Different KCO and VA combinations exist for the same DLCO value in patients with diffuse parenchymal lung diseases.
BACKGROUND
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).


METHODS
To this end, we designed a retrospective, cross-sectional study of three distinct types of DPLD and analysed pulmonary function test (PFT) datasets.


RESULTS
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.


CONCLUSIONS
Clinicians should take into account not only DLCO but also VA and KCO values when managing patients with DPLD.
Université Paris Descartes, Sorbonne Paris Cité and AP-HP, Service de Pneumologie, Hôpital Européen Georges Pompidou, Paris, France. jean.pastre@egp.aphp.fr.
Jean
J
Pastre
Université Paris Diderot, Sorbonne Paris Cité and AP-HP, Service de Physiologie, Hôpital Bichat-Claude Bernard, Paris, France. laurent.plantier@aphp.fr.
Laurent
L
Plantier
Université Paris 13, Sorbonne Paris Cité and AP-HP, Service de Physiologie, Hôpital Avicenne, Bobigny, France. carole.planes@aphp.fr.
Carole
C
Planes
Université Paris Descartes, Sorbonne Paris Cité and AP-HP, Service de Pneumologie, Hôpital Bichat-Claude Bernard, Paris, France. raphael.borie@aphp.fr.
Raphaël
R
Borie
Université Paris 13, Sorbonne Paris Cité and AP-HP, Service de Pneumologie, Hôpital Avicenne, Bobigny, France. hilario.nunes@aphp.fr.
Hilario
H
Nunes
Université Paris Descartes, Sorbonne Paris Cité and AP-HP, Service de Physiologie, Hôpital Européen Georges Pompidou, Paris, France. christophe.delclaux@egp.aphp.fr.
Christophe
C
Delclaux
Université Paris Descartes, Sorbonne Paris Cité and AP-HP, Service de Pneumologie, Hôpital Européen Georges Pompidou, Paris, France. dominique.israel-biet@egp.aphp.fr.
Dominique
D
Israël-Biet
D000368:Aged; D000402:Airway Obstruction / Q000503:physiopathology; D002248:Carbon Monoxide / Q000737:chemistry*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D017563:Lung Diseases, Interstitial / Q000145:classification* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011653:Pulmonary Diffusing Capacity / Q000502:physiology*; D012189:Retrospective Studies; D014109:Total Lung Capacity / Q000502:physiology*
D002248:Carbon Monoxide