Document Detail


Diffusing Capacity for Carbon Monoxide is Linked to Ventilatory Demand in Patients with Chronic Obstructive Pulmonary Disease.
MedLine Citation:
PMID:  22292594     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Abstract Dyspnea is deemed to result from an imbalance between ventilatory demand and capacity. The single-breath diffusing capacity for carbon monoxide (DLCO) is often the best correlate to dyspnea in COPD. We hypothesized that DLCO contributes to the assessment of ventilatory demand, which is linked to physiological dead space /tidal volume (VD/VT) ratio. An additional objective was to assess the validity of non-invasive measurement of transcutaneous P(CO2) allowing the calculation of this ratio. Forty-two subjects (median [range] age: 66 [43-80] years; 12 females) suffering mainly from moderate-to-severe COPD (GOLD stage 2 or 3: n = 36) underwent pulmonary function and incremental exercise tests while taking their regular COPD treatment. DLCO% predicted correlated with both resting and peak physiological VD/VT ratios (r = -0.55, p = 0.0015 and r = -0.40, p = 0.032; respectively). The peak physiological VD/VT ratio contributed to increase ventilation (increased ventilatory demand), to increase dynamic hyperinflation and to impair oxygenation on exercise. Indirect (MRC score) and direct (peak Borg score/% predicted V˙O2) exertional dyspnea assessments were correlated and demonstrated significant relationships with DLCO% predicted and physiological VD/VT at peak exercise, respectively. The non-invasive measurement of transcutaneous P(CO2) both at rest and on exercise was validated by Bland-Altman analyses. In conclusion, DLCO constitutes and indirect assessment of ventilatory demand, which is linked to exertional dyspnea in COPD patients. The assessment of this demand can also be non invasively obtained on exercise using transcutaneous PCO(2) measurement.
Authors:
Bruno Mahut; Brigitte Chevalier-Bidaud; Laurent Plantier; Mohamed Essalhi; Etienne Callens; Semia Graba; Karine Gillet-Juvin; Judith Valcke-Brossollet; Christophe Delclaux
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  COPD     Volume:  9     ISSN:  1541-2563     ISO Abbreviation:  COPD     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101211769     Medline TA:  COPD     Country:  England    
Other Details:
Languages:  eng     Pagination:  16-21     Citation Subset:  IM    
Affiliation:
1AP-HP, Hôpital Européen Georges-Pompidou, Service de Physiologie -Clinique de la Dyspnée , Paris , France.
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