Document Detail

Impaired lung diffusing capacity for nitric oxide and alveolar-capillary membrane conductance results in oxygen desaturation during exercise in patients with cystic fibrosis.
MedLine Citation:
PMID:  21050829     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Exercise has been shown to be beneficial for patients with cystic fibrosis (CF), but for some CF patients there is a risk of desaturation, although the predicting factors are not conclusive or reliable. We sought to determine the relationship between the diffusion capacity of the lungs for nitric oxide and carbon monoxide (DLNO and DLCO) and the components of DLCO: alveolar-capillary membrane conductance (D(M)), and pulmonary capillary blood volume (V(C)) on peripheral oxygen saturation (SaO(2)) at rest and during exercise in CF.
METHODS: 17 mild/moderate CF patients and 17 healthy subjects were recruited (age=26±7 vs. 23±8 years, ht=169±8 vs. 166±8 cm, wt=65±9 vs. 59±8 kg, BMI=23±3 vs. 22±3 kg/m(2), VO(2PEAK)=101±36 vs. 55±25%pred., FEV(1)=92±22 vs. 68±25%pred., for healthy and CF, respectively, mean±SD, VO(2PEAK) and FEV(1) p<0.001). Subjects performed incremental cycle ergometry to exhaustion with continuous monitoring of SaO(2) and measures of DLNO, DLCO, D(M) and V(C) at each stage.
RESULTS: CF patients had a lower SaO(2) at rest and peak exercise (rest=98±1 vs. 96±1%, peak=97±2 vs. 93±5%, for healthy and CF, respectively, p<0.01). At rest, DLNO, DLCO, D(M) were significantly lower in the CF group (p<0.01). The difference between groups was augmented with exercise (DLNO=117±4 vs. 73±3ml/min/mmHg; DLCO=34±8 vs. 23±8ml/min/mmHg; D(M)=50±1 vs. 34±1, p<0.001, for healthy and CF respectively). Peak SaO(2) was related to resting DLNO in CF patients (r=0.65, p=0.003).
CONCLUSIONS: These results suggest a limitation in exercise-mediated increases in membrane conductance in CF which may contribute to a drop in SaO(2) and that resting DLNO can account for a large portion of the variability in SaO(2).
Courtney M Wheatley; William T Foxx-Lupo; Nicholas A Cassuto; Eric C Wong; Cori L Daines; Wayne J Morgan; Eric M Snyder
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Publication Detail:
Type:  Journal Article     Date:  2010-11-02
Journal Detail:
Title:  Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society     Volume:  10     ISSN:  1873-5010     ISO Abbreviation:  J. Cyst. Fibros.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101128966     Medline TA:  J Cyst Fibros     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  45-53     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
Department of Pharmacy Practice and Science, University of Arizona, Tucson, Arizona, United States.
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