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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]
A nitrogen washout can obtain the following parameters: Closing volume (CV); the amount of air remaining in the lungs beyond that of the residual volume when the flow from the lower sections of the lungs becomes severely reduced or halts altogether during expiration as the small airways begin to close.
Measurement of static lung volumes using body plethysmography or other techniques typically reveals reduced lung volumes (restriction). This reflects the difficulty encountered in inflating the fibrotic lungs. The diffusing capacity for carbon monoxide (DLCO) is invariably reduced in IPF and may be the only abnormality in mild or early disease ...
Pulmonary function measurements are reduced, as indicated by a reduction in the amount of air that the lungs can hold (vital capacity) and changes in expiratory function and lung elasticity. [31] [32] Lung diffusing capacity decreases leading eventually to hypoxaemia. [27]
Restrictive lung diseases are a category of extrapulmonary, pleural, or parenchymal respiratory diseases that restrict lung expansion, [2] resulting in a decreased lung volume, an increased work of breathing, and inadequate ventilation and/or oxygenation. Pulmonary function test demonstrates a decrease in the forced vital capacity.
The majority (approximately 80%) of patient will have decrease diffusion capacity while fewer patients (approximately 20%) will have issues with airflow (either obstructive or restrictive). [14] These airflow issues will typically resolve within six months and the diffusion issues will resolve within five years.
Air in the alveoli of the lungs is diluted by saturated water vapour (H 2 O) and carbon dioxide (CO 2), a metabolic product given off by the blood, and contains less oxygen (O 2) than atmospheric air as some of it is taken up by the blood for metabolic use. The resulting partial pressure of nitrogen is about 0.758 bar.