Impaired lung diffusing capacity for nitric oxide and alveolar-capillary membrane conductance results in oxygen desaturation during exercise in patients with cystic fibrosis

Courtney M. Wheatley, William T. Foxx-Lupo, Nicholas A. Cassuto, Eric C. Wong, Cori L Daines, Wayne J Morgan, Eric M. Snyder

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Exercise has been shown to be beneficial for patients with cystic fibrosis (CF), but for some CF patients there is a risk of desaturation, although the predicting factors are not conclusive or reliable. We sought to determine the relationship between the diffusion capacity of the lungs for nitric oxide and carbon monoxide (DLNO and DLCO) and the components of DLCO: alveolar-capillary membrane conductance (DM), and pulmonary capillary blood volume (VC) on peripheral oxygen saturation (SaO2) at rest and during exercise in CF. Methods: 17 mild/moderate CF patients and 17 healthy subjects were recruited (age=26±7 vs. 23±8 years, ht=169±8 vs. 166±8 cm, wt=65±9 vs. 59±8 kg, BMI=23±3 vs. 22±3 kg/m2, VO2PEAK=101±36 vs. 55±25%pred., FEV1=92±22 vs. 68±25%pred., for healthy and CF, respectively, mean±SD, VO2PEAK and FEV1 p<0.001). Subjects performed incremental cycle ergometry to exhaustion with continuous monitoring of SaO2 and measures of DLNO, DLCO, DM and VC at each stage. Results: CF patients had a lower SaO2 at rest and peak exercise (rest=98±1 vs. 96±1%, peak=97±2 vs. 93±5%, for healthy and CF, respectively, p<0.01). At rest, DLNO, DLCO, DM were significantly lower in the CF group (p<0.01). The difference between groups was augmented with exercise (DLNO=117±4 vs. 73±3ml/min/mmHg; DLCO=34±8 vs. 23±8ml/min/mmHg; DM=50±1 vs. 34±1, p<0.001, for healthy and CF respectively). Peak SaO2 was related to resting DLNO in CF patients (r=0.65, p=0.003). Conclusions: These results suggest a limitation in exercise-mediated increases in membrane conductance in CF which may contribute to a drop in SaO2 and that resting DLNO can account for a large portion of the variability in SaO2.

Original languageEnglish (US)
Pages (from-to)45-53
Number of pages9
JournalJournal of Cystic Fibrosis
Volume10
Issue number1
DOIs
StatePublished - Jan 2011

Fingerprint

Lung Volume Measurements
Cystic Fibrosis
Nitric Oxide
Exercise
Oxygen
Membranes
Ergometry
Carbon Monoxide
Blood Volume
Healthy Volunteers

Keywords

  • Cystic fibrosis
  • DLCO
  • DLNO
  • Exercise
  • Lung diffusion
  • Peripheral oxygen saturation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Impaired lung diffusing capacity for nitric oxide and alveolar-capillary membrane conductance results in oxygen desaturation during exercise in patients with cystic fibrosis. / Wheatley, Courtney M.; Foxx-Lupo, William T.; Cassuto, Nicholas A.; Wong, Eric C.; Daines, Cori L; Morgan, Wayne J; Snyder, Eric M.

In: Journal of Cystic Fibrosis, Vol. 10, No. 1, 01.2011, p. 45-53.

Research output: Contribution to journalArticle

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abstract = "Background: Exercise has been shown to be beneficial for patients with cystic fibrosis (CF), but for some CF patients there is a risk of desaturation, although the predicting factors are not conclusive or reliable. We sought to determine the relationship between the diffusion capacity of the lungs for nitric oxide and carbon monoxide (DLNO and DLCO) and the components of DLCO: alveolar-capillary membrane conductance (DM), and pulmonary capillary blood volume (VC) on peripheral oxygen saturation (SaO2) at rest and during exercise in CF. Methods: 17 mild/moderate CF patients and 17 healthy subjects were recruited (age=26±7 vs. 23±8 years, ht=169±8 vs. 166±8 cm, wt=65±9 vs. 59±8 kg, BMI=23±3 vs. 22±3 kg/m2, VO2PEAK=101±36 vs. 55±25{\%}pred., FEV1=92±22 vs. 68±25{\%}pred., for healthy and CF, respectively, mean±SD, VO2PEAK and FEV1 p<0.001). Subjects performed incremental cycle ergometry to exhaustion with continuous monitoring of SaO2 and measures of DLNO, DLCO, DM and VC at each stage. Results: CF patients had a lower SaO2 at rest and peak exercise (rest=98±1 vs. 96±1{\%}, peak=97±2 vs. 93±5{\%}, for healthy and CF, respectively, p<0.01). At rest, DLNO, DLCO, DM were significantly lower in the CF group (p<0.01). The difference between groups was augmented with exercise (DLNO=117±4 vs. 73±3ml/min/mmHg; DLCO=34±8 vs. 23±8ml/min/mmHg; DM=50±1 vs. 34±1, p<0.001, for healthy and CF respectively). Peak SaO2 was related to resting DLNO in CF patients (r=0.65, p=0.003). Conclusions: These results suggest a limitation in exercise-mediated increases in membrane conductance in CF which may contribute to a drop in SaO2 and that resting DLNO can account for a large portion of the variability in SaO2.",
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T1 - Impaired lung diffusing capacity for nitric oxide and alveolar-capillary membrane conductance results in oxygen desaturation during exercise in patients with cystic fibrosis

AU - Wheatley, Courtney M.

