Effect of Low Hemoglobin Levels on the Diffusing Capacity of the Lungs for CO

Petermann, W

doi:10.1159/000194746

Cited by 10 publications

(6 citation statements)

References 12 publications

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“…Heard [23] and Perry et al [24] have described parenchymal fibrosis and fibrin masses in the air spaces of chronic uremic patients which could lead to alveolar-capillary block and the DLCO reduction. Since our results are in agreement with Peterman's data [7], it is possible that in uremic patients on chronic HD with 'healthy lungs' (diagnosed radiologically and spirometrically) the DLCO reduction is a function of coexisting ane mia and low Hb levels. A possible explanation for HD-induced DLCO reduction may be HD-induced decreased pulmonary perfusion, as evidenced by de creased Vc.…”

Section: Discussionsupporting

confidence: 92%

“…Dinkara et al [6] reported that a reduction of Hb lev el by 10 g/1 resulted in a decrease of the DLCO by 7%. Investigating the influence of Hb concentration on DLCO and the effect of BT in patients with anemias of various etiologies, Peterman [7] reported similar findings. Based on the mean value of Hb of 145 g/1 for men and women, the present study showed that a 10-g/1 change in Hb concentration caused by transfusion corresponded to a 7.2% change in the DLCO.…”

Section: Discussionmentioning

confidence: 76%

“…Patients with anemia have low values of pulmonary diffusion capacity for carbon monoxide (DLCO) [5][6][7], Decreased DLCO has also been observed in pa tients on chronic hemodialysis (HD) and was ex plained by coexisting anemia [8]. Dinkara et al [6] re ported that a reduction of the hemoglobin (Hb) level by 10 g/l in anemic patients resulted in a 1% DLCO decrease.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of Hemodialysis and Anemia on Pulmonary Diffusing Capacity, Membrane Diffusing Capacity and Capillary Blood Volume in Uremic Patients

Dujić¹,

Tocilj

Ljutić³

et al. 1991

Respiration

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The study aimed at investigating pulmonary function in uremic patients, emphasizing the lung diffusing capacity for CO (DLCO) and its membrane and pulmonary capillary blood volume (Vc) components. The study sample comprised 25 uremic patients without clinical/radiological evidence of lung disease. They were enrolled in a chronic hemodialysis (HD) program and had anemia requiring transfusions. The subjects were tested for their lung function before and after both a first HD and a HD with blood transfusion (BT) that followed a few days later. After HD-induced removal of body fluid, and increase in pre-HD reduced forced vital capacity, alveolar volume and mid-expiratory flow rate (FEF_25-75%) was observed. HD-induced DLCO decrease (p < 0.005) was observed and was related to decreased Vc. The second HD with BT increased DLCO, due to partially normalized Hb. On average, a 7.2% DLCO increase corresponded to each 10-g/l Hb rise. In conclusion, (1) the beneficial effect of HD in uremic patients reverts the small-airway obstruction; (2) the lower values of DLCO in these patients are due to reduced Hb and HD causes further DLCO reduction via decrease of Vc, and (3) HD with BT still increases DLCO because improvement of Hb predominates

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

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Effects of Hemodialysis and Anemia on Pulmonary Diffusing Capacity, Membrane Diffusing Capacity and Capillary Blood Volume in Uremic Patients

Dujić¹,

Tocilj

Ljutić³

et al. 1991

Respiration

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“…Studies examining the effect of just anaemia or anaemia combined with disorder of the alveolocapillary membrane consistently mention that anaemia does affect the diffusion capacity, but the defect of the respiratory membrane on diffusing capacity is greater. 22 23 In this study, we have patients with COPD and anaemia who commonly also have defect with the respiratory membrane, both contributing to the reduced DLco as noted. We think that the initial poor correlation with blood gases in this study is because the compensatory mechanisms are not yet fully dysfunctional and the anaemia not severe.…”

