RESUMEN

La difusión pulmonar de monóxido de carbono (DL,CO, por sus siglas en inglés), también referida como factor de transferencia de monóxido de carbono (TL,CO), se usa para evaluar la transferencia de oxígeno desde el espacio alveolar hasta la hemoglobina de los eritrocitos contenidos en los capilares pulmonares. En este manuscrito abordamos los principios fisiológicos de la prueba de DL,CO con la técnica de una sola respiración (DL,COsb) y emitimos recomendaciones, tanto para su ejecución como para su interpretación. El procedimiento se apega al estándar vigente publicado en 2005 por la Sociedad Americana del Tórax y la Sociedad Respiratoria Europea.

PALABRAS CLAVE

Difusión pulmonar de monóxido de carbono, COsb, pruebas de función pulmonar.

REFERENCIAS

1. Crapo RO, Forster RE 2nd. Carbon monoxide diffusing capacity. Clin Chest Med 1989;10(2):187-198.

2. Krogh M. The diffusion of gases through the lungs of man. J Physiol 1915;49(4):271-300.

3. Macintyre N, Crapo RO, Viegi G, et al.; American Thoracic Society/ European Respiratory Society. Standardization of the single breath determination of carbon monoxide uptake in the lung. Eur Respir J 2005;26(4):720-735.

4. Wanger J, Clausen JL, Coates A, et al.; American Thoracic Society/ European Respiratory Society. Standardisation of the measurement of lung volumes. Eur Respir J 2005;26(3):511-522.

5. Jensen RL, Crapo RO. Diffusing capacity: how to get it right. Respir Care 2003;48(8):777-782.

6. Epler GR, Saber FA, Gaensler EA. Determination of severe impairment (disability) in interstitial lung disease. Am Rev Respir Dis 1980;121(4):647-659.

7. Nordenfelt I, Svensson G. The transfer factor (diffusing capacity) as a predictor of hypoxaemia during exercise in restrictive and chronic obstructive pulmonary disease. Clin Physiol 1987;7(5):423-430.

8. Gelb AF, Gold WM, Wright RR, Bruch HR, Nadel JA. Physiologic diagnosis of subclinical emphysema. Am Rev Respir Dis 1973;107(1):50-63.

9. Renzetti AD, Bleecker ER, Epler GR, et al. Evaluation of impairment/ disability secondary to respiratory disorders. Statement of the American Thoracic Society. Am Rev Respir Dis 1986;133(6):1205- 1209.

10. Owens GR, Rogers RM, Pennock BE, Levin D. The diffusing capacity as a predictor of arterial oxygen desaturation during exercise in patients with chronic obstructive pulmonary disease. N Engl J Med 1984;310(19):1218-1221.

11. Mohsenifar Z, Brown HV, Schnitzer B, Prause JA, Koerner SK. The effect of abnormal levels of hematocrit on the single breath diffusing capacity. Lung 1982;160(6):325-330.

12. Clark EH, Woods RL, Hughes JM. Effects of blood transfusion on the carbon monoxide transfer factor of the lung in man. Clin Sci Mol Med 1978;54(6):627-631.

13. Cotes JE, Dabbs JM, Elwood PC, Hall AM, McDonald A, Saunders MJ. Iron-deficiency anaemia: its effect on transfer factor for the lung (diffusing capacity) and ventilation and cardiac frequency during submaximal exercise. Clin Sci 1972;42(3):325-335.

14. Cotes JE. Lung function. 5th Ed. London: Blackwell Scientific Publications; 1993.

15. Mottram CD. Ruppel’s manual of pulmonary function testing. 10th ed. Maryland Heights: Elsevier; 2013.

16. Miller MR, Hankinson J, Brusasco V, et al.; ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J 2005;26(2):319-338.

17. Jones RS, Meade F. A theoretical and experimental analysis of anomalies in the estimation of pulmonary diffusing capacity by the single breath method. Q J Exp Physiol Cogn Med Sci 1961;46:131-143.

18. Morris AH, Crapo RO. Standardization of computation of single-breath transfer factor. Bull Eur Physiopathol Respir 1985;21(2):183-189.

19. Gray C, Zamel N, Crapo RO. Effect of a simulated 3,048 meter altitude on the single-breath transfer factor. Bull Eur Physiopathol Respir 1986;22(5):429-431.

20. Stam H, Kreuzer FJ, Versprille A. Effect of lung volume and positional changes on pulmonary diffusing capacity and its components. J Appl Physiol (1985) 1991;71(4):1477-1488.

21. Milne JA, Mills RJ, Coutts JRT, Macnaughton MC, Moran F, Pack AI. The effect of human pregnancy on the pulmonary transfer factor for carbon monoxide as measured by the single breath method. Clin Sci Mol Med 1977;53(3):271-276.

22. Gazioglu K, Kaltreider NL, Rosen M, Yu PN. Pulmonary function during pregnancy in normal women and in patients with cardiopulmonary disease. Thorax 1970;25(4):445-450.

23. Krumholz RA, Echt CR, Ross JC. Pulmonary diffusing capacity, capillary blood volume, lung volumes, and mechanics of ventilation in early and late pregnancy. J Lab Clin Med 1964;63:648-655.

24. Frey TM, Crapo RO, Jensen RL, Elliott CG. Diurnal variation of the diffusing capacity of the lung: is it real? Am Rev Respir Dis 1987;136(6):1381-1384.

25. Sansores RH, Abboud RT, Kennell C, Haynes N. The effect of menstruation on the pulmonary carbon monoxide diffusing capacity. Am J Respir Crit Care Med 1995;152(1):381-384.

26. Peavy HH, Summer WR, Gurtner C. The effects of acute ethanol ingestion on pulmonary diffusing capacity. Chest 1980;77(4):488-492.

27. Marrades RM, Diaz O, Roca J, et al. Adjustment of DLCO for hemoglobin concentration. Am J Respir Crit Care Med 1997;155(1):236-241.

28. McGrath MW, Thomson ML. The effect of age, body size and lung volume change on alveolar-capillary permeability and diffusing capacity in man. J Physiol 1959;146(3):572-582.