The Experts below are selected from a list of 14481 Experts worldwide ranked by ideXlab platform
Peter W. Callas - One of the best experts on this subject based on the ideXlab platform.
-
DLCO versus DLCO va as predictors of pulmonary gas exchange
Respiratory Medicine, 2007Co-Authors: David A. Kaminsky, Todd Whitman, Peter W. CallasAbstract:Summary Background The diffusing capacity of the lung is usually reported as both the diffusing capacity (DLCO) and the diffusing capacity divided by the alveolar volume (DLCO/VA). However, it is unclear which measure to use when interpreting pulmonary gas exchange. We therefore conducted this study to determine whether the DLCO or the DLCO/VA is a better predictor of oxygen desaturation with exercise. Methods We retrospectively analyzed the pulmonary function records of all patients who had measurement of their diffusing capacity and 6-min walk oximetry in our university pulmonary function laboratory over a 2-year period. Results There were data available on 97 patients, most of who had interstitial lung disease and/or lung volume restriction. The median DLCO was 51% predicted and the median DLCO/VA was 64% predicted. The prevalence of exercise desaturation was 43%. The overall sensitivity and specificity as determined by the area under the receiver operator characteristic (ROC) curve was higher for DLCO than DLCO/VA, with an optimal cut-off of normal of 55% predicted. The positive predictive values were equally low for both measures, ranging from 50% to 70%. After adjustment for VA, there were no differences between the ROC curves or predictive values for DLCO and DLCO/VA. Conclusion After adjusting for VA, neither the DLCO nor the DLCO/VA was better at predicting oxygen desaturation with exercise. The optimal cut-off of normal was 55% predicted.
-
DLCO versus DLCO/VA as predictors of pulmonary gas exchange.
Respiratory medicine, 2006Co-Authors: David A. Kaminsky, Todd Whitman, Peter W. CallasAbstract:Summary Background The diffusing capacity of the lung is usually reported as both the diffusing capacity (DLCO) and the diffusing capacity divided by the alveolar volume (DLCO/VA). However, it is unclear which measure to use when interpreting pulmonary gas exchange. We therefore conducted this study to determine whether the DLCO or the DLCO/VA is a better predictor of oxygen desaturation with exercise. Methods We retrospectively analyzed the pulmonary function records of all patients who had measurement of their diffusing capacity and 6-min walk oximetry in our university pulmonary function laboratory over a 2-year period. Results There were data available on 97 patients, most of who had interstitial lung disease and/or lung volume restriction. The median DLCO was 51% predicted and the median DLCO/VA was 64% predicted. The prevalence of exercise desaturation was 43%. The overall sensitivity and specificity as determined by the area under the receiver operator characteristic (ROC) curve was higher for DLCO than DLCO/VA, with an optimal cut-off of normal of 55% predicted. The positive predictive values were equally low for both measures, ranging from 50% to 70%. After adjustment for VA, there were no differences between the ROC curves or predictive values for DLCO and DLCO/VA. Conclusion After adjusting for VA, neither the DLCO nor the DLCO/VA was better at predicting oxygen desaturation with exercise. The optimal cut-off of normal was 55% predicted.
Anthony W. Kim - One of the best experts on this subject based on the ideXlab platform.
-
diffusion lung capacity for carbon monoxide DLCO is an independent prognostic factor for long term survival after curative lung resection for cancer
Journal of Surgical Oncology, 2009Co-Authors: Michael J. Liptay, Sanjib Basu, Michael C. Hoaglin, Neil Freedman, William H. Warren, Zane Hammoud, Penfield L Faber, Anthony W. KimAbstract:Introduction We examined the early and late prognostic significance of DLCO and forced expiratory volume in 1 sec (FEV1) in patients who underwent surgical resection of lung cancer. Methods From 1997 to 2004, 462 patients underwent successful complete resection of their lung cancer and had full pulmonary function testing including DLCO performed. Mean follow-up was over 5 years (64.8 months—range: 0–158 months). Results Postoperative 90-day mortality was 2.6% (12/462). At last follow-up, of the remaining 450 patients, 182 patients were alive, 130 had died of cancer, and 138 have died of other causes and did not have recurrent cancer. Mean DLCO values were 69.4%, 66.8%, and 53.9%, respectively. Mean FEV1 values were 81.3%, 78.1%, and 71.5%, respectively. Mean DLCOs and FEV1s between patients who died of cancer versus other causes were significantly different (P < 0.0001 and P = 0.0157). When cause-specific survival was analyzed for both DLCO and FEV1 simultaneously, DLCO had a very significant effect on survival from other causes (HR 0.966, P < 0.0001) when adjusted for FEV1. However, when adjusted by DLCO, FEV1 had no significant effect. A DLCO <40% best predicted decreased survival from causes other than cancer within stage I lung cancers (stage IA HR 0.953, P < 0.0001; stage IB HR 0.968, P < 0.0001). Conclusions DLCO was found to be a significant prognostic factor for long-term survival after lung cancer surgery. This may serve as a surrogate for competing morbidities with declining values predicting a higher risk of late non-cancer-related death. J. Surg. Oncol. 2009;100:703–707. © 2009 Wiley-Liss, Inc.
