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Recruitment of Lung Diffusing Capacity*: Update of Concept and Application

Connie C. W. Hsia, MD, FCCP
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*From the Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas TX.

Correspondence to: Connie C. W. Hsia, MD, FCCP, Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas TX 75390-9034



Chest. 2002;122(5):1774-1783. doi:10.1378/chest.122.5.1774
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Lung diffusing capacity (Dl) for carbon monoxide (Dlco), nitric oxide (Dlno) or oxygen (Dlo2) increases from rest to peak exercise without reaching an upper limit; this recruitment results from interactions among alveolar volume (Va), and cardiac output (), as well as changing physical properties and spatial distribution of capillary erythrocytes, and is critical for maintaining a normal arterial oxygen saturation. Dlco and Dlno can be used to interpret the effectiveness of diffusive oxygen transport and track structural alterations of the alveolar-capillary barrier, providing sensitive noninvasive indicators of microvascular integrity in health and disease. Clinical interpretation of Dl should take into account in addition to Va and hemoglobin concentration.

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