Ch. 5 - Diffusing Capacity Tests (PFT)
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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show | transfer factor
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what is DLCO used to assess? | show 🗑
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what is the most common DLCO method and most standardized method? | show 🗑
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what does DLCO measure? | show 🗑
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show | mL of CO/min/mm of mercury at 0 degree C, 760 mmHg, dry
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show | 210
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show | status of the alveolocapillary membranes
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what are the 2 components that the process of conductance across the membranes can be divided into? | show 🗑
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show | process of diffusion across alveolocapillary membrane; reaction rate/pulm capillary blood vol
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show | factors that change the membrane component, alterations in Hb, capillary blood volume
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show | alveolar pressure
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what is the equation that all methods of DLCO are based on? | show 🗑
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what does the pt do in the single-breath technique? | show 🗑
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what does the diffusion mixture usually contain? | show 🗑
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what is usually the tracer gas? | show 🗑
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what are used to detect changes in CO? | show 🗑
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how much should the pt ideally inhale of the VC? | show 🗑
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after inspiring the VC breath, how long does the pt hold the breath at TLC? | show 🗑
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after a suitable ________ _______ (750-1000 mL) has been discarded, a sample of _________ ____ is collected in a small bag or by continually aspirating a sample of the exhaled gas. | show 🗑
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what is the sample analyzed to obtain? | show 🗑
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show | breath hold
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what does the change in the tracer gas concentration reflect? | show 🗑
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what is this change used to determine? | show 🗑
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what are the two times the dilution of the tracer gas is used? | show 🗑
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show | diffusion of gas thru the alveolocapillary membrane
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show | full scale; zero
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if the analyzers have a linear response to each other, the fractional concentration of the tracer gas in the alveolar sample is equal to the ______. | show 🗑
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systems that use the same detector for both CO and the tracer gas also need to provide _______ _______. the linearity of the system should be within ____% of full scale. | show 🗑
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show | multigas analysis; methane
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show | CO and CH4 (methane) are measured rapidly and continuously
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what tracer gas is used for gas chromatography? carrier gas? | show 🗑
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gas chromatography is slow (60-90 secs), but is extremely __________. | show 🗑
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what should the resistance of the breathing circuit be? | show 🗑
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show | demand valve; <10 cmH2O
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the ______ method of timing the breath hold hsould be used. what does this method measure? | show 🗑
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show | 2.2 mL/kg IBW
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show | 350
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what is anatomic and instrument VD subtracted from before the alveolar vol is calculated? | show 🗑
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all gas volumes must be corrected from _____ to _____ for DLCO calculations. | show 🗑
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show | 3.5%; 8
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what is absorption of CO2 usually accomplished with? | show 🗑
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show | anhydrous CaSO4; selectively permeable tubing
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show | after pt has been seated for 5 minutes
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show | exercise increases CO (increases DLCO)
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show | usually 6 secs or less; rapid but not forced
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show | 85%; 4
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show | instantaneous filling of the lung
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what should the pt avoid excessiveness of? | show 🗑
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what might the valsalva/muller maneuver cause the DLCO to do? | show 🗑
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show | 4; 3
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how long should the breath-hold time, measured using the hones method be? | show 🗑
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what is one of the most common problems encountered when performing the DLCOsb maneuver? | show 🗑
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to obtain an alveolar sample, _____ _____ gas needs to be washed out. what is usually a sufficient washout time? what about with small VCs? | show 🗑
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show | 0.5-1.0 L
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show | alveolar plateau
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show | two; 3; 10%
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why should no more than 5 repeated maneuvers be performed? | show 🗑
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show | 4-minute
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the predicted DLCO should be corrected so that it reflects the DLCO at an Hb value of ____g% for adult and adolescent males, and to an Hb value of ____g% for women/children of either sex younger than 15. | show 🗑
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what does DLCO vary inversely with? | show 🗑
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show | rebreathes from a reservoir containing 0.3% CO, tracer gas, and air; 30-60 secs at 30 breaths/min
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the rebreathing method can be used during ________. | show 🗑
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what happens during the slow exhalation single-breath-intrabreath method? | show 🗑
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what does the pt do during this method? | show 🗑
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____ is used as the tracer gas because it can be rapidly measured using an infrared analyzer. | show 🗑
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the _________ _______ can also be used during exercise. | show 🗑
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show | pt performs 2 DLCOsb tests, each at a different level of alveolar PO2
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show | distinguish resistance caused by alveolocapillary membrane from resistance caused by RBC membrane/Hb reaction rate
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show | nitric oxide
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what is DLNO a direct measure of? | show 🗑
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show | 280
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DLNO reflects the ________ __________ to gas diffusion in the lungs. | show 🗑
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show | 25
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DLCO is often decreased in _________ lung disorders, particularly pulmonary fibrosis. | show 🗑
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what are other causes of decreased DLCO? | show 🗑
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show | early stage - normal or increased; most times decreased
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what is an exception to the extent of reduction being directly proportional to the vol of lung removed? | show 🗑
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DLCO is commonly used to monitor _____ ________. | show 🗑
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show | hepatopulmonary
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decreases in DLCO are termed _________ _______. | show 🗑
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show | breath a gas mixture of 0.1%-0.2% CO in air for 5-6 mins; last 2 mins expired gas collected in bag/balloon; ABG drawn
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what is exhaled volume measure and analyzed for? | show 🗑
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show | DLCOss= VCO/PACO
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DLCO may be decreased in both acute and chronic ____________ lung disease, like __________. | show 🗑
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DLCO measurements at rest have been suggested to estimate the probability of ___ ___________ during exercise. | show 🗑
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what is DLCO directly related to in healthy individuals? | show 🗑
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show | whether a decrease is due to loss of lung volume (restriction) or from uneven V/Q (obstruction)
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show | 4-5
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how is VA measured? | show 🗑
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show | not requiring a breath hold at TLC
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what indicates a restrictive cause of decreased DLCO? obstructive cause? | show 🗑
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what are 7 other physiologic factors that can influence the observed DLCO? | show 🗑
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what are the 3 methods to measure breath-hold time? | show 🗑
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a ______-_________ _______ has been proposed that uses separate equations for the three phases of the maneuver. | show 🗑
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