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Related Concept Videos

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External respiration occurs in the lungs, and it is the first step in the journey of oxygen inside the body. When we inhale, oxygen enters our lungs and diffuses across the thin alveolar membrane. The alveoli are tiny, air-filled sacs that provide a vast surface area for gas exchange. Oxygen in the alveoli has a higher partial pressure (105 mmHg) than in the adjacent pulmonary capillaries (40 mmHg), establishing a pressure gradient. As a result, oxygen molecules move from the alveoli into the...
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Assessing the respiratory rate and rhythm for a complete minute is crucial for evaluating the breathing pattern. Even a minor increase in the patient's average respiratory rate, by as little as three to five breaths per minute, is an early and vital indicator of respiratory distress. Patients with a respiratory rate exceeding twenty-four breaths per minute require close monitoring to determine the physiological alterations. This careful observation is essential for prompt recognition and...
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The respiratory system is responsible for the intake of oxygen and the expulsion of carbon dioxide from the body. Respiratory volumes describe the volume of air in the lungs at different phases of the respiratory cycle. Tidal volume is the air breathed in and out during normal, quiet breathing. Inspiratory reserve volume is the air that can be forcefully inspired beyond the tidal volume. In contrast, expiratory reserve volume refers to the air that can be expelled from the lungs after a normal...
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Author Spotlight: Integrating Alveolar-Capillary Reserve Measurements in Exercise Adaptation and Therapeutic Strategies
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Intersession Variability in Single-Breath Diffusing Capacity of Carbon Monoxide.

Hemang Yadav1, Paul Scanlon1, Timothy Aksamit1

  • 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.

Chest
|September 18, 2025
PubMed
Summary
This summary is machine-generated.

Diffusing capacity for carbon monoxide (Dlco) shows significant variability in clinical practice, exceeding typical thresholds. New evidence-based guidelines and a 3-tier system help interpret these Dlco changes accurately.

Keywords:
clinical thresholdsdiffusing capacitydiffusing capacity of the lung for carbon monoxideintersession variabilitypulmonary function testing

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Area of Science:

  • Pulmonary Function Testing
  • Cardiorespiratory Disease Diagnosis
  • Clinical Measurement Variability

Background:

  • Diffusing capacity for carbon monoxide (Dlco) is vital for cardiorespiratory disease management.
  • Current clinical guidelines lack thresholds to differentiate significant Dlco changes from normal variability.

Purpose of the Study:

  • To quantify Dlco intersession variability in routine clinical practice.
  • To identify determinants of Dlco variability.
  • To establish evidence-based thresholds for interpreting serial Dlco measurements.

Main Methods:

  • Analysis of data from 5,069 patients with stable spirometry and at least two hemoglobin-adjusted Dlco measurements.
  • Assessment of absolute difference, percent predicted difference, and relative percentage difference in Dlco.
  • Development of a 3-tier grading system and a hybrid approach with Dlco-specific thresholds.

Main Results:

  • Substantial intersession Dlco variability was observed, with 90th percentile values exceeding conventional thresholds.
  • Factors like higher baseline Dlco, lower hemoglobin, male sex, and restrictive patterns influenced absolute variability.
  • Measurement variability increases with Dlco magnitude, necessitating baseline-specific interpretation thresholds.

Conclusions:

  • Diffusing capacity for carbon monoxide (Dlco) exhibits significant intersession variability in clinical settings.
  • Established evidence-based thresholds and a 3-tier classification system aid in distinguishing clinically significant Dlco changes.
  • Practical tools are provided for accurate interpretation of serial Dlco measurements in cardiorespiratory disease monitoring.