Pulmonary Artery Occlusion Increases the Ratio of Diffusing Capacity for Nitric Oxide to Carbon Monoxide in Prone Sheep

Harris, R. Scott; Hadian, Mehrnaz; Hess, Dean; Chang, Yuchiao; Venegas, José G.

doi:10.1378/chest.126.2.559

Cited by 12 publications

(7 citation statements)

References 19 publications

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“…Therefore, a decreased TL,NO/TL,CO ratio would be expected in the New York Heart Association (NYHA) grades I and II. As Diffuse parenchymal disease # [24] Chronic thromboembolic pulmonary hypertension [24] Hepatopulmonary syndrome [25] Pulmonary artery occlusion in sheep [34] Greater involvement of microvascular compartment reduces TL,CO more than TL,NO…”

Section: Suggestions For Future Researchmentioning

confidence: 99%

TheT_L,NO/T_L,COratio in pulmonary function test interpretation

Hughes

Lee

2012

Eur Respir J

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The transfer factor of the lung for nitric oxide (TL,NO) is a new test for pulmonary gas exchange. The procedure is similar to the already well-established transfer factor of the lung for carbon monoxide (TL,CO). Physiologically, TL,NO predominantly measures the diffusion pathway from the alveoli to capillary plasma. In the Roughton-Forster equation, TL,NO acts as a surrogate for the membrane diffusing capacity (DM). The red blood cell resistance to carbon monoxide uptake accounts for ,50% of the total resistance from gas to blood, but it is much less for nitric oxide.TL,NO and TL,CO can be measured simultaneously with the single breath technique, and DM and pulmonary capillary blood volume (Vc) can be estimated. TL,NO, unlike TL,CO, is independent of oxygen tension and haematocrit. The TL,NO/TL,CO ratio is weighted towards the DM/Vc ratio and to a; where a is the ratio of physical diffusivities of NO to CO (a51.97). The TL,NO/TL,CO ratio is increased in heavy smokers, with and without computed tomography evidence of emphysema, and reduced in the voluntary restriction of lung expansion; it is expected to be reduced in chronic heart failure. The TL,NO/TL,CO ratio is a new index of gas exchange that may, more than derivations from them of DM and Vc with their in-built assumptions, give additional insights into pulmonary pathology.

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Section: Suggestions For Future Researchmentioning

confidence: 99%

TheT_L,NO/T_L,COratio in pulmonary function test interpretation

Hughes

Lee

2012

Eur Respir J

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“…But as with aerobic capacity (26), DL NO seems to be better compared with DL CO to detect emphysema and cystic fibrosis (10,22). Furthermore, individuals who have a high DM-to-V c ratio (which is proportional to the DL NO -to-DL CO ratio) may indicate high pulmonary artery pressure compatible with pulmonary hypertension/ occlusion (1,4,15,24). However, in a wide spectrum of pulmonary vascular diseases, such as sarcoidosis (18) or systemic microangiopathy brought on by type 2 diabetes (9), there would be a disproportionate reduction in DM relative to V c decreasing the D M -to-V c ratio (and thus decreasing the DL NOto-DL CO ratio).…”

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confidence: 99%

No red cell resistance to NO? I think not!

Zavorsky

2010

Journal of Applied Physiology

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PULMONARY CAPILLARY BLOOD VOLUME and alveolar-membrane diffusing capacity are components to overall pulmonary diffusing capacity. The equation deriving pulmonary diffusing capacity into these components was first published in 1957 by Francis Roughton and Robert Forster (19) in which the total resistance to pulmonary diffusion is the addition of alveolarmembrane resistance and red blood cell resistance placed in series, such that

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“…BLM could mimic this pattern. e TLNO/TLCO ratio is also known to increase aer obstruction of the pulmonary artery in animals [31]. e authors of this work suggest that this rise may be the consequence of a better sensitivity of TLCO than TLNO in response to a local reduction in capillary blood �ow.…”

Section: Discussionmentioning

confidence: 62%

Combined Lung Transfer of NO and CO in Patients Receiving Methotrexate or Bleomycin Therapy Compared to Normal Subjects

et al. 2013

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e �rst aim of the study is to determine whether combined lung diffusing capacities of nitric oxide (TLNO) and of carbon monoxide (TLCO) are accurate in the followup of patients receiving either methotrexate (MTX) or bleomycin (BLM). e second objective is to determine whether TLCO, TLNO, KCO, and TLCO/VI% (inspiratory volume expressed as percentage of predicted value) correlate better with the diffusing capacity of the membrane (Dm) and/or capillary lung volume (Vc). TLNO and TLCO were measured in three groups: 22 "normal" subjects (N group), 17 patients receiving MTX, and 12 patients treated with BLM. TLCO, TLNO, Dm, and Vc were much lower in the MTX and BLM groups compared to those of the N one. e ratio TLNO/TLCO was higher in the BLM group compared to that of the N group and compared to that of the MTX group. KCO correlated neither with Dc nor with Vc, whereas TLCO/VI% correlated signi�cantly with both Dm and Vc. Combined measurement of TLCO and TLNO seems to be useful in the followup of patients receiving agents inducing lung toxicity and gives a good idea of the alveolar membrane and the capillary volume.

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Pulmonary Artery Occlusion Increases the Ratio of Diffusing Capacity for Nitric Oxide to Carbon Monoxide in Prone Sheep

Cited by 12 publications

References 19 publications

TheT_L,NO/T_L,COratio in pulmonary function test interpretation

TheT_L,NO/T_L,COratio in pulmonary function test interpretation

No red cell resistance to NO? I think not!

Combined Lung Transfer of NO and CO in Patients Receiving Methotrexate or Bleomycin Therapy Compared to Normal Subjects

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Pulmonary Artery Occlusion Increases the Ratio of Diffusing Capacity for Nitric Oxide to Carbon Monoxide in Prone Sheep

Cited by 12 publications

References 19 publications

TheTL,NO/TL,COratio in pulmonary function test interpretation

TheTL,NO/TL,COratio in pulmonary function test interpretation

No red cell resistance to NO? I think not!

Combined Lung Transfer of NO and CO in Patients Receiving Methotrexate or Bleomycin Therapy Compared to Normal Subjects

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TheT_L,NO/T_L,COratio in pulmonary function test interpretation

TheT_L,NO/T_L,COratio in pulmonary function test interpretation