-
Diffusion lung capacity for carbon monoxide (DLCO) is an independent prognostic factor for long‐term survival after curative lung resection for cancer
Journal of surgical oncology, 2009Co-Authors: Michael J. Liptay, Sanjib Basu, Michael C. Hoaglin, Neil Freedman, L. Penfield Faber, William H. Warren, Zane Hammoud, Anthony W. KimAbstract:Introduction We examined the early and late prognostic significance of DLCO and forced expiratory volume in 1 sec (FEV1) in patients who underwent surgical resection of lung cancer. Methods From 1997 to 2004, 462 patients underwent successful complete resection of their lung cancer and had full pulmonary function testing including DLCO performed. Mean follow-up was over 5 years (64.8 months—range: 0–158 months). Results Postoperative 90-day mortality was 2.6% (12/462). At last follow-up, of the remaining 450 patients, 182 patients were alive, 130 had died of cancer, and 138 have died of other causes and did not have recurrent cancer. Mean DLCO values were 69.4%, 66.8%, and 53.9%, respectively. Mean FEV1 values were 81.3%, 78.1%, and 71.5%, respectively. Mean DLCOs and FEV1s between patients who died of cancer versus other causes were significantly different (P
David A. Kaminsky - One of the best experts on this subject based on the ideXlab platform.
-
DLCO versus DLCO va as predictors of pulmonary gas exchange
Respiratory Medicine, 2007Co-Authors: David A. Kaminsky, Todd Whitman, Peter W. CallasAbstract:Summary Background The diffusing capacity of the lung is usually reported as both the diffusing capacity (DLCO) and the diffusing capacity divided by the alveolar volume (DLCO/VA). However, it is unclear which measure to use when interpreting pulmonary gas exchange. We therefore conducted this study to determine whether the DLCO or the DLCO/VA is a better predictor of oxygen desaturation with exercise. Methods We retrospectively analyzed the pulmonary function records of all patients who had measurement of their diffusing capacity and 6-min walk oximetry in our university pulmonary function laboratory over a 2-year period. Results There were data available on 97 patients, most of who had interstitial lung disease and/or lung volume restriction. The median DLCO was 51% predicted and the median DLCO/VA was 64% predicted. The prevalence of exercise desaturation was 43%. The overall sensitivity and specificity as determined by the area under the receiver operator characteristic (ROC) curve was higher for DLCO than DLCO/VA, with an optimal cut-off of normal of 55% predicted. The positive predictive values were equally low for both measures, ranging from 50% to 70%. After adjustment for VA, there were no differences between the ROC curves or predictive values for DLCO and DLCO/VA. Conclusion After adjusting for VA, neither the DLCO nor the DLCO/VA was better at predicting oxygen desaturation with exercise. The optimal cut-off of normal was 55% predicted.
-
DLCO versus DLCO/VA as predictors of pulmonary gas exchange.
Respiratory medicine, 2006Co-Authors: David A. Kaminsky, Todd Whitman, Peter W. CallasAbstract:Summary Background The diffusing capacity of the lung is usually reported as both the diffusing capacity (DLCO) and the diffusing capacity divided by the alveolar volume (DLCO/VA). However, it is unclear which measure to use when interpreting pulmonary gas exchange. We therefore conducted this study to determine whether the DLCO or the DLCO/VA is a better predictor of oxygen desaturation with exercise. Methods We retrospectively analyzed the pulmonary function records of all patients who had measurement of their diffusing capacity and 6-min walk oximetry in our university pulmonary function laboratory over a 2-year period. Results There were data available on 97 patients, most of who had interstitial lung disease and/or lung volume restriction. The median DLCO was 51% predicted and the median DLCO/VA was 64% predicted. The prevalence of exercise desaturation was 43%. The overall sensitivity and specificity as determined by the area under the receiver operator characteristic (ROC) curve was higher for DLCO than DLCO/VA, with an optimal cut-off of normal of 55% predicted. The positive predictive values were equally low for both measures, ranging from 50% to 70%. After adjustment for VA, there were no differences between the ROC curves or predictive values for DLCO and DLCO/VA. Conclusion After adjusting for VA, neither the DLCO nor the DLCO/VA was better at predicting oxygen desaturation with exercise. The optimal cut-off of normal was 55% predicted.
Larry C Lands - One of the best experts on this subject based on the ideXlab platform.
