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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| show | gas-exchange ability of lungs, specifically oxygenation of mixed venous blood
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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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| what does DM reflect? and what does the uptake of CO by Hb depend on? | show 🗑
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| show | factors that change the membrane component, alterations in Hb, capillary blood volume
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| basically, what is the pressure gradient causing diffusion? | show 🗑
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| show | DLCO = VCO/(PACO-PCCO)
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| what does the pt do in the single-breath technique? | show 🗑
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| show | 0.3% CO, "tracer" gas, 21% O2, balance is N2
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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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| show | 90% within 2.5-4 secs
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| show | 10 secs, exhales within 4 secs
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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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| the concentration of CO in the alveoli at the beginning of the _______ _____ must be determined as well. | show 🗑
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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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| what is the difference in the amount of the CO between inspiration and expiration? | show 🗑
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| the tracer gas and CO analyzers may be calibrated to real ____ ______ when sampling the diffusion mizture, and to read _____ when sampling air. | show 🗑
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| show | FACO0
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| show | linear output; 0.5%
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| show | multigas analysis; methane
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| what is one advantage of multi-gas analysis? | show 🗑
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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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| show | jones; breath-hold time from 0.3 of the I time to the midpoint of the alveolar sample collection
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| what should anatomic dead space be calculated as? | show 🗑
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| show | 350
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| show | inspired volume
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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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| what does the single-breath calculation assume? | show 🗑
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| show | positive intrathoracic pressure (valsalva maneuver) or negative intrathoracic pressure (muller maneuver)
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| show | valsalva - decrease DLCO; muller - increase DLCO
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| exhalation should take less than __ secs and alveolar gas sampling should occur in less than __ secs. | show 🗑
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| how long should the breath-hold time, measured using the hones method be? | show 🗑
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| show | failure to inspire 85% of previously measured VC
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| show | dead space; 0.75-1.0 L; 0.5 L
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| what is the sample volume size? | show 🗑
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| alveolar sampling may be adjusted to begin at the point where the tracer gas and CO indicate an "________ ________." | show 🗑
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| show | two; 3; 10%
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| show | b/c of the effect of increasing COHb from inhalation of the test gas.
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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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| what does the pt do during the rebreathing technique? | show 🗑
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| show | exercise
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| show | pt inspires a VC breath of test gas containing 0.3% CO, 0.3% CH4, 21% O2, & balance N2
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| show | exhales slowly and evenly at approximately 0.5L/sec from TLC to RV
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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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| the membrane component of resistance to gas transfer can also be estimated by measuring the rate of uptake of ______ ______. | show 🗑
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| show | conductance of alveolocapillary membrane
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| show | 280
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| DLNO reflects the ________ __________ to gas diffusion in the lungs. | show 🗑
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| the avg DLCO value for resting adult pts by the single-breath method is approximately ___ mL CO/min/mmHg (STPD) with significant variability. | show 🗑
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| show | resistrictive
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| show | pulmonary edema; medical/surgical intervention for cardiopulmonary disease; radiation therapy; chemo drugs; inhalation of toxic gases
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| what is DLCO in CHF? | show 🗑
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| show | lung volume reduction surgery and bullectomy
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| DLCO is commonly used to monitor _____ ________. | show 🗑
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| DLCO may be helpful in evaluating disorders such as ____________ syndrome. | show 🗑
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| decreases in DLCO are termed _________ _______. | show 🗑
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| what is the steady state (filey) technique? | show 🗑
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| what is exhaled volume measure and analyzed for? | show 🗑
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| what is the calculation of steady diffusing? | show 🗑
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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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| show | lung volume
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| what can analysis of this relationship help to determine? | show 🗑
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| show | 4-5
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| show | by the dilution of the tracer gas used
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| what is the advantage of the intrabreath method? | show 🗑
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| show | decreased without a reduction in VA; if DLCO and DL/VA are decreased
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| show | 1. Hb/Hct 2. COHb (increases reduce DLCO) 3. alveolar PCO2 4. pulmonary capillary blood vol 5. body position (supine increases DLCO) 6. altitude about sea level 7. asthma/obesity
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| show | 1. jones method 2. epidemiology standardization project method (midpoint of I to beginning of alveolar sampling) 3. ogilvie method (beginning of I to beginning of alveolar sampling)
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| a ______-_________ _______ has been proposed that uses separate equations for the three phases of the maneuver. | show 🗑
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