• Respiratory care · Sep 2016

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

    • Juan Carlos Vázquez-García, Rogelio Pérez-Padilla, Alejandro Casas, Patricia Schönffeldt-Guerrero, Jonatan Pereira, Claudia Vargas-Domínguez, Mónica Velázquez-Uncal, David Martínez-Briseño, Luis Torre-Bouscoulet, and Laura Gochicoa-Rangel.
    • Departamento de Fisiología Respiratoria. Instituto Nacional de Enfermedades Respiratorias, "Ismael Cosío Villegas," Tlalpan, Distrito Federal, Mexico. drjcvazquez@gmail.com.
    • Respir Care. 2016 Sep 1; 61 (9): 1217-23.

    BackgroundThe 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.MethodsWe 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.ResultsWe 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.ConclusionsWe 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.Copyright © 2016 by Daedalus Enterprises.

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