medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2020-9-15-23medalphabet-1512Research ArticleФУНКЦИЯ ВНЕШНЕГО ДЫХАНИЯФУНКЦИЯ ВНЕШНЕГО ДЫХАНИЯНовые стандарты измерения диффузионной способности легких по монооксиду углерода методом одиночного вдохаNew standards for measuring the diffusion capacity of the lungs by carbon monoxide by single breath methodНеклюдоваГ. В.NekludovaG. V.

д. м. н., ведущий научный сотрудник лаборатории функциональных и ультразвуковых методов исследования; доцент кафедры пульмонологии лечебного факультета

ЧернякА. В.ChernyakA. V.

к. м. н., заведующий лабораторией функциональных и ультразвуковых методов исследования; врач функциональной диагностики отделения функциональной и ультразвуковой диагностики

Федеральное государственное бюджетное учреждение «Научно-исследовательский институт пульмонологии» Федерального медико-биологического агентства России; Федеральное государственное бюджетное образовательное учреждение высшего образования Первый Московский государственный медицинский университет имени И. М. Сеченова Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Institution «Pulmonology Scientific Research Institute under Federal Medical and Biological Agency of Russsian Federation»; The State Education Institution of Higher Professional Training The First Sechenov Moscow State Medical University under Ministry of Health of the Russian FederationRussian FederationФедеральное государственное бюджетное учреждение «Научно-исследовательский институт пульмонологии» Федерального медико-биологического агентства России; Государственное бюджетное учреждение здравоохранения города Москвы «Городская клиническая больница имени Д. Д. Плетнёва Департамента здравоохранения города Москвы»РоссияFederal State Budgetary Institution «Pulmonology Scientific Research Institute under Federal Medical and Biological Agency of Russsian Federation»; City Clinical Hospital named after D. D. Pletnev of Moscow Department of HealthRussian Federation20201706202009Современная функциональная диагностика1523Copyright © Неклюдова Г.В., Черняк А.В., 20202020Неклюдова Г.В., Черняк А.В.