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Pulmonary diffusing capacity for nitric oxide in disease: a scoping review.

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Single-breath pulmonary diffusing capacity for nitric oxide (D_LNO) shows promise in detecting lung changes across various diseases. Larger studies are needed to fully understand D_LNO

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Area of Science:

  • Pulmonary physiology
  • Respiratory medicine
  • Diagnostic techniques

Background:

  • Single-breath pulmonary diffusing capacity for nitric oxide (D_LNO) is an emerging measure.
  • Its application across diverse clinical conditions requires comprehensive mapping.

Purpose of the Study:

  • To map existing research on D_LNO in various diseases.
  • To identify research gaps in the study of D_LNO.

Main Methods:

  • A scoping review methodology was employed.
  • Systematic literature searches were conducted across major databases (Embase, MEDLINE, PubMed, Scopus, Web of Science, Cochrane Library) from 1983 to 2025.
  • Data extraction and screening were performed using Rayyan and REDCap.

Main Results:

  • 69 studies met eligibility criteria, covering respiratory, immunological, post-COVID-19, cardiovascular, and metabolic conditions.
  • Significant heterogeneity in study design, small sample sizes (62.3% <50 participants), and lack of registered protocols were noted.
  • D_LNO demonstrated sensitivity in detecting interstitial/fibrotic changes and, with D_LCO, identified vascular-haematological perturbations.

Conclusions:

  • Single-breath D_LNO and D_LCO measurements offer insights into diffusion resistance and vascular-haematological status.
  • Larger, well-designed studies are necessary to establish clear interpretations of D_LNO across different disease states.