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Diffusing capacity for nitric oxide: reference values and dependence on alveolar volume.

Ivo van der Lee1, Pieter Zanen, Nadine Stigter

  • 1Department of Pulmonary Medicine, Spaarne Hospital, P.O. Box 770, 2130 AT Hoofddorp, The Netherlands. vdlee@tiscali.nl

Respiratory Medicine
|January 19, 2007
PubMed
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Nitric oxide (NO) diffusing capacity (DLNO) is a better measure of lung membrane diffusion than carbon monoxide (CO) diffusing capacity (DLCO). New reference equations for DLNO and K(NO) were generated for healthy individuals.

Area of Science:

  • Pulmonary Physiology
  • Respiratory Medicine
  • Gas Exchange

Background:

  • Nitric oxide (NO) exhibits a higher affinity for hemoglobin than carbon monoxide (CO).
  • Diffusing capacity for NO (DLNO) is less affected by capillary blood volume variations compared to diffusing capacity for CO (DLCO).
  • DLNO is considered a more accurate reflection of the lung's membrane diffusing capacity.

Purpose of the Study:

  • To establish reference equations for DLNO and K(NO) in healthy adults.
  • To compare the relationship of DLNO and K(NO) with alveolar volume (VA).
  • To evaluate K(NO) as a superior index for diffusion capacity per unit lung volume.

Main Methods:

  • Combined single-breath DLNO/DLCO measurements were performed in 124 healthy subjects.

Related Experiment Videos

  • Reference equations for DLNO and K(NO) were derived based on height and age.
  • Measurements were repeated at varying inspiratory levels in a subset of 21 subjects.

    • Main Results:

    • Reference equations for DLNO and K(NO) were established for both females and males.
    • DLNO showed a strong correlation with alveolar volume (VA), while K(NO) was largely independent of VA.
    • K(CO) (DLCO/VA) increased with decreasing VA, suggesting altered blood volume per unit lung volume.

    Conclusions:

    • K(NO) is proposed as a more reliable index for diffusion capacity per unit lung volume (transfer coefficient) than K(CO).
    • The independence of K(NO) from VA makes it a more precise measure of the lung's diffusion characteristics.
    • Established reference equations provide a baseline for assessing DLNO and K(NO) in clinical settings.