Reference values of pulmonary diffusing capacity during exercise by a rebreathing technique

Abstract

Normal reference values of the pulmonary diffusing capacity for carbon monoxide (DLCO), diffusing capacity of the membrane (DMCO), and pulmonary capillary blood volume (VC) were derived by a rebreathing technique in 44 normal, healthy, nonsmoking individuals ranging from 17 to 68 yr of age. Simultaneous measurements of DLCO, lung volumes, pulmonary blood flow, and septal tissue volume were determined at rest and during steady-state exercise of 25, 50, and 80% of maximal workload and at two levels of alveolar O2 tension. DMCO and VC were calculated using the Roughton-Forster relationship. Using stepwise regression analysis, DLCO and DMCO (in ml CO/min/mm Hg) were found to be significantly related to pulmonary blood flow (Qc in L/min), age (in years), and body surface area (BSA in square meters). VC (in ml) was found to be significantly related to QC and BSA. Normalization of measured data with respect to these variables largely eliminated male versus female differences. We conclude that QC is the most important determinant of the recruitment of diffusing capacity. From rest to near-maximal exercise, DLCO, DMCO, and VC increase linearly with respect to QC without evidence of reaching a plateau.