The authors declare that they have no competing interests.
JP, DIB and CD2 designed the cohort design and analysis plan. Analyses were performed by CD2. All authors (JP, LP, CP, RB, HN, CD2 and DIB) contributed to recruitment, data collection, discussion of results and final approval of the submitted manuscript.
DLCO is the product of the CO transfer coefficient (KCO) by the “accessible” alveolar volume (VA). In theory, the same DLCO may result from various combinations of KCO and VA values, each of which reflect different injury sites and mechanisms. We sought to determine in this study the potential variability of both VA and KCO for fixed values of DLCO in diffuse parenchymal lung diseases (DPLD).
To this end, we designed a retrospective, cross-sectional study of three distinct types of DPLD and analysed pulmonary function test (PFT) datasets.
We show here that for the same value of DLCO (50 % predicted), KCO varied from 60 to 95 % predicted and VA from 55 to 85 % predicted in various types of DPLD idiopathic pulmonary fibrosis, sarcoidosis and connective tissue disease-associated DPLD, indicating distinct pathogenic mechanisms in these diseases. In addition, a comparison of VA with total lung capacity may help to evidence the distal airway obstruction sometimes associated with certain DPLD particularly sarcoidosis.
Clinicians should take into account not only DLCO but also VA and KCO values when managing patients with DPLD.
Van der Lee I, Zanen P, van den Bosch JMM, Lammers J-WJ. Pattern of diffusion disturbance related to clinical diagnosis: The K(CO) has no diagnostic value next to the DL(CO). Respir Med janv. 2006;100(1):101–9. CrossRef
Corte TJ, Wort SJ, MacDonald PS, Edey A, Hansell DM, Renzoni E, et al. Pulmonary function vascular index predicts prognosis in idiopathic interstitial pneumonia. Respirol Carlton Vic mai. 2012;17(4):674–80. CrossRef
Peelen L, Wells AU, Prijs M, Blumenthal JP, van Steenwijk RP, Jonkers RE, et al. Fibrotic idiopathic interstitial pneumonias: mortality is linked to a decline in gas transfer. Respirol Carlton Vic nov. 2010;15(8):1233–43. CrossRef
Berend N. Respiratory disease and respiratory physiology: Putting lung function into perspective interstitial lung disease. Respirol Carlton Vic oct. 2014;19(7):952–9. CrossRef
Wanger J, Clausen JL, Coates A, Pedersen OF, Brusasco V, Burgos F, et al. Standardisation of the measurement of lung volumes. Eur Respir J sept. 2005;26(3):511–22. CrossRef
Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. Eur Respir J juill. 2005;26(1):153–61. CrossRef
Macintyre N, Crapo RO, Viegi G, Johnson DC, van der Grinten CPM, Brusasco V, et al. Standardisation of the single-breath determination of carbon monoxide uptake in the lung. Eur Respir J oct. 2005;26(4):720–35. CrossRef
Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl mars. 1993;16:5–40. CrossRef
Roberts CM, MacRae KD, Seed WA. Multi-breath and single breath helium dilution lung volumes as a test of airway obstruction. Eur Respir J mai. 1990;3(5):515–20.
Chevalier-Bidaud B, Gillet-Juvin K, Callens E, Chenu R, Graba S, Essalhi M, et al. Non specific pattern of lung function in a respiratory physiology unit: causes and prevalence: results of an observational cross-sectional and longitudinal study. BMC Pulm Med. 2014;14:148. CrossRefPubMedPubMedCentral
- Different KCO and VA combinations exist for the same DLCO value in patients with diffuse parenchymal lung diseases
- BioMed Central
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