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

Pastré, Jean; Plantier, Laurent; Planès, Carole; Borie, Raphaël; Nunès, Hilario; Delclaux, Christophe; Israël‐Biet, Dominique

doi:10.1186/s12890-015-0084-1

Cited by 13 publications

(9 citation statements)

References 13 publications

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“…Airway epithelial cells proliferate and differentiate with increased numbers of bronchioles in patients with IPF [ 37 – 39 ], and airway dilation occurs as part of the disease process [ 16 ]. Therefore, FEV 1 /FVC of patients with IPF is higher than that of healthy subjects, which shows that airflow obstruction becomes milder in IPF [ 40 ]. Hence, respiratory resistance, which is obtained theoretically by dividing respiratory pressure by respiratory airflow, has been considered to decline in IPF [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Oscillometry and computed tomography findings in patients with idiopathic pulmonary fibrosis

et al. 2020

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Although the utility of oscillometry for predicting disease severity in idiopathic pulmonary fibrosis (IPF) had been researched, little has been reported on the mechanism of why respiratory impedance reflects the disease severity. In addition, traction bronchiectasis has been considered to reduce respiratory resistance and correlate negatively with airflow obstruction, but this hypothesis has not been validated. The present study aimed to investigate the correlations between oscillometric parameters and fibrosis-related lung abnormalities in IPF and to assess the utility of oscillometry as a surrogate marker for traction bronchiectasis and airflow obstruction.Eighty Japanese patients with IPF underwent high-resolution computed tomography (HRCT), spirometry, and oscillometry and were retrospectively investigated. Fibrosis-related HRCT findings were scored regarding airspace consolidation, honeycombing, architectural distortion, traction bronchiectasis, and fibrosis. Correlations between the HRCT scores, spirometric parameters, and oscillometric parameters were analysed.Respiratory reactance correlated positively with all fibrosis-related HRCT scores. Vital capacity and forced vital capacity (FVC) correlated negatively with oscillometric parameters and HRCT scores, reflecting the severity of restrictive ventilatory deficiency. Respiratory resistance was not related to any of the HRCT scores or forced expiration volume in 1 s/FVC. However, forced expiration volume in 1 s/FVC correlated positively with HRCT scores, which showed that airflow obstruction became milder as the disease progressed.In conclusion, respiratory reactance reflects fibrosis and restrictive ventilatory deficiency in IPF. Moreover, respiratory resistance is independent of traction bronchiectasis and airflow obstruction in patients with IPF, which implies that respiratory resistance might reflect different properties of the airways.

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Section: Discussionmentioning

confidence: 99%

Oscillometry and computed tomography findings in patients with idiopathic pulmonary fibrosis

et al. 2020

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“…The magnitudes of KCO and VA values might indicate distinct disease mechanisms and thereby bear a relative prognostic value in addition to giving clues to the pathogenesis of these diseases. There are several studies confirming clinicians should take into account not only DLCO but also VA and KCO when seeking to assess ILD (8). Because of its high sensitivity in ILD we used KCO in our study.…”

Section: Discussionmentioning

confidence: 99%

Association of neutrophil/lymphocyte ratio with the degree ofinterstitial lung disease in systemic sclerosis

Atilla¹,

Çetin²,

Balkarlı³

2016

Turk J Med Sci

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Background/aim: Determining the severity of systemic sclerosis related interstitial lung disease (SSc-ILD) is based on clinical and radiological findings, inflammation marker levels, and carbon monoxide diffusing capacity of the lung (DLCO). Recently studies are ongoing for objective and easy markers. Neutrophil/lymphocyte ratio (NLR) is shown to be a good marker for inflammation in recent clinical trials. In this study, we aimed to identify the possible relationship between NLR and carbon monoxide transfer coefficient (KCO) of SSc-ILD patients. Materials and methods: Fifty-nine patients with systemic sclerosis (SSc) were enrolled in the study. We used high-resolution computed tomography for diagnosis and used DLCO to evaluate degree of lung involvement. Complete blood cell counts and acute phase reactants were included as laboratory assessments. Results: NLR values were significantly higher in the SSc-ILD group (3.66 ± 1.32 vs. 2.85 ± 1.12, P = 0.01) and correlated negatively with KCO. The NLR cutoff value was 3.21, its sensitivity was 81%, and its specificity was 81%. Conclusion: NLR level may serve as a marker of lung involvement in the presence of ILD in patients with SSc.

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“…Of note, KCO is in the normal range in up to 30% of patients with IPF [55], particularly in patients with moderately altered DLCO [56]. It is important not to misinterpret this finding as being indicative of a preservation of gas exchange units, as it can be surmised that full lung inflation may not be attainable in IPF where subpleural fibrosis impairs lung inflation.…”

Section: Alterations In Pulmonary Gas Exchangementioning

confidence: 98%

“…Among 55 IPF patients with a mean age of 71 years, the mean ratio of the forced expiratory volume in 1 s (FEV1) to FVC (FEV1/FVC) was 0.83 [56], which is higher than expected (0.74 for males, 0.75 for females according to European Respiratory Society reference equations) [83]. The ratio of the forced expiratory flow at 25-75% of FVC (FEF25-75%) to FVC (FEF25-75%/FVC) correlates positively with HRCT indices of IPF [39], suggesting that airway dilation occurs as part of the disease process.…”

Section: Chronic Arterial Hypoxaemiamentioning

confidence: 99%

Physiology of the lung in idiopathic pulmonary fibrosis

et al. 2018

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The clinical expression of idiopathic pulmonary fibrosis (IPF) is directly related to multiple alterations in lung function. These alterations derive from a complex disease process affecting all compartments of the lower respiratory system, from the conducting airways to the lung vasculature. In this article we review the profound alterations in lung mechanics (reduced lung compliance and lung volumes), pulmonary gas exchange (reduced diffusing capacity, increased dead space ventilation, chronic arterial hypoxaemia) and airway physiology (increased cough reflex and increased airway volume), as well as pulmonary haemodynamics related to IPF. The relative contribution of these alterations to exertional limitation and dyspnoea in IPF is discussed.

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

Cited by 13 publications

References 13 publications

Oscillometry and computed tomography findings in patients with idiopathic pulmonary fibrosis

Oscillometry and computed tomography findings in patients with idiopathic pulmonary fibrosis

Association of neutrophil/lymphocyte ratio with the degree ofinterstitial lung disease in systemic sclerosis

Physiology of the lung in idiopathic pulmonary fibrosis

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