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Updated: May 5, 2026

Author Spotlight: Integrating Alveolar-Capillary Reserve Measurements in Exercise Adaptation and Therapeutic Strategies
Published on: February 2, 2024
[Pulmonary CO/NO transfer: physiological basis, technical aspects and clinical impact].
B Degano1, F Perrin2, T Soumagne1
1Physiologie-explorations fonctionnelles, EA 3920, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France.
The single-breath transfer factor for nitric oxide (TL,NO) better assesses alveolar-capillary membrane diffusion than carbon monoxide (TL,CO), which is affected by red blood cells. Both methods offer insights into lung pathologies.
Area of Science:
- Pulmonary Physiology
- Respiratory Medicine
Context:
- Alveolar-capillary membrane and capillary blood vessel diseases impair pulmonary gas exchange and lung diffusion.
- The single-breath transfer factor for carbon monoxide (TL,CO) is the standard method for measuring gas transfer to pulmonary capillary blood.
Purpose:
- To explore pulmonary gas exchange using the transfer factor for nitric oxide (TL,NO).
- To compare TL,NO with TL,CO for assessing the diffusing capacity of the alveolar-capillary membrane and pulmonary capillary blood volume.
Summary:
- TL,NO is a superior index for alveolar-capillary membrane diffusing capacity, whereas TL,CO is more influenced by red blood cell resistance.
- The Roughton-Forster equation can derive membrane diffusing capacity (DM) and pulmonary capillary blood volume (Vc) from both TL,CO and TL,NO.
- These derived parameters offer additional insights into pulmonary pathologies.
Impact:
- TL,NO provides an alternative method for investigating the alveolar membrane and gas-blood interactions.
- Further clinical studies are needed to precisely define the impact of combined CO/NO transfer measurements in diagnosing lung diseases.
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