Journal of Applied Physiology, Vol 71, Issue 4 1477-1488, Copyright © 1991 by American Physiological Society

ARTICLES

Effect of lung volume and positional changes on pulmonary diffusing capacity and its components

H. Stam, F. J. Kreuzer and A. Versprille
Department of Pulmonary Diseases, University Hospital Dijkzigt, Erasmus University, Rotterdam, The Netherlands.

Normal subjects have a larger diffusing capacity normalized per liter alveolar volume (DL/VA) in the supine than in the sitting position. Body position changes total lung diffusing capacity (DL), DL/VA, membrane conductance (Dm), and effective pulmonary capillary blood volume (Qc) as a function of alveolar volume (VA). These functions were studied in 37 healthy volunteers. DL/VA vs. VA yields a linear relationship in sitting as well as in supine position. Both have a negative slope but usually do not run parallel. In normal subjects up to 50 yr old DL/VA and DL increased significantly when subjects moved from a sitting to a supine posture at volumes between 50 and 100% of total lung capacity (TLC). In subjects greater than 50 yr old the responses of DL/VA and DL to change in body position were not significant at TLC. Functional residual capacity (FRC) decreases and DL/VA increases in all normal subjects when they change position from sitting to supine. When DL/VA increases more than predicted from the DL/VA vs. VA relationship in a sitting position, we may infer an increase in effective Qc in the supine position. In 56% of the volunteers, supine DL was smaller than sitting DL despite a higher DL/VA at FRC in the supine position because of the relatively larger decrease in FRC. When the positional response at TLC is studied, an estimation obtained accidentally at a volume lower than TLC may influence results. Above 80% of TLC, Dm decreased significantly from sitting to supine. Below this lung volume the decrease was not significant. The relationship between Qc and VA was best described by a second-order polynomial characterized by a maximum Qc at a VA greater than 60% of TLC. Qc was significantly higher in the supine position than in the sitting position, but the difference became smaller with increasing age. In observing the sitting and supine positions, we saw a decrease in maximum Qc normalized per square meter of body surface area with age.

This article has been cited by other articles:

				B. Aguilaniu, J. Maitre, S. Glenet, A. Gegout-Petit, and H. Guenard European reference equations for CO and NO lung transfer Eur. Respir. J., May 1, 2008; 31(5): 1091 - 1097. [Abstract] [Full Text] [PDF]

				S. N. Glenet, C. De Bisschop, F. Vargas, and H. J. P. Guenard Deciphering the nitric oxide to carbon monoxide lung transfer ratio: physiological implications J. Physiol., July 15, 2007; 582(2): 767 - 775. [Abstract] [Full Text] [PDF]

				E. M. Snyder, B. D. Johnson, and K. C. Beck An open-circuit method for determining lung diffusing capacity during exercise: comparison to rebreathe J Appl Physiol, November 1, 2005; 99(5): 1985 - 1991. [Abstract] [Full Text] [PDF]

				N. MacIntyre, R. O. Crapo, G. Viegi, D. C. Johnson, C. P. M. van der Grinten, V. Brusasco, F. Burgos, R. Casaburi, A. Coates, P. Enright, et al. Standardisation of the single-breath determination of carbon monoxide uptake in the lung Eur. Respir. J., October 1, 2005; 26(4): 720 - 735. [Abstract] [Full Text] [PDF]

				P. Palermo, G. Cattadori, M. Bussotti, A. Apostolo, M. Contini, and P. Agostoni Lateral Decubitus Position Generates Discomfort and Worsens Lung Function in Chronic Heart Failure Chest, September 1, 2005; 128(3): 1511 - 1516. [Abstract] [Full Text] [PDF]

				I. M. Olfert and G. K. Prisk Effect of 60{degrees} head-down tilt on peripheral gas mixing in the human lung J Appl Physiol, September 1, 2004; 97(3): 827 - 834. [Abstract] [Full Text] [PDF]

				G. Peces-Barba, M. J. Rodriguez-Nieto, S. Verbanck, M. Paiva, and N. Gonzalez-Mangado Lower pulmonary diffusing capacity in the prone vs. supine posture J Appl Physiol, May 1, 2004; 96(5): 1937 - 1942. [Abstract] [Full Text] [PDF]

				M. Rohdin, J. Petersson, P. Sundblad, M. Mure, R. W. Glenny, S. G. E. Lindahl, and D. Linnarsson Effects of gravity on lung diffusing capacity and cardiac output in prone and supine humans J Appl Physiol, July 1, 2003; 95(1): 3 - 10. [Abstract] [Full Text] [PDF]

				S. Montmerle, J. Spaak, and D. Linnarsson Lung function during and after prolonged head-down bed rest J Appl Physiol, January 1, 2002; 92(1): 75 - 83. [Abstract] [Full Text] [PDF]

				J.M.B. Hughes and N.B. Pride In defence of the carbon monoxide transfer coefficient KCO (TL/VA) Eur. Respir. J., February 1, 2001; 17(2): 168 - 174. [Abstract] [Full Text] [PDF]

				H. Stam, T. A. W. Splinter, and A. Versprille Evaluation of Diffusing Capacity in Patients With a Restrictive Lung Disease Chest, March 1, 2000; 117(3): 752 - 757. [Abstract] [Full Text] [PDF]

				F. Manning, E. Dean, J. Ross, and R. T Abboud Effects of Side Lying on Lung Function in Older Individuals Physical Therapy, May 1, 1999; 79(5): 456 - 466. [Abstract] [Full Text] [PDF]

				S. Verbanck, H. Larsson, D. Linnarsson, G. K. Prisk, J. B. West, and M. Paiva Pulmonary tissue volume, cardiac output, and diffusing capacity in sustained microgravity J Appl Physiol, September 1, 1997; 83(3): 810 - 816. [Abstract] [Full Text] [PDF]