Diffusing Capacity of the Lungs for Carbon Monoxide Essay

Diffusing Capacity of the Lungs for Carbon Monoxide Essay

Diffusing Capacity of the Lungs for Carbon Monoxide Essay

What is DLCO? and what does it measure

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Diffusing Capacity of the Lungs for Carbon Monoxide

Diffusing Capacity of the Lungs for Carbon Monoxide
Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO) is a measurement that assesses the ability of the lungs ability to transfer gas from inspired air to the bloodstream. It measures carbon monoxide transfer from alveolar gas to hemoglobin in pulmonary capillary blood. DLCO is measured by having the patient fully inhale a low concentration of carbon monoxide and an inert tracer gas (MacIntyre et al., 2022). During a 10-second breath-hold, DLCO measures the uptake of CO per unit time per mm of driving pressure of CO (cc of CO/sec/mm of Hg).
DLCO is measured using Single breath, Intrabreath, and Rebreathing techniques. In the single-breath technique, the patient is initially instructed to take normal resting breaths followed by full expiration up to residual volume. The patient is then instructed to rapidly inhale the test gas up to vital capacity and hold their breath for 10 seconds at total lung capacity (Modi & Cascella, 2023). After that, the patient breathes out completely, and the exhaled gas is collected for analysis after ruling out the initial amount of gas from dead space. In the intrabreath method, DLCO is calculated when breathing out. The air that exits during the initial phase of exhalation has less time to diffuse from alveoli to capillaries and has a higher concentration of CO than the gas during the later stages of expiration.
DLCO is indicated in assessing parenchymal and non-parenchymal lung diseases alongside spirometry. It is also used to assess the severity of obstructive and restrictive lung diseases, pulmonary vascular disease, and preoperative risk (Modi & Cascella, 2023). However, it is contraindicated in patients with oral or facial pain, chest, and abdominal pain, dementia, or stress incontinence.

References
MacIntyre, N., Balasubramanian, A., & Kaminsky, D. (2022). Diffusing Capacity of the Lungs for Carbon Monoxide Test. JAMA, 327(5), 480-481. doi:10.1001/jama.2021.24323
Modi, P., & Cascella, M. (2023). Diffusing Capacity Of The Lungs For Carbon Monoxide. In StatPearls. StatPearls Publishing.