AU - Foxx-Lupo, William T.

AU - Cassuto, Nicholas A.

AU - Wong, Eric C.

AU - Daines, Cori L

AU - Morgan, Wayne J

AU - Snyder, Eric M.

PY - 2011/1

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N2 - Background: Exercise has been shown to be beneficial for patients with cystic fibrosis (CF), but for some CF patients there is a risk of desaturation, although the predicting factors are not conclusive or reliable. We sought to determine the relationship between the diffusion capacity of the lungs for nitric oxide and carbon monoxide (DLNO and DLCO) and the components of DLCO: alveolar-capillary membrane conductance (DM), and pulmonary capillary blood volume (VC) on peripheral oxygen saturation (SaO2) at rest and during exercise in CF. Methods: 17 mild/moderate CF patients and 17 healthy subjects were recruited (age=26±7 vs. 23±8 years, ht=169±8 vs. 166±8 cm, wt=65±9 vs. 59±8 kg, BMI=23±3 vs. 22±3 kg/m2, VO2PEAK=101±36 vs. 55±25%pred., FEV1=92±22 vs. 68±25%pred., for healthy and CF, respectively, mean±SD, VO2PEAK and FEV1 p<0.001). Subjects performed incremental cycle ergometry to exhaustion with continuous monitoring of SaO2 and measures of DLNO, DLCO, DM and VC at each stage. Results: CF patients had a lower SaO2 at rest and peak exercise (rest=98±1 vs. 96±1%, peak=97±2 vs. 93±5%, for healthy and CF, respectively, p<0.01). At rest, DLNO, DLCO, DM were significantly lower in the CF group (p<0.01). The difference between groups was augmented with exercise (DLNO=117±4 vs. 73±3ml/min/mmHg; DLCO=34±8 vs. 23±8ml/min/mmHg; DM=50±1 vs. 34±1, p<0.001, for healthy and CF respectively). Peak SaO2 was related to resting DLNO in CF patients (r=0.65, p=0.003). Conclusions: These results suggest a limitation in exercise-mediated increases in membrane conductance in CF which may contribute to a drop in SaO2 and that resting DLNO can account for a large portion of the variability in SaO2.

AB - Background: Exercise has been shown to be beneficial for patients with cystic fibrosis (CF), but for some CF patients there is a risk of desaturation, although the predicting factors are not conclusive or reliable. We sought to determine the relationship between the diffusion capacity of the lungs for nitric oxide and carbon monoxide (DLNO and DLCO) and the components of DLCO: alveolar-capillary membrane conductance (DM), and pulmonary capillary blood volume (VC) on peripheral oxygen saturation (SaO2) at rest and during exercise in CF. Methods: 17 mild/moderate CF patients and 17 healthy subjects were recruited (age=26±7 vs. 23±8 years, ht=169±8 vs. 166±8 cm, wt=65±9 vs. 59±8 kg, BMI=23±3 vs. 22±3 kg/m2, VO2PEAK=101±36 vs. 55±25%pred., FEV1=92±22 vs. 68±25%pred., for healthy and CF, respectively, mean±SD, VO2PEAK and FEV1 p<0.001). Subjects performed incremental cycle ergometry to exhaustion with continuous monitoring of SaO2 and measures of DLNO, DLCO, DM and VC at each stage. Results: CF patients had a lower SaO2 at rest and peak exercise (rest=98±1 vs. 96±1%, peak=97±2 vs. 93±5%, for healthy and CF, respectively, p<0.01). At rest, DLNO, DLCO, DM were significantly lower in the CF group (p<0.01). The difference between groups was augmented with exercise (DLNO=117±4 vs. 73±3ml/min/mmHg; DLCO=34±8 vs. 23±8ml/min/mmHg; DM=50±1 vs. 34±1, p<0.001, for healthy and CF respectively). Peak SaO2 was related to resting DLNO in CF patients (r=0.65, p=0.003). Conclusions: These results suggest a limitation in exercise-mediated increases in membrane conductance in CF which may contribute to a drop in SaO2 and that resting DLNO can account for a large portion of the variability in SaO2.

KW - Cystic fibrosis

KW - DLCO

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KW - Lung diffusion

KW - Peripheral oxygen saturation

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