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

Eduardo L.L. Praca, Christina J. Tiller, Jeffrey A. Kisling, Robert Tepper

Research output: Contribution to journalArticle

Abstract

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 = 49) had significantly lower DLCO, but similar VA compared to healthy controls (n = 34) (DLCO: 4.2 vs 4.6 mL/min/mmHg, P = 0.047; VA: 614 vs 608 mL, P = 0.772). (2) Among newly evaluated infants (n = 28), DLCO and VA obtained with a mass spectrometer and a gas chromatograph were highly correlated (R2 = 0.94 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.

Original languageEnglish (US)
Pages (from-to)332-336
Number of pages5
JournalPediatric Pulmonology
Volume53
Issue number3
DOIs
StatePublished - Mar 1 2018

Fingerprint

Lung Volume Measurements
Carbon Monoxide
Gases
Bronchopulmonary Dysplasia
Noble Gases
Lung

Keywords

  • end-expiration
  • gas analyzer
  • gas chromatograph
  • mass spectrometer
  • pulmonary diffusion

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

An alternative method to measure the diffusing capacity of the lung for carbon monoxide in infants. / Praca, Eduardo L.L.; Tiller, Christina J.; Kisling, Jeffrey A.; Tepper, Robert.

In: Pediatric Pulmonology, Vol. 53, No. 3, 01.03.2018, p. 332-336.

Research output: Contribution to journalArticle

Praca, Eduardo L.L. ; Tiller, Christina J. ; Kisling, Jeffrey A. ; Tepper, Robert. / An alternative method to measure the diffusing capacity of the lung for carbon monoxide in infants. In: Pediatric Pulmonology. 2018 ; Vol. 53, No. 3. pp. 332-336.
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abstract = "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 = 49) had significantly lower DLCO, but similar VA compared to healthy controls (n = 34) (DLCO: 4.2 vs 4.6 mL/min/mmHg, P = 0.047; VA: 614 vs 608 mL, P = 0.772). (2) Among newly evaluated infants (n = 28), DLCO and VA obtained with a mass spectrometer and a gas chromatograph were highly correlated (R2 = 0.94 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.",
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