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An alternative method to measure the diffusing capacity of the lung for carbon monoxide in infants.

Journal:
Pediatric pulmonology


Issue Date:
2018


Abstract(summary):

BACKGROUND: Lung diffusion assessed by the uptake of carbon monoxide (DLCO ) and alveolar volume (VA ) by inert gas dilution are readily assessed in cooperative older subjects; however, obtaining these measurements in infants has been much more difficult. Our laboratory has measured DLCO and VA in sleeping infants using a mass spectrometer, which continuously measures gas concentrations, and demonstrated that infants with bronchopulmonary dysplasia (BPD) have lower DLCO , but no difference in VA compared to full-term controls. The mass spectrometer is expensive and lacks portability; therefore, we evaluated whether measurement of end-expiratory alveolar gas concentrations using a gas chromatograph would provide an alternative approach.; METHODS: (1) Using our previously digitized data for infants with BPD and full-term controls, DLCO and VA were calculated at end-expiration rather than between 60 and 80% of expired volume, as previously reported. (2) In a new group of infants, DLCO and VA were measured using gas concentrations obtained at end-expiration with a mass spectrometer and a gas chromatograph.; RESULTS: (1) Using end-expiratory concentrations, infants with BPD (n=3D49) had significantly lower DLCO , but similar VA compared to healthy controls (n=3D34) (DLCO : 4.2 vs 4.6mL/min/mmHg, P=3D0.047; VA : 614 vs 608mL, P=3D0.772). (2) Among newly evaluated infants (n=3D28), DLCO and VA obtained with a mass spectrometer and a gas chromatograph were highly correlated (R2 =3D0.94 and 0.99, respectively), and were not significantly different for the two analyzers.; CONCLUSION: Measuring DLCO and VA at end-expiration using a gas chromatograph can provide an effective assessment of gas exchange in sleeping infants. =C2=A9 2017 Wiley Periodicals, Inc.


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