Recruitment of lung diffusing capacity: update of concept and application

Chest. 2002 Nov;122(5):1774-83. doi: 10.1378/chest.122.5.1774.


Lung diffusing capacity (DL) for carbon monoxide (DLCO), nitric oxide (DLNO) or oxygen (DLO2) increases from rest to peak exercise without reaching an upper limit; this recruitment results from interactions among alveolar volume (VA), and cardiac output (q), as well as changing physical properties and spatial distribution of capillary erythrocytes, and is critical for maintaining a normal arterial oxygen saturation. DLCO and DLNO can be used to interpret the effectiveness of diffusive oxygen transport and track structural alterations of the alveolar-capillary barrier, providing sensitive noninvasive indicators of microvascular integrity in health and disease. Clinical interpretation of DL should take into account Q in addition to VA and hemoglobin concentration.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Erythrocytes
  • Exercise
  • Heart Diseases / physiopathology
  • Hematocrit
  • Humans
  • Lung Diseases / physiopathology
  • Pulmonary Alveoli
  • Pulmonary Diffusing Capacity* / physiology