationship was only good. These findings lead us to believe that MVV and FEF values can be predicted about from the FEV1 results.

Carbon Dioxide↗

Sarcoidosis: the value of exercise testing.

STUDY OBJECTIVES: To evaluate exercise testing for the assessment of the extent of pulmonary disease in patients with sarcoidosis. DESIGN: Retrospective analysis of consecutive patients with sarcoidosis referred to the Pulmonary Physiology Laboratory between 1992 and 1997, who completed at least 6 min of progressive bicycle exercise. Resting and exercise pulmonary function measurements were compared to radiographic stage of disease. SETTING: Pulmonary Physiology Laboratory at Washington, DC, Veterans Affairs Medical Center. PATIENTS: Forty-eight outpatient veterans with biopsy specimen-proven sarcoidosis. RESULTS: Across all radiographic stages of sarcoidosis, total lung capacity, resting diffusing capacity, and exercise gas exchange measurements had a significant variance with radiographic stage. Across the early radiographic stage disease (stages 0 to 2), the change in alveolar-arterial oxygen pressure gradient between rest and exercise, normalized for oxygen uptake, was the most significant measurement in its variation with radiographic stage. CONCLUSIONS: Changes in gas exchange with exercise may be the most sensitive physiologic measurements to assess the extent of disease in early radiographic stages of sarcoidosis.

Adult↗

[Differential diagnosis of chronic obstructive lung disease, A statistical analysis of the discriminating power of various lung function tests (author's transl)].

Among 65 patients admitted to the hospital for chronic obstructive lung disease, the following pulmonary tests were systematically performed : spirometric vital capacity and total lung capacity, FEV1, functional residual capacity and total lung capacity measured by body plethysmography, airway resistance and specific conductance, CO diffusion capacity measured by single-breath test, N2 clearance by single breath oxygen dilution, and blood gases. The patients were divided into bronchitics, emphysematous and broncho-emphysematous, according to the clinical and radiological Nash's score, and to another personal score derived from the former. The simple and multiple correlations between the clinico-radiological score and the functional results are low. The clustering analysis groups the 65 patients into four clouds of points, around two principal axes : the volume axis and the overinflation axis. This study indicates that the most suggestive results for emphysema diagnosis are increased FRC and TLC and low Tlco/V'a. The clinical score is not dominant for the clustering of the patients into the dynamic clouds. Beneath the bronchitic, the broncho-emphysematous and the emphysematous groups, the clustering analysis individualizes a fourth group of cases characterized by chronic asthma, and which were not isolated by Nash's score.

Airway Resistance↗

Early emphysema in patients with anorexia nervosa.

Postmortem studies of patients who died in the Warsaw Ghetto during World War II suggested that death from starvation was associated with pulmonary emphysema. This study re-examines this hypothesis in patients who are chronically malnourished because of anorexia nervosa. Age, smoking history, body mass index, and pulmonary function were measured in 21 subjects with anorexia nervosa and 16 control subjects. Computed tomography (CT) scans were obtained from three regions of the lung (at the level of the aortic arch, the carina, and the posterior position of the eighth rib) using a multislice scanner. The CT measurements of lung density, emphysema, and surface area-to-volume ratio were obtained using the X-ray attenuation values. CT measurements of emphysema were greater in the group that was anorexic than in historical control subjects (p < 0.001). Furthermore, there were significant correlations between the body mass index and the CT measures of emphysema for all the patients and between diffusing capacity and the CT measurements in the patients who were anorexic. A multiple linear regression analysis showed the diffusing capacity was predicted best by the percentage of lung voxels within the large emphysematous changes category. These data demonstrate that emphysema-like changes are present in the lungs of patients who are chronically malnourished.

Adult↗

Cardiopulmonary function after recovery from swimming-induced pulmonary edema.

OBJECTIVE: This study aimed to compare cardiopulmonary function in patients with a history of swimming-induced pulmonary edema (SIPE) with controls by measuring pulmonary function tests, oxygen consumption with exercise, and the pulmonary arterial pressure response to hypoxemia. DESIGN: Case control study. SETTING: Tertiary Military Medical Center. PATIENTS: US Navy Special Warfare members who had previously suffered SIPE. INTERVENTIONS: Measurement of pulmonary function tests, cardiopulmonary exercise test, pulmonary artery pressure by echocardiography at rest on room air and with hypoxia. MAIN OUTCOME MEASUREMENTS: Pulmonary function testing, carbon monoxide diffusing capacity, maximal oxygen consumption, and pulmonary arterial pressure response to hypoxemia. RESULTS: Subjects who previously had SIPE did not demonstrate differences in pulmonary function tests, carbon monoxide diffusing capacity, maximal oxygen consumption, or pulmonary arterial pressure response to hypoxemia. CONCLUSIONS: Subjects with a history of SIPE do not have abnormal pulmonary function tests, abnormal exercise capacity, or abnormal pulmonary arterial pressure response to hypoxemia when tested in dry conditions.

