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Evaluation of lung diffusing capacity by physiological and morphometric techniques.

J D Crapo1, R O Crapo, R L Jensen

  • 1Department of Medicine, Duke University, Durham, North Carolina 27710.

Journal of Applied Physiology (Bethesda, Md. : 1985)
|May 1, 1988
PubMed
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Physiological methods underestimate the membrane component of diffusing capacity for CO (DmCO) by over tenfold compared to morphometric analysis. This discrepancy in DmCO measurement is due to factors affecting carbon monoxide binding to hemoglobin.

Area of Science:

  • Pulmonary Physiology
  • Respiratory Medicine
  • Biophysics

Background:

  • Significant discrepancies exist between physiological and morphometric techniques for measuring pulmonary diffusing capacity for carbon monoxide (DLCO).
  • These differences extend to DLCO's primary components: the membrane component (DmCO) and pulmonary capillary blood volume (Vc).

Purpose of the Study:

  • To investigate and reconcile the differing values of DLCO and its components obtained from physiological versus morphometric measurement methods.
  • To evaluate the accuracy of current physiological techniques in estimating DmCO and Vc.

Main Methods:

  • Measurements of DLCO, DmCO, and Vc were performed on isolated, perfused dog lungs using multiple gas-rebreathing techniques.
  • The same lungs were subsequently perfusion-fixed for detailed morphometric analysis of DLCO components.

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  • Morphometric estimates were compared with concurrently measured physiological values.

    • Main Results:

    • Morphometric estimates of pulmonary capillary blood volume (Vc) closely matched physiological measurements.
    • Morphometric DmCO values were over 10 times higher than those estimated using physiological techniques.
    • Perfusion fixation minimally impacted morphometric DmCO estimates compared to previous studies using inflation fixation.

    Conclusions:

    • Physiological methods significantly underestimate DmCO, likely due to uncharacterized factors influencing carbon monoxide binding to hemoglobin in vivo.
    • The Roughton-Forster relationship, used in physiological assessments, may be unreliable for accurately determining DmCO and Vc due to unknown variables.
    • Further research is needed to elucidate the in vivo factors affecting CO-hemoglobin binding and refine DLCO measurement techniques.