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Related Experiment Videos

Clinical significance of elevated diffusing capacity.

Ghulam Saydain1, Kenneth C Beck, Paul A Decker

  • 1Pulmonary and Critical Care Division, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, USA. gsaydain@numc.edu

Chest
|February 11, 2004
PubMed
Summary
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A high diffusing capacity of the lung for carbon monoxide (DLCO) in pulmonary function tests is often linked to larger lung volumes, obesity, and asthma. These factors can mask underlying conditions that would typically lower DLCO.

Area of Science:

  • Pulmonary Medicine
  • Respiratory Physiology
  • Diagnostic Testing

Background:

  • The single-breath diffusing capacity of the lung for carbon monoxide (DLCO) is a key pulmonary function test (PFT) assessing lung gas exchange.
  • While the clinical implications of a low DLCO are established, the significance of an elevated DLCO remains less understood.
  • Understanding high DLCO is crucial for accurate interpretation of PFT results.

Purpose of the Study:

  • To investigate the clinical correlates and significance of an elevated DLCO.
  • To identify patient characteristics and diagnoses associated with high DLCO values.
  • To clarify the clinical context in which DLCO may appear deceptively normal.

Main Methods:

  • A retrospective analysis of 45,000 PFT results from January 1997 to December 1999.

Related Experiment Videos

  • Identification of 245 patients with high DLCO (>140% predicted) and a matched control group with normal DLCO (85-115% predicted).
  • Comparison of demographic data, clinical diagnoses, and PFT parameters between the high DLCO and normal DLCO groups.

    • Main Results:

    • Patients with high DLCO exhibited significantly greater weight, body mass index, body surface area, total lung capacity, and alveolar volume.
    • Obesity and asthma were diagnosed more frequently in the high DLCO group (62% had either or both).
    • Conditions like polycythemia, hemoptysis, and left-to-right shunt were rarely observed in patients with high DLCO.

    Conclusions:

    • Elevated DLCO in PFTs is predominantly associated with increased lung volumes, obesity, and asthma.
    • These conditions can lead to a high DLCO, potentially masking other clinical issues that might otherwise reduce DLCO.
    • A high DLCO finding warrants consideration of these associated factors for comprehensive patient assessment.