Case-Control Studies↗

6-minute walk work for assessment of functional capacity in patients with COPD.

UNLABELLED: The 6-min walk (6MW) test is commonly used to assess exercise capacity in patients with COPD and to track functional change resulting from disease progression or therapeutic intervention. Not surprisingly, distance covered has been the preferred outcome for this test. However, distance walked does not account for differences in body weight that are known to influence exercise capacity. OBJECTIVE: The aim of this study was to evaluate the 6-min distance x body weight product (6MWORK) as an improved outcome measure with a solid physiologic foundation. PATIENTS AND METHODS: One hundred twenty-four men and women with moderate-to-severe COPD volunteered and completed the testing sequence, which included pulmonary function, a peak effort ramp cardiopulmonary exercise study with gas exchange, and the 6MW. Means and SD were generated for the variables of interest. Differences were analyzed using analysis of variance techniques. Correlation coefficients and receiver operating characteristic (ROC) curves were calculated for the 6-min walk distance (6MWD) and 6MWORK with indexes of pulmonary function, work performance, and Borg scores for dyspnea and effort. RESULTS: Men and women presented with a significant smoking history that also differed by gender (48 vs 66 pack-years, respectively; p < 0.01). The mean (+/- SD) FEV(1) values were 45 +/- 12.6% and 48 +/- 12.1%, respectively (not significant), while the diffusing capacity of the lung for carbon monoxide (DLCO) was 14.7 +/- 6.1 vs 10.3 +/- 3.9 mL/min/mm Hg, respectively (p < 0.001), for men and women. The 6MWD averaged 416.8 +/- 79.0 m for men and 367.8 +/- 78.6 m for women, and these differences were significant (p < 0.002). When 6MWD was compared as the percent predicted of normal values, each gender presented with a similar reduction of 78.6 +/- 14.5% vs 79.9 +/- 17.5% (p > 0.05), respectively. 6MWORK averaged 35,370 +/- 9,482 kg/m and 25,643 +/- 9,080 kg/m (p < 0.0001) for men and women, respectively. 6MWORK yielded higher correlation coefficients than did 6MWD when correlated with DLCO, lung diffusion for alveolar ventilation, FEV(1), FEV(1)/FVC ratio, watts, peak oxygen uptake, peak minute ventilation, and peak tidal volume. The ROC curve demonstrated that 6MWORK had a significantly larger calculated area under the curve (p < 0.05) [plot of 100-sensitivity to specificity for each variable of interest for all subjects] than 6MWD when differentiating an objectively selected definition of low work capacity vs high work capacity (bike ergometry work, < 55 vs > 55 W, respectively). CONCLUSIONS: We conclude that work calculated as the product of distance x body weight is an improved outcome measure for the 6MW. 6MWORK can be used whenever the 6MW is required to estimate a patient's functional capacity. This measure is also a common measure, which can be converted to indexes of caloric expenditure for direct cross-modality comparisons.

Aged↗

The diabetic lung: relevance of alveolar microangiopathy for the use of inhaled insulin.

The alveolar-capillary network receives the entire cardiac output and constitutes the largest microvascular organ in the body, making it highly susceptible to systemic microangiopathy. Owing to its large reserves, symptoms and disability develop later in the lung than in smaller microvasculature such as the kidney or retina despite a comparable severity of anatomic involvement. Hence, pulmonary impairment in diabetes mellitus is under-recognized. Nonetheless, respiratory autonomic neuropathy and structural derangement of the thorax and lung parenchyma develop in many asymptomatic diabetic patients; the pathophysiology parallels that in other target organs. Even subclinical loss of alveolar microvascular reserves can be quantified noninvasively from lung diffusing capacity and its components (membrane diffusing capacity and alveolar-capillary blood volume) measured at a given cardiac output at rest or during exercise. The alveolar diffusion-perfusion relation tracks the recruitment of microvascular reserves in a manner independent of physical fitness. This article addresses the importance and pathophysiologic basis of diabetic pulmonary involvement, the assessment of diabetic alveolar microangiopathy, and the relevance of this understanding for the emerging use of inhaled insulin.

