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Reference Values for the Diffusing Capacity Determined by the Single-Breath Technique at Different Altitudes: The Latin American Single-Breath Diffusing Capacity Reference Project

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2016
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Vázquez García, Juan Carlos
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Reference Values for the Diffusing Capacity Determined by the Single-Breath Technique at Different Altitudes: The Latin American Single-Breath Diffusing Capacity Reference Project
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Author
  • Vázquez García, Juan Carlos;
  • Pérez Padilla, Rogelio;
  • Casas, Alejandro;
  • Schonffeldt Guerrero, Patricia;
  • Pereira, Jonatan;
  • Vargas Domínguez, Claudia;
  • Velázquez Uncal, Monica;
  • Martínez Briseno, David;
  • Torre Bouscoulet, Luis;
  • Gochicoa Rangel, Laura;
Abstract
BACKGROUND: The lung diffusion capacity (DLCO) determined by the single-breath technique greatly helps in the differential diagnosis and classification of severity of common lung diseases. However, widespread use of single-breath DLCO tests in Latin America has been limited, in part, by the lack of appropriate reference values. Our objective was to derive robust reference equations for single-breath DLCO from healthy Hispanic adults, using the most recent guidelines and taking into account altitude above sea level and hemoglobin. METHODS: We recruited healthy adults from Caracas (690 m), Santiago (650 m), Mexico City (2,240 m), and Bogota (2,640 m). DLCO testing was completed using an instrument that exceeds American Thoracic Society/European Respiratory Society 2005 guidelines for spirometry and single-breath DLCO and provided centralized training and a quality assurance program. RESULTS: We included 480 healthy Hispanic adults (58.3% women) with a mean age of 46 y (range 22-83 y). Their mean +/- SD single-breath DLCO was 30.4 +/- 9.2 mL/min/mm Hg. Results as a percentage of predicted by Crapo's reference values (the closest to obtained values) were 83 +/- 10% (Caracas), 91 +/- 10% (Santiago), 104 +/- 17% (Mexico City), and 118 +/- 19% (Bogota), and current suggested adjustments by hemoglobin or altitude did not correct differences, especially in Santiago and Caracas. CONCLUSIONS: We recommend these new single-breath DLCO reference equations to predict single-breath DLCO in Latin America performed with current instruments and procedures and including as a predictor altitude above sea level.
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URI: https://repositorio.uchile.cl/handle/2250/142386
DOI: 10.4187/respcare.04590
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Respiratory Care. Volumen: 61 Número: 9 Páginas: 1217-1223 (2016)
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