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Diffusing capacity of the lung (D L) (also known as transfer factor) measures the transfer of gas from air in the lung, to the red blood cells in lung blood vessels. It is part of a comprehensive series of pulmonary function tests to determine the overall ability of the lung to transport gas into and out of the blood.
D LCO or T LCO (diffusing capacity or transfer factor of the lung for carbon monoxide (CO), [1]) is the extent to which oxygen passes from the air sacs of the lungs into the blood. Commonly, it refers to the test used to determine this parameter. It was introduced in 1909. [2]
Deviation from guidelines can result in false-positive or false negative test results, even though only a small minority of pulmonary function laboratories followed published guidelines for spirometry, lung volumes and diffusing capacity in 2012. [19]
Diffusing capacity (or DLCO) is the carbon monoxide uptake from a single inspiration in a standard time (usually 10 seconds). During the test the person inhales a test gas mixture that consisting of regular air that includes an inert tracer gas and CO, less than one percent.
In obstructive lung disease however, the FEV1/FVC is less than 0.7, indicating that FEV1 is significantly reduced when compared to the total expired volume. This indicates that the FVC is also reduced, but not by the same ratio as FEV1. [8] One definition requires a total lung capacity which is 80% or less of the expected value. [9]
The diffusing capacity for carbon monoxide (DLCO) is invariably reduced in IPF and may be the only abnormality in mild or early disease. Its impairment underlies the propensity of patients with IPF to exhibit oxygen desaturation with exercise which can also be evaluated using the 6-minute walk test (6MWT).
Pulmonary function tests usually show a restrictive defect with decreased diffusion capacity of carbon monoxide indicating reduced alveolar to blood capillary transport. [8] Pulmonary function testing is indicated for all people with ILD and the FVC loss and DLCO is prognostic, with an FVC loss of greater than 5% per year associated with a poor ...
Most were in their 40s and had abnormalities in pulmonary function tests, most commonly reduced diffusion capacity for carbon monoxide (DLCO). Their symptoms generally remained stable (did not worsen) over up to 10 years of follow-up. [7]