Administration, Inhalation↗

Health effects of subchronic exposure to low levels of wood smoke in rats.

Wood smoke is a significant source of air pollution in many parts of the United States, and epidemiological data suggest a causal relationship between elevated wood smoke levels and health effects. The present study was designed to provide information on the potential respiratory health responses to subchronic wood smoke exposures in a Native American community in New Mexico. Therefore, this study used the same type of wood under similar burning conditions and wood smoke particle concentrations to mimic the conditions observed in this community. Brown Norway rats were exposed 3 h/day, 5 days/week for 4 or 12 weeks to air as control, or to 1 or 10 mg/m3 concentrations of wood smoke particles from pinus edulis. The wood smoke consisted of fine particles (< 1 microm) that formed larger chains and aggregates having a size distribution of 63-74% in the < 1-microm fraction and 26-37% in the > 1-microm fraction. The particle-bound material was primarily composed of carbon, and the majority of identified organic compounds consisted of sugar and lignin derivatives. Pulmonary function, specifically carbon monoxide-diffusing capacity and pulmonary resistance, was somewhat affected in the high-exposure group. Mild chronic inflammation and squamous metaplasia were observed in the larynx of the exposed groups. The severity of alveolar macrophage hyperplasia and pigmentation increased with smoke concentration and length of exposure, and the alveolar septae were slightly thickened. The content of mucous cells lining the airways changed from Periodic Acid Schiff- to Alcian Blue-positive material in the low-exposure group after 90 days. Together, these observations suggest that exposure to wood smoke caused minor but significant changes in Brown Norway rats. Further studies are needed to establish whether exposure to wood smoke exacerbates asthmalike symptoms that resemble those described for children living in homes using wood stoves for heating and cooking.

Air Pollutants↗

Transient pulmonary impairment during attacks of Crohn's disease.

Lung function was studied in 10 patients with Crohn's disease during and after an attack of the disease. Pulmonary volumes and lung transfer factor were not impaired but functional residual capacity was greater during the attack than during remission; it was also greater than in normal subjects. FRC values and disease activity decreased concomitantly during remission as well as finger clubbing. The etiology of this impairment was unknown.

Adult↗

Lung transfer factor for CO at rest in normal children by a steady-state method.

Lung transfer for CO (TLCO) was measured at rest in 94 normal children (47 boys and 47 girls) whose ages ranged from 3.5 to 16 years. A steady-state method, using a technique of alveolar sampling based on the equality of the mean expiratory and alveolar respiratory quotients, was employed. Highly significant correlations, statistically different for boys and girls, were fond between TLCO and standing height. TLCO was also linearly correlated with the functional residual capacity--the only pulmonary volume measurable in very young children--but without any sex difference. A multiple linear regression relates TLCO to FRC and height. Variance analysis shows the preponderant influence of FRC.

Adolescent↗

[Ventilation distribution disorders. Evaluation based on nitrogen elimination curves of the lung and on an inspiratory gas-distribution index derived from it].

An uneven distribution of the inspiratory gas volume to the alveolar volume leads to disturbances of the ventilation/perfusion ratio VA/Q with resulting arterial hypoxemia. These ventilatory disturbances can be verified by nitrogen-washout-curves and an inspiratory gas distribution index derived from those curves. Preoperative diagnostic and the control of respiratory diseases during intensive therapy are possible without technical difficulties.

Humans↗

Decrease in the single-breath diffusing capacity after saturation dives.

Before and after saturation dives, we measured lung volumes and diffusing capacity (DL(CO)/V(A] with a single-breath method on 12 divers (6 divers per dive) who participated in 300-msw saturation dives (total dive time of 15 days with P(O)2 = 0.42 atm abs) and on 6 divers who were engaged in a 320-msw saturation dive (6 days of bottom time with P(O)2 = 0.42 atm abs and 12 days of total decompression time with P(O)2 = 0.495 atm abs. In all divers, vital capacity right after surfacing did not significantly decrease compared with predive values. In the 300-msw saturation divers after surfacing, DL(CO)/V(A) adjusted for hemoglobin (Hb) changes did not significantly decrease, but in the 320-msw saturation divers Hb-adjusted DL(CO)/V(A) was significantly (P less than 0.001) decreased by 0.70 (mean) +/- 0.21 (SD) (ml.min(-1).mmHg(-1).liter(-1]. These observations indicate that the diffusing capacity is a more sensitive index of pulmonary oxygen toxicity than vital capacity that is traditionally used, and that oxygen partial pressure less than 0.5 atm abs can induce a decrease in pulmonary function.

