CO and NO pulmonary diffusing capacity during pregnancy: Safety and diagnostic potential

Zavorsky, Gerald S.; Blood, Arlin B.; Power, Gordon G.; Longo, Lawrence D.; Artal, Raúl; Vlastos, Emanuel

doi:10.1016/j.resp.2010.02.001

Cited by 12 publications

(6 citation statements)

References 113 publications

(142 reference statements)

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“…There are no contraindications for DLNO and DLCO measurements other than patients who are unable to understand or collaborate to the procedure or unwilling to provide consent. Children aged <18 years are allowed to undergo DLNO and DLCO measurements, as are pregnant subjects [112].…”

Section: Contraindications To Dlno and Dlco Assessmentsmentioning

confidence: 99%

Standardisation and application of the single-breath determination of nitric oxide uptake in the lung

et al. 2017

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Diffusing capacity of the lung for nitric oxide (), otherwise known as the transfer factor, was first measured in 1983. This document standardises the technique and application of single-breath This 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 sampled rapid 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 ( ) 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·mmHg·mL of blood; 6) the equation for 1/θCO should be (0.0062· +1.16)·(ideal haemoglobin/measured haemoglobin) based on breath-holding and adjusted to an average haemoglobin concentration (male 14.6 g·dL, female 13.4 g·dL); 7) a membrane diffusing capacity ratio (/) should be 1.97, based on tissue diffusivity.

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Section: Contraindications To Dlno and Dlco Assessmentsmentioning

confidence: 99%

Standardisation and application of the single-breath determination of nitric oxide uptake in the lung

et al. 2017

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“…Early after conception, major hemodynamic changes begin, reaching a peak during the 2 nd trimester. Some studies have shown a slight decrease in diffusing capacity of the lung for carbon monoxide (DLCO) [28]. Systemic vascular resistances tend to decrease while heart rate accelerates.…”

Section: Physiological Changes During Pregnancymentioning

confidence: 99%

Special considerations in pregnant systemic sclerosis patients

Sobanski

Launay

Depret

et al. 2016

Expert Review of Clinical Immunology

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Evaluating the fertility and pregnancy outcomes in systemic sclerosis (SSc) women is challenging. Studies are still limited or subject to potential methodological biases. Areas covered: This work is a comprehensive review of the literature. We discuss the potential impact of SSc on women's pregnancy outcomes and the effects of pregnancy on SSc. We summarize the physiological changes during pregnancy and describe our experience. Expert commentary: Although the miscarriage rate does not appear increased in SSc, women are exposed to a higher risk of premature birth and intrauterine growth restriction compared with the general population. Early diffuse cutaneous SSc and use of corticosteroids are risk factors, whereas folic acid use prevents against premature birth. All SSc women wishing to conceive should be counselled during a preconception visit. Physiological changes arising during pregnancy may be the source of clinical problems in SSc women with organs with limited capacities.

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“…Furthermore, all complaints of dyspnea in pregnant SSc patients should prompt an immediate evaluation for development or worsening of PAH. Assessing diffusion capacity using carbon monoxide is considered safe during pregnancy [ 29 ].…”

Section: Pulmonary Arterial Hypertensionmentioning

confidence: 99%

Vascular Complications of Systemic Sclerosis during Pregnancy

Chakravarty

2010

International Journal of Rheumatology

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Systemic sclerosis (SSc) is a chronic autoimmune disorder characterized by progressive fibrosis of the skin and visceral tissues as well as a noninflammatory vasculopathy. Vascular disease in systemic sclerosis is a major cause of morbidity and mortality among nonpregnant patients with SSc and is even a bigger concern in the pregnant SSc patient, as the underlying vasculopathy may prevent the required hemodynamic changes necessary to support a growing pregnancy. Vascular manifestations including scleroderma renal crisis and pulmonary arterial hypertension should be considered relative contraindications against pregnancy due to the high associations of both maternal and fetal morbidity and mortality. In contrast, Raynaud's phenomenon may actually improve somewhat during pregnancy. Women with SSc who are considering a pregnancy or discover they are pregnant require evaluation for the presence and extent of underlying vasculopathy. In the absence of significant visceral vasculopathy, most women with SSc can expect to have reasonable pregnancy outcomes.

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CO and NO pulmonary diffusing capacity during pregnancy: Safety and diagnostic potential

Cited by 12 publications

References 113 publications

Standardisation and application of the single-breath determination of nitric oxide uptake in the lung

Standardisation and application of the single-breath determination of nitric oxide uptake in the lung

Special considerations in pregnant systemic sclerosis patients

Vascular Complications of Systemic Sclerosis during Pregnancy

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