Lung diffusing capacity and red blood cell volume

The aim of this study was to test whether a large surface to volume ratio of the red blood cells is advantageous for O2 transfer in lungs. Suspensions of washed large (human) and small (sheep) red blood cells were used to perfuse in random order isolated cat lungs (n = 7). The lungs were kept at 27 degrees C, ventilated with 1.0 l/min and perfused with 110 ml/min. Hemoglobin concentration was 70 g/l. Assuming an inhomogeneous lung with an alveolar dead space compartment, pulmonary diffusing capacity for O2 (DLO2) was 0.53 +/- 0.10 ml.min-1.mmHg-1 (mean +/- SD) when perfusing with sheep red cells and 0.52 +/- 0.13 with human red cells. On the basis of a lung model with a low VA/Q and a high VA/Q compartment the values were 0.86 and 0.93. Thus, DLO2 was not larger with smaller red blood cells, i.e. with higher red cell surface area per blood volume. Possible explanations for this unexpected result are discussed.