An alternative method to measure the diffusing capacity of the lung for carbon monoxide in infants.
Pediatr Pulmonol 2018;
53:332-336. [PMID:
29265767 DOI:
10.1002/ppul.23926]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 11/16/2017] [Indexed: 11/09/2022]
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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