Chemiluminescent measurements of nitric oxide pulmonary diffusing capacity and alveolar production in humans.

Measurements of nitric oxide (NO) pulmonary diffusing capacity (DL(NO)) multiplied by alveolar NO partial pressure (PA(NO)) provide values for alveolar NO production (VA(NO)). We evaluated applying a rapidly responding chemiluminescent NO analyzer to measure DL(NO) during a single, constant exhalation (Dex(NO)) or by rebreathing (Drb(NO)). With the use of an initial inspiration of 5-10 parts/million of NO with a correction for the measured NO back pressure, Dex(NO) in nine healthy subjects equaled 125 +/- 29 (SD) ml x min(-1) x mmHg(-1) and Drb(NO) equaled 122 +/- 26 ml x min(-1) x mmHg(-1). These values were 4.7 +/- 0.6 and 4.6 +/- 0.6 times greater, respectively, than the subject's single-breath carbon monoxide diffusing capacity (Dsb(CO)). Coefficients of variation were similar to previously reported breath-holding, single-breath measurements of Dsb(CO). PA(NO) measured in seven of the subjects equaled 1.8 +/- 0.7 mmHg x 10(-6) and resulted in VA(NO) of 0.21 +/- 0.06 microl/min using Dex(NO) and 0.20 +/- 0.6 microl/min with Drb(NO). Dex(NO) remained constant at end-expiratory oxygen tensions varied from 42 to 682 Torr. Decreases in lung volume resulted in falls of Dex(NO) and Drb(NO) similar to the reported effect of volume changes on Dsb(CO). These data show that rapidly responding chemiluminescent NO analyzers provide reproducible measurements of DL(NO) using single exhalations or rebreathing suitable for measuring VA(NO).     

Exercise-induced oxyhemoglobin desaturation and pulmonary diffusing capacity during high-intensity exercise

The purpose of this investigation was to examine if exercise-induced arterial oxyhemoglobin desaturation selectively observed in highly trained endurance athletes could be related to differences in the pulmonary diffusing capacity (D _L) measured during exercise. The D _L of 24 male endurance athletes was measured using a 3-s breath-hold carbon monoxide procedure (to give D _LCO) at rest as well as during cycling at 60% and 90% of these previously determined O_2max. Oxyhemoglobin saturation (S _aO₂%) was monitored throughout both exercise protocols using an Ohmeda Biox II oximeter. Exercise-induced oxyhemoglobin desaturation (DS) (S _aO₂% < 91% at O_2max) was observed in 13 subjects [88.2 (0.6)%] but not in the other 11 nondesaturation subjects [NDS: 92.9 (0.4)%] (P ≤ 0.05), although O_2max was not significantly different between the groups [DS: 4.34 (0.65) l / min vs NDS: 4.1 (0.49) l / min]. At rest, no differences in either D _LCO [m1 CO · mmHg⁻¹ · min⁻¹: 41.7 (1.7) (DS) vs 41.1 (1.8) (NDS)], D _LCO / _A [8.2 (0.4) (DS) vs 7.3 (0.9) (NDS)], MVV [l / min: 196.0 (10.4) (DS) vs 182.0 (9.9) (NDS)] or FEV₁/FVC [86.3 (2.2) (DS) vs 82.9 (4.7) (NDS)] were found between groups (P ≥ 0.05). However, _E /O₂ at O_2max was lower in the DS group [33.0 (1.1)] compared to the NDS group [36.8 (1.5)] (P ≤ 0.05). Exercise D _LCO (m1 CO · mmHg⁻¹ · min⁻¹) was not different between groups at either 60% O_2max [DS: 55.1 (1.4) vs NDS: 57.2 (2.1)] or at 90% O_2max [DS: 61.0 (1.8) vs NDS: 61.4 (2.9)]. A significant relationship (r = 0.698) was calculated to occur between S _aO₂% and _E /O₂ during maximal exercise. The present findings indicate that the exercise-induced oxyhemoglobin desaturation seen during submaximal and near-maximal exercise is not related to differences in D _L, although during maximal exercise S _aO₂ may be limited by a relatively lower exercise ventilation. Accepted: 25 September 1996     

Evolution of pulmonary diffusing capacity in man during high altitude acclimatization]

Pulmonary diffusing capacity (DLCO) has been measured at 3500 m in highlander and lowlander subjects. DLCO is more elevated in highlanders than in lowlanders. In these subjects, a transient increase of DLCO is observed during the first hours of hypoxia which is related to transient changes in pulmonary circulation.     

