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Diffusing capacity for carbon monoxide as a predictor of gas exchange during exercise
The New England Journal of Medicine
|May 21, 1987
Summary
Diffusing capacity for carbon monoxide (DLCO) at rest is specific but insensitive for predicting abnormal exercise gas exchange in lung disease. Arterial blood gas measurements during exercise are more sensitive indicators.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
Background:
- Diffusing capacity for carbon monoxide (DLCO) is a common measure for lung disease.
- Abnormal arterial blood gases during exercise are more sensitive indicators of lung dysfunction.
Purpose of the Study:
- To compare resting DLCO with exercise gas exchange measurements.
- To evaluate DLCO's sensitivity and specificity in predicting exercise impairment.
Main Methods:
- Compared resting single-breath DLCO with exercise gas exchange (arterial oxygen, alveolar-arterial oxygen difference, arterial-end-tidal CO2 difference, dead-space/tidal-volume ratio).
- Studied 276 shipyard workers (current and former).
Main Results:
- 14 of 16 workers with low DLCO (<70% predicted) had abnormal exercise gas exchange.
- Only 14 of 96 workers with abnormal exercise gas exchange had low DLCO.
- Resting DLCO could not predict the type or severity of exercise gas exchange abnormalities.
Conclusions:
- Resting DLCO is a specific but insensitive predictor of abnormal exercise gas exchange.
- Exercise arterial blood gas measurements are recommended for sensitive detection of lung disease manifestations.