Effect of salbutamol on the measurement of single‐breath diffusing capacity

Yang, Jun; Stanton, Josh D.; Wang, Lexin; Beckert, Lutz; Frampton, Chris; Burton, Debbie; Swanney, Maureen P.

doi:10.1111/resp.12125

Cited by 11 publications

(8 citation statements)

References 25 publications

(47 reference statements)

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“…Increased airway conductance and accessible alveolar volume caused by sustained effects from asthma therapy could possibly influence the findings in the few participants with asthma. The available data in this area is scarce [49], and the 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung does not provide specific advice regarding discontinuation of asthma medications [9].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Development of lung diffusion to adulthood following extremely preterm birth

et al. 2021

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BackgroundGas exchange in extremely preterm (EP) infants must take place in foetal lungs. Childhood lung diffusing capacity for carbon monoxide (DLCO) is reduced; however, longitudinal development has not been investigated. We describe growth of DLCO and its sub-components to adulthood in EP-born compared to term-born subjects.MethodsTwo area-based cohorts born at gestational age ≤28 weeks or birth weight ≤1000 grams in 1982–1985 (n=48) and 1991–1992 (n=35) were examined twice, at ages 18 and 25, and 10 and 18 years, respectively, and compared to matched term-born controls. Single-breath DLCO was measured at two oxygen pressures, with sub-components [membrane diffusion (DM) and pulmonary capillary blood volume (VC)] calculated using the Roughton–Forster equation.ResultsAge-, sex- and height-standardized transfer coefficients for carbon monoxide (KCO), and DLCO were reduced in EP-born compared to term-born and remained so during puberty and early adulthood (p-values for all time points and both cohorts ≤0.04), whereas alveolar volume was similar. Development occurred in parallel to term-born controls, with no signs of pubertal catch-up growth nor decline at 25 years (p-values for lack of parallelism within cohorts 0.99, 0.65, 0.71, 0.94, and 0.44 for z-DLCO, z-VA, z-KCO, DM, and VC, respectively). Split by membrane and blood volume components, findings were less clear; however, membrane diffusion seemed most affected.ConclusionPulmonary diffusing capacity was reduced in EP-born compared to term-born, and development from childhood to adulthood tracked in parallel to term-born, with no signs of catch-up growth nor decline at age 25.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Development of lung diffusion to adulthood following extremely preterm birth

et al. 2021

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“…Pulmonary function test sequence DLCO manoeuvres are frequently conducted immediately following the administration of 400 μg of salbutamol in the interval between pre-and post-bronchodilator spirometry testing [60]. While an older study in obstructive lung disease subjects found that DLCO may increase by up to 6% after administration of a bronchodilator [86], a newer study has found that the administration of 400 μg of salbutamol has no significant effect on DLCO in normal control subjects or in patients with either reversible on non-reversible airflow obstruction [87]. A further study has found no significant salbutamol effect on DLCO in COPD patients at doses of less than 1000 μg [88].…”

Section: Miscellaneous Factorsmentioning

confidence: 99%

2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung

et al. 2017

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This document provides an update to the European Respiratory Society (ERS)/American Thoracic Society (ATS) technical standards for single-breath carbon monoxide uptake in the lung that was last updated in 2005. Although both D (diffusing capacity) and T (transfer factor) are valid terms to describe the uptake of carbon monoxide in the lung, the term D is used in this document. A joint taskforce appointed by the ERS and ATS reviewed the recent literature on the measurement of D and surveyed the current technical capabilities of instrumentation being manufactured around the world. The recommendations in this document represent the consensus of the taskforce members in regard to the evidence available for various aspects of D measurement. Furthermore, it reflects the expert opinion of the taskforce members on areas in which peer-reviewed evidence was either not available or was incomplete. The major changes in these technical standards relate to D measurement with systems using rapidly responding gas analysers for carbon monoxide and the tracer gas, which are now the most common type of D instrumentation being manufactured. Technical improvements and the increased capability afforded by these new systems permit enhanced measurement of D and the opportunity to include other optional measures of lung function.

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“…However, in those with reversible airway disease, salbutamol increased alveolar ventilation and decreased the transfer coefficient for carbon monoxide, while the mean change in DL CO was not different. Furthermore, a small group of individuals who had significant reversibility in FEV 1 demonstrated a considerable reduction in DL CO after salbutamol …”

Section: Pulmonary Physiologymentioning

confidence: 96%

“…The American Thoracic Society and European Respiratory Society Guidelines for pulmonary function testing have differing recommendations regarding how bronchodilators effect single breath diffusion capacity for carbon monoxide (DL CO ) . Yang et al . report that salbutamol has no effect on DL CO in normal individuals or those with fixed airway obstruction.…”

Section: Pulmonary Physiologymentioning

confidence: 99%