-
lung diffusion capacity for nitric oxide and carbon monoxide is impaired similarly following short term graded exercise
Nitric Oxide, 2005Co-Authors: Gerald S Zavorsky, Larry C LandsAbstract:Abstract Study aimed to determine whether short-term graded exercise affects single-breath lung diffusion capacity for nitric oxide (DLNO) and carbon monoxide (DLCO) similarly, and whether the DLNO/DLCO ratios during rest are altered post-exercise compared to pre-exercise. Eleven healthy subjects (age = 29 ± 6 years; weight = 76.6 ± 13.2 kg; height = 177.9 ± 13.2 cm; and maximal oxygen uptake or V ˙ O 2 max = 52.7 ± 9.3 ml kg − 1 min − 1 ) performed simultaneous single-breath DLNO and DLCO measurements at rest (inspired NO concentration = 43.2 ± 4.1 ppm, inspired CO concentration = 0.30%) 15 min before and 2 h after a graded exercise test to exhaustion (exercise duration = 593 ± 135 s). Resting DLNO and DLCO was similarly reduced 2 h post-exercise (DLNO = −7.8 ± 3.5%, DLCO = −10.3 ± 6.9%, and P
-
the relationship between single breath diffusion capacity of the lung for nitric oxide and carbon monoxide during various exercise intensities
Chest, 2004Co-Authors: Gerald S Zavorsky, Karine Badra Quiron, Philip S Massarelli, Larry C LandsAbstract:Study objectives: To determine the relationship between single-breath diffusion capacity of the lung for nitric oxide (DLNO) and single-breath diffusion capacity of the lung for carbon monoxide (DLCO), and to determine the single-breath DLNO/DLCO ratios during rest and at several exercise intensities using a commercial lung diffusion system that uses electrochemical cells to analyze gases. Setting and participants: Eight healthy men (age, 27 5 years; weight, 83.0 11.8 kg; height, 180.4 9.5 cm; maximal oxygen uptake (VO2max), 47.6 10.2 mL/kg/min (mean SD)) per- formed single-breath DLNO measurements (inspired nitric oxide concentration, 66.5 10.6 ppm) and carbon monoxide (0.30%) randomized on different days at rest and at various exercise intensities (40%, 75%, and 90% of VO2max reserve (VO2R)) on a electrically braked load simulator. The DLCO measured on day 1 was compared to the DLCO measured during the DLNO method from another day. Results: The relationship between DLNO and DLCO was linear (DLNO 4.47 DLCO; r 2 0.91; standard error of the estimate 0.04; p < 0.05). DLNO was 4.52 0.24 times greater than DLCO, independent of exercise intensity. DLNO increased from 210.3 18.2 mL/min/mm Hg at rest to 284.2 38.6 mL/min/mm Hg at 90% VO2R (oxygen uptake 42.6 9.8 mL/kg/min; 284.2 31.6 W; p < 0.05). Stepwise regression demonstrated that DLNO is predicted by alveolar volume (VA) (in liters) and workload (watts) such that DLNO 13.4 VA 0.23 workload 107.7 (r 2 0.90; SEE 17.5; p < 0.05). Conclusion: (1) Single-breath DLNO and DLCO increase linearly with increasing workload; (2) the single-breath DLNO/DLCO ratios are independent of exercise intensity, suggesting that using either nitric oxide or carbon monoxide as transfer gases are valid in the study of lung diffusion during any level of exercise; and (3) DLNO is mainly predicted by VA and workload. (CHEST 2004; 125:1019 -1027)
Robert A Wise - One of the best experts on this subject based on the ideXlab platform.
-
single breath diffusing capacity of the lung for carbon monoxide a predictor of pao2 maximum work rate and walking distance in patients with emphysema
Chest, 2003Co-Authors: Zab Mohsenifar, Philip T Diaz, Gerard J Criner, Frank C Sciurba, Mark Ginsburg, Robert A WiseAbstract:Objective: The National Emphysema Treatment Trial (NETT) is a randomized, multicenter, clinical trial comparing two different methods of lung volume reduction surgery plus medical therapy to medical treatment alone in patients with advanced emphysema. The purpose of this article was to use the data obtained from the NETT to assess the ability of the single-breath diffusing capacity of the lung for carbon monoxide (DLCO) to predict the need for supplemental oxygen during rest and exercise, as well as overall exercise capacity. Methods: One thousand seventy-one patients with a mean ( SD) FEV1 of 0.76 0.24 L were studied. Results: The mean DLCO was 8.0 3.1 mL/min/mm Hg (28 10% of predicted). The mean resting PaO2 was 64 10 mm Hg. There was a positive association between DLCO and both resting PaO2 and the requirement for oxygen during a walk at 1 mile per hour (mph). The odds of requiring supplemental oxygen while walking at 1 mph was nine times greater in patients with a DLCO of 35% of predicted, after adjusting for age and gender. Eighty four percent of individuals with a DLCO of 35%. Conclusion: Our results demonstrated that patients with reduced DLCO, particularly when < 20% of predicted, are more likely to have reduced PaO2 at rest and are more likely to require supplemental oxygen with low levels of activity. Thus, DLCO is useful in evaluating whether supplemental oxygen is required for exercise. (CHEST 2003; 123:1394 –1400)