Pulmonary diffusing capacity and pulmonary capillary blood volume during parabolic flights

Vaïda, Pierre, Christian Kays, Daniel Rivière,Pierre Téchoueyres, and Jean-Luc Lachaud.Pulmonary diffusing capacity and pulmonary capillary blood volumeduring parabolic flights. J. Appl.Physiol. 82(4): 1091-1097, 1997.Data from theSpacelab Life Sciences-1 (SLS-1) mission have shown sustained butmoderate increase in pulmonary diffusing capacity(DL). Because of the occupational constraints of the mission, data were only obtained after24 h of exposure to microgravity. Parabolic flights are often used tostudy some effects of microgravity, and we measured changes inDL occurring at the very onsetof weightlessness. Measurements ofDL, membrane diffusing capacity,and pulmonary capillary blood volume were made in 10 male subjectsduring the 20-s 0-G phases of parabolic flights performed by the"zero-G" Caravelle aircraft. Using the standardized single-breathtechnique, we measuredDL for CO andnitric oxide simultaneously. We found significant increases inDL for CO (62%),in membrane diffusing capacity for CO (47%), inDL for nitric oxide (47%), andin pulmonary capillary blood volume (71%). We conclude that majorchanges in the alveolar membrane gas transfers and in the pulmonarycapillary bed occur at the very onset of microgravity. Because thesechanges are much greater than those reported during sustainedmicrogravity, the effects of rapid transition from hypergravity tomicrogravity during parabolic flights remain questionable.

     

Characteristics of pulmonary diffusing capacity for CO at rest and during exercise

Characteristic patterns of changes in pulmonary diffusing capacity (DL) at rest and during exercise were investigated and characteristics of normal DL values concerned on sex, age, and ethnic groups were examined by viewing our studies and other reports. The relation of DL and pulmonary capillary blood volume (Vc) was represented as a logarithmic regression at rest and as a linear regression during exercise. The curve relation at rest is considered to show that the increase in Vc mainly reflects the process of transport from pulmonary capillary recruitment to pulmonary capillary dilation. The increasing rate of DL was not decreased during exercise, which seemed to be due to an increase in pulmonary blood flow accompanying exercise. The linear regression was also found between DL and oxygen intake during exercise and the slope was always constant among individuals and among subject groups. The general results concerned with sex difference in Japanese or ethnic difference between Japanese and Caucasians in both sexes could show that DL per stature was greater in males or Caucasians than in females or Japanese in young adults, however, the sex or ethnic difference disappeared in middle or old aged group. DL per alveolar volume which showed no sex or ethnic difference in young adults, was greater in middle or old aged group of females or Japanese than in that of males or Caucasians.     

Temporal effects in the estimation of pulmonary diffusing capacity

Steady state estimates of the pulmonary diffusing capacity for carbon monoxide (DLCO) require measurement of the uptake and the average alveolar partial pressure of carbon monoxide (PACO). The expired alveolar sample obtained by different experimental methods and/or breathing patterns rarely represents the actual PACO. It is widely accepted that nonuniform distribution of ventilation, diffusion and perfusion causes discrepancies in the measurement of diffusing capacity. tan additional source of error in choosing PACO arises in the sampling time chosen by the experimental method. A theoretical study of a ramp-with-pause and a square breathing pattern demonstrates that the sample-time error exists even in the homogeneous lung. The study shows for the homogeneous lung that the correct fractional concentration of alveolar carbon monoxide (FAV) occurs at a time (TAV), one-half of a breathing period after the effective inspiration time (TI) for the two very different breathing patterns. TI is well-defined in relation to any breathing pattern which can be approximated by ramps and pauses. If TAV and the sample time chosen by the experimental method are known, then the measured DLCO can be corrected to the actual diffusing capacity (DL). The theory agrees with experimental results and computer simulations of inhomogeneous lungs from the literature. This agreement suggests that the theory for the homogeneous lung is also relevant to the inhomogeneous lung.