Red cell distortion and conceptual basis of diffusing capacity estimates: finite element analysis

Hsia, C. C. W., C. J. C. Chuong, and R. L. Johnson, Jr.Red cell distortion and conceptual basis of diffusing capacity estimates: finite element analysis. J. Appl.Physiol. 83(4): 1397-1404, 1997.To understandthe effects of dynamic shape distortion of red blood cells (RBCs) as itdevelops under high-flow conditions on the standard physiological andmorphometric methods of estimating pulmonary diffusing capacity, wecomputed the uptake of CO across a two-dimensional geometric capillarymodel containing a variable number of equally spaced RBCs. RBCs arecircular or parachute shaped, with the same perimeter length. Total COdiffusing capacity (DL_CO)and membrane diffusing capacity(DM_CO)were calculated by a finite element method.DL_COcalculated at two levels of alveolar PO₂ were used to estimateDM_CO by theRoughton-Forster (RF) technique. The same capillary model was subjectedto morphometric analysis by the random linear intercept method toobtain morphometric estimates ofDM_CO. Results show thatshape distortion of RBCs significantly reduces capillary diffusive gasuptake. Shape distortion exaggerates the conceptual errors inherent inthe RF technique (J. Appl. Physiol.79: 1039-1047, 1995); errors are exaggerated at a high capillaryhematocrit. Shape distortion also introduces additional error inmorphometric estimates ofDM_CO causedby a biased sampling distribution of random linear intercepts; errors are exaggerated at a low capillary hematocrit.