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Diffusing Capacity for Nitric Oxide and Carbon Monoxide in Patients With Diffuse Parenchymal Lung Disease and Pulmonary Arterial Hypertension: Recommendation
An interesting study was performed by Bonay et al, who investigated whether the Vcap (determined with the single-breath high/low oxygen method) would be lower in subjects with DPLD and associated PAH than in subjects with DPLD without PAH. This appeared not to be the case, thus excluding the Vcap measurement as a screening test for […]
Diffusing Capacity for Nitric Oxide and Carbon Monoxide in Patients With Diffuse Parenchymal Lung Disease and Pulmonary Arterial Hypertension: Conclusion
There have been several studies dealing with the subdivision of the Dlco in interstitial lung diseases. In 1976, Saumon et al found that in patients with sarcoidosis with radiologic stage I and II disease, the decrease in Dlco was mainly due to decreased Dmco, but that in stage III sarcoidosis the decrease was associated with […]
Diffusing Capacity for Nitric Oxide and Carbon Monoxide in Patients With Diffuse Parenchymal Lung Disease and Pulmonary Arterial Hypertension: Discussion
In this prospective study, we found a difference in the Dlno/Dlco ratio between patients with DPLD and patients with PAH. Although this difference did reach statistical significance, the large overlap between the groups makes the Dlno/Dlco ratio inapplicable as a clinical tool in discriminating between PAH and DPLD. Although we used a lower inspiratory NO […]
Diffusing Capacity for Nitric Oxide and Carbon Monoxide in Patients With Diffuse Parenchymal Lung Disease and Pulmonary Arterial Hypertension: Results
The Dlco and Dlno were corrected to BTPS conditions, and a minimum of two measurements was performed, in which a variability of < 10% for the VA and Dlco was acceptable. All Dlco measurements were corrected to the standard Hb value according to American Thoracic Society recommendations. The obtained Dlno/ Dlco ratios were compared by […]
Diffusing Capacity for Nitric Oxide and Carbon Monoxide in Patients With Diffuse Parenchymal Lung Disease and Pulmonary Arterial Hypertension: Dlno Measurement
All patients with suspected PAH underwent radionuclide perfusion and ventilation scans, echocardiography with estimation of the pulmonary artery pressure by tricuspid regurgitation measurement (assessed by experienced cardiologists), CT scan of the pulmonary arteries in order to detect central thromboembolic disease, right heart catheterization with measurements of the pulmonary artery pressure with reversibility testing in most […]
Diffusing Capacity for Nitric Oxide and Carbon Monoxide in Patients With Diffuse Parenchymal Lung Disease and Pulmonary Arterial Hypertension: Patients
Assuming that the Dlno is not affected or is less affected by impaired capillary filling, and thus represents the diffusing capacity of the pulmonary membrane, the Dlno/Dlco ratio has to differ between subjects with a pure alveolocapillary membrane disturbance and subjects with microvascular disease. Subjects with a decreased Dlco due to lowering of the Vcap […]
Diffusing Capacity for Nitric Oxide and Carbon Monoxide in Patients With Diffuse Parenchymal Lung Disease and Pulmonary Arterial Hypertension
The diffusing capacity of the lung for carbon monoxide (Dlco) estimates the amount of gas uptake by the lungs and is a valuable tool in the assessment of pulmonary diseases. According to the model of Roughton and Forster, Dlco is determined by the following several factors: the passage of carbon monoxide (CO) through the alveolocapillary […]