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A small amount of inhaled nitric oxide does not increase lung diffusing capacity

Dept of Anesthesia, McGill University Health Center, Montreal, Canada.

CORRESPONDENCE: G. S. Zavorsky, Dept of Anesthesia, McGill University Health Center, Montreal General Hospital, 1650 Cedar Avenue, Room D10-144, Montreal, Quebec H3G 1A4, Canada. Fax: 1 5149348249. E-mail: gerald.zavorsky{at}mcgill.ca

Keywords: Diffusing capacity, nitric oxide, repeatability

Received: December 12, 2005
Accepted February 24, 2006

The aim of the present study was to determine: 1) whether 40–50 ppm nitric oxide (NO) increases diffusing capacity of the lung for NO (D_L,NO) and carbon monoxide (D_L,CO), membrane diffusing capacity for CO (D_m,CO) and pulmonary capillary blood volume (V_c); 2) the actual number of tests required to provide a reasonable estimate of D_L,NO, D_L,CO, D_m,CO and V_c; and 3) repeatability of these parameters using the single-breath D_L,NO–D_L,CO method.

In total, 31 subjects performed five single-breath hold manoeuvres at rest, inhaling 43±3 ppm NO together with a standard diffusion mixture.

D_L,NO (D_m,CO) remained unchanged from the first to fifth trial. However, compared with the first trial, D_L,CO and V_c had decreased by the fourth (–4±5%; 95% confidence interval (CI) = –5– –2%) and third trial (–5±7%; 95% CI = –7– –2%), respectively. Repeatability over five trials was 17, 3 and 7 mL·min^–1·mmHg^–1 for D_L,NO, D_L,CO and D_m,CO, respectively, and 13 mL for V_c when D_m,CO = D_L,NO/2.42.

In conclusion, nitric oxide inhaled during sequential single-breath manoeuvres has no effect on diffusing capacity of the lung for nitric oxide and, thus, membrane diffusing capacity for carbon monoxide. Since more than two and three trials will lower pulmonary capillary blood volume and diffusing capacity of the lung for carbon monoxide, respectively, the average value of only two properly performed trials is suggested.

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