Diving↗

[Pulmonary gas exchange during isovolaemic haemodilution (author's transl)].

In experiments on 6 closed chest dogs the behaviour of pulmonary gas exchange during isovolaemic haemodilution with 6% dextran was studied. The dogs were ventilated artificially using an inspiratory gas mixture containing 25% O2. A slight increase of arterial Po2 values was found. This change was accompanied by a decrease in alveolar-arterial Po2 and Pco2 gradients. The size of effective pulmonary capillary blood flow varied in accordance with the size of cardiac output. The changes of pulmonary O2 diffusing capacity could be explained by the effect of haemodilution per se.

Animals↗

Pulmonary function abnormalities in patients with CT-determined emphysema.

The CT quantification of both the extent and severity of emphysema was undertaken in 30 subjects. The CT scans at five preselected anatomic levels were analyzed using two methods. Correlation of the results of the CT methods were with pulmonary function results of airway obstruction and alveolar diffusion for carbon monoxide. Analysis by direct observation of the CT scans gave insignificantly different results for a complex grid method of analysis. The emphysema score with the observational method had a positive correlation with airflow obstruction (r = -0.817) as did the score with the grid method (r = -0.873). The diffusing capacity for carbon monoxide also correlated with both emphysema scores. The CT methods for quantifying emphysema correlate closely with functional abnormalities. As previously demonstrated with pathological assessment of lung slices for emphysema, direct observation of CT scans is as precise as a more complex grid method.

Aged↗

Specific pulmonary responses during the cycle-run succession in triathletes.

The aim of the present study was to investigate the relationship between alterations in pulmonary function (i.e., diffusing capacity for carbon monoxide and pulmonary volumes) and the ventilatory response elicited during the cycle-run succession in triathletes. Ten well-trained triathletes performed three exercises: 1) 30 min cycling plus 20 min of running, termed the cycle-run succession; 2) 30 min cycling; and 3) 20 min running. Before and 10 min after each trial, the triathletes underwent pulmonary function testing, including spirometry and diffusing capacity for carbon monoxide. During all trials, ventilatory data were collected every minute using an automated breath-by-breath system. The ventilatory response was significantly higher in the run subsequent to cycling as compared with the run performed independently (P<0.001). There was no change in pulmonary volumes before and after exercises; however, the diffusing capacity for carbon monoxide and the transfer coefficient were similarly decreased (P<0.05) after cycling and the cycle-run succession, but not decreased after running. The increase in minute ventilation in the run segment of the cycle-run succession versus in running alone was significantly correlated with the decrease in diffusing capacity for carbon monoxide measured after versus before the cycle-run succession (P<0.01). This same increase in ventilation was also correlated with the decrease in diffusing capacity measured after the cycle-run succession versus after cycling alone (P<0.03). These results suggest the possibility that the DLCO decrease contributes in part to the ventilatory increase noted in the run after cycling during the cycle-run succession of the triathlon.

Adult↗

Diffusional inhomogeneity: gas mixing efficiency in the new-born lung.

1. The results of 105 nitrogen washouts on seventy-six new-born babies are presented; the mean lung volume (functional residual capacity, FRC) of the seventy-six babies measured at more than 1 hr of age was 77.5 +/- 2.9 (S.E. of mean; S.D. = 25.4). 2. The mean gas mixing efficiency was 0.466 +/- 0.0097 (S. E. of mean; S.D. = 0.096). The reasons for the difference between this figure and the normal for adults of 0.66--0.76 are discussed, and it is suggested that the very much greater turnover rate of gas within the lungs is responsible for diffusion inefficiency. 3. Calculations indicate that there is a tenfold fall in diffusion inefficiency for every 9.8 sec turnover time (the time for VE to equal VFRC). In the baby the turnover time is 5--6 sec on average but with a very wide spread; in the adult it is of the order of 30 sec, so that diffusion inefficiency of gas in the lung would be only 0.001 or 0.1%. 4. The significance of this is that the effective alveolar ventilation of the average neonate is less than half the total ventilation (as opposed to two-thirds if deadspace only is considered), becoming a smaller fraction of VE on hyperventilation. This would explain discrepancies in the calculation of alveolar carbon dioxide levels from the output of that gas and the non-deadspace ventilation.

Diffusion↗