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Reappraisal of DLCO adjustment to interpret the adaptive response of the air-blood barrier to hypoxia.
- Source :
-
Respiratory physiology & neurobiology [Respir Physiol Neurobiol] 2017 Apr; Vol. 238, pp. 59-65. Date of Electronic Publication: 2016 Sep 03. - Publication Year :
- 2017
-
Abstract
- DLCO measured in hypoxia must be corrected due to the higher affinity (increase in coefficient θ) of CO with Hb. We propose an adjustment accounting for individual changes in the equation relating DLCO to subcomponents Dm (membrane diffusive capacity) and Vc (lung capillary volume): 1/DLCO=1/Dm+1/θVc. We adjusted the individual DLCO measured in hypoxia (HA, 3269m) by interpolating the 1/DLCO to the sea level (SL) 1/θ value. Nineteen healthy subjects were studied at SL and HA. Based on the proposed adjustment, DLCO increased in HA in 53% of subjects, reflecting the increase in Dm that largely overruled the decrease in Vc. We hypothesize that a decrease in Vc (buffering microvascular filtration) and the increase in Dm (possibly resulting from a decrease in thickness of the air-blood barrier) represent the anti-edemagenic adaptation of the lung to hypoxia exposure. The efficiency of this adaptation varied among subjects as DLCO did not change in 31% of subjects and decreased in 16%.<br /> (Copyright © 2016 Elsevier B.V. All rights reserved.)
- Subjects :
- Adult
Blood Gas Analysis
Blood Volume physiology
Carbon Monoxide metabolism
Female
Healthy Volunteers
Hemoglobins metabolism
Humans
Male
Respiratory Function Tests
Statistics as Topic
Blood-Air Barrier physiopathology
Hypoxia pathology
Hypoxia physiopathology
Pulmonary Diffusing Capacity physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1878-1519
- Volume :
- 238
- Database :
- MEDLINE
- Journal :
- Respiratory physiology & neurobiology
- Publication Type :
- Academic Journal
- Accession number :
- 27595980
- Full Text :
- https://doi.org/10.1016/j.resp.2016.08.009