Section: Discussionmentioning

confidence: 98%

Impact of anaemia on lung function and exercise capacity in patients with stable severe chronic obstructive pulmonary disease

et al. 2015

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ObjectiveThis study intended to search for potential correlations between anaemia in patients with severe chronic obstructive pulmonary disease (COPD; GOLD stage III) and pulmonary function at rest, exercise capacity as well as ventilatory efficiency, using pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET).SettingThe study was undertaken at Shanghai Pulmonary Hospital, a tertiary-level centre affiliated to Tongji University. It caters to a large population base within Shanghai and referrals from centres in other cities as well.Participants157 Chinese patients with stable severe COPD were divided into 2 groups: the anaemia group (haemoglobin (Hb) <12.0 g/dL for males, and <11 g/dL for females (n=48)) and the non-anaemia group (n=109).Primary and secondary outcome measuresArterial blood gas, PFT and CPET were tested in all patients.Results(1) Diffusing capacity for carbon monoxide (DLCO) corrected by Hb was significantly lower in the anaemia group ((15.3±1.9) mL/min/mm Hg) than in the non-anaemia group ((17.1±2.1) mL/min/mm Hg) (p<0.05). A significant difference did not exist in the level of forced expiratory volume in 1 s (FEV1), FEV1%pred, FEV1/forced vital capacity (FVC), inspiratory capacity (IC), residual volume (RV), total lung capacity (TLC) and RV/TLC (p>0.05). (2) Peak Load, Peak oxygen uptake (), Peak %pred, Peak , Peak pulse and the ratio of increase to WR increase () were significantly lower in the anaemia group (p<0.05); however, Peak minute ventilation (VE), Lowest /carbon dioxide output () and Peak dead space/tidal volume ratio (VD/VT) were similar between the 2 groups (p>0.05). (3) A strong positive correlation was found between Hb concentration and Peak in patients with anaemia (r=0.702, p<0.01).ConclusionsAnaemia has a negative impact on gas exchange and exercise tolerance during exercise in patients with severe COPD. The decrease in amplitude of Hb levels is related to the quantity of oxygen uptake.

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“…It is known that Hb can affect the oxygen carrying capacity of blood in circulation. 20 In the case of anemia, the oxygen carrying capacity decreases and the respiratory function changes accordingly. This helps explain our finding of higher respiratory rate in patients with anemia.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Function Testing in Pediatric Pneumonia Patients With Wheezing Younger Than 3 Years of Age

Chen

Liu

et al. 2019

Global Pediatric Health

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Background. Wheezing symptoms are one of the risk factors in young pneumonia patients that often leads to asthma development. Infant pulmonary function test (iPFT) is potentially a useful tool to help identify and manage these high-risk pneumonia patients. Methods. To examine whether patients with wheezing symptoms are more likely to have poorer pulmonary function and treatment outcomes, and also to explore the clinical benefit of iPFT in young pneumonia patients, we conducted a retrospective analysis of 1005 pneumonia inpatients <3 years of age who had undergone iPFT testing in 2016 at Liuzhou Maternity and Child Healthcare Hospital in Guang-Xi, China. Results . We identified from the hospital database 505 pneumonia patients who presented with wheezing and 500 without wheezing. Univariate analysis showed that wheezing symptoms, viral infection, age <1 year, female gender, and prematurity were significantly associated with poorer iPFT results. After adjusting for confounders, patients with wheezing showed significantly poorer pulmonary function. Patients with wheezing had longer length of stay (7.9 ± 3.9 days vs 6.5 ± 2.6 days; P < .001) and lower percent with no residual clinical symptoms at discharge (58% vs 98%; P < .001) when compared with those of non-wheezing patients. In addition, 81% of patients with viral infection as compared with 43% of patients with nonviral infection presented with wheezing symptoms ( P < .001). Conclusion. Wheezing symptoms were associated with poorer iPFT measures and treatment outcomes for pneumonia inpatients <3 years of age. Patients with wheezing had poorer treatment outcomes. iPFT can be useful in assessing and monitoring young patients with high risk of developing asthma or chronic lung disease later in life.

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Effect of Low Hemoglobin Levels on the Diffusing Capacity of the Lungs for CO

Cited by 10 publications

References 12 publications

Effects of Hemodialysis and Anemia on Pulmonary Diffusing Capacity, Membrane Diffusing Capacity and Capillary Blood Volume in Uremic Patients

Effects of Hemodialysis and Anemia on Pulmonary Diffusing Capacity, Membrane Diffusing Capacity and Capillary Blood Volume in Uremic Patients

Impact of anaemia on lung function and exercise capacity in patients with stable severe chronic obstructive pulmonary disease

Pulmonary Function Testing in Pediatric Pneumonia Patients With Wheezing Younger Than 3 Years of Age

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