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DLCO
DLCO or TLCO (diffusing capacity or transfer factor of the lung for carbon monoxide (CO),) is the extent to which oxygen passes from the air sacs of the lungs into the blood. Commonly, it refers to the test used to determine this parameter. It was introduced in 1909.
==Mechanism of The DLCO Test==
This test involves measuring the partial pressure difference between inspired and expired carbon monoxide. It relies on the strong affinity and large absorption capacity of erythrocytes for carbon monoxide and thus demonstrates gas uptake by the capillaries that are less dependent on cardiac output.〔Sue DY, Oren A, Hansen JE & Wasserman K (1987). Diffusing capacity for carbon monoxide as a predictor of gas exchange during exercise. N. Engl. J. Med., 316(21):1301-1306.〕 The measurement of DLCO is affected by atmospheric pressure and/or altitude and correction factors can be calculated using the method recommended by the American Thoracic Society.〔American Thoracic society, Single Breath Carbon Monoxide Diffusing Capacity (transfer factor) Recommendations for a Standard Technique- 1995 Update, Am J Respir Crit Care Med. 152 pp 2185-2198 (1995).〕 Expected DLCO is also affected by the amount of hemoglobin, carboxyhemoglobin, age and sex. The correction for hemoglobin is based on the method of Cotes〔J.E. Cotes 1993, Lung Function, 5th Edition., Blackwell Scientific Publications, London〕〔J.E. Cotes, J.M. Dabbs, P.C. Elwood, A.M. Hall, A. McDonald, and M.J. Saunders. Iron-deficiency anaemia: its effects on transfer factor for the lung (diffusing capacity) and ventilation and cardiac frequency during submaximal exercise. Clin. Sci. 42:325-33 (1972).〕 as recommended by the American Thoracic Society. Online resources exist to facilitate these corrections for (altitude ), (hemoglobin ), and (carboxyhemoglobin ).
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