Standardisation and application of the single-breath determination of nitric oxide uptake in the lung.
Diffusing capacity of the lung for nitric oxide (DLNO), otherwise known as the transfer factor, was first measured in 1983. This document standardises the technique and application of single-breathDLNOThis panel agrees that 1) pulmonary function systems should allow for mixing and measurement of both nitric oxide (NO) and carbon monoxide (CO) gases directly from an inspiratory reservoir just before use, with expired concentrations measured from an alveolar "collection" or continuously sampledviarapid gas analysers; 2) breath-hold time should be 10 s with chemiluminescence NO analysers, or 4-6 s to accommodate the smaller detection range of the NO electrochemical cell; 3) inspired NO and oxygen concentrations should be 40-60 ppm and close to 21%, respectively; 4) the alveolar oxygen tension (PAO2) should be measured by sampling the expired gas; 5) a finite specific conductance in the blood for NO (θNO) should be assumed as 4.5 mL·min-1·mmHg-1·mL-1of blood; 6) the equation for 1/θCO should be (0.0062·PAO2+1.16)·(ideal haemoglobin/measured haemoglobin) based on breath-holdingPAO2and adjusted to an average haemoglobin concentration (male 14.6 g·dL-1, female 13.4 g·dL-1); 7) a membrane diffusing capacity ratio (DMNO/DMCO) should be 1.97, based on tissue diffusivity.
Dept of Respiratory Therapy, Georgia State University, Atlanta, GA, USA zavorsky@gsu.edu.
Gerald S
0000-0002-4473-1601
GS
Zavorsky
Dept of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Connie C W
CC
Hsia
National Heart and Lung Institute, Imperial College, London, UK.
J Michael B
JM
Hughes
Dept of Medicine, University of Cambridge, Hinchingbrooke Hospital, Huntingdon, UK.
Colin D R
CD
Borland
Dept of Physiology and Pulmonary Laboratory, University of Bordeaux and CHU, Bordeaux, France.
Hervé
H
Guénard
Dept of Pulmonary Diseases, Spaarne Hospital, Hoofddorp, The Netherlands.
Ivo
I
van der Lee
Pulmonary Laboratory, Isala Hospital, Zwolle, The Netherlands.
Irene
I
Steenbruggen
Dept of Cardiology, Erasme University Hospital, Brussels, Belgium.
Robert
R
Naeije
Dept of Statistics and Actuarial Science, Simon Fraser University, Burnaby, BC, Canada.
Jiguo
J
Cao
Dept of Physiology, Cochin Hospital, Paris Descartes University, Paris, France.
Anh Tuan
AT
Dinh-Xuan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001810:Blood Volume; D002199:Capillary Permeability; D002248:Carbon Monoxide / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood*; D010100:Oxygen / Q000097:blood; D011650:Pulmonary Alveoli / Q000098:blood supply*; D011653:Pulmonary Diffusing Capacity / Q000592:standards*; D055815:Young Adult
D006454:Hemoglobins; D009569:Nitric Oxide; D002248:Carbon Monoxide; D010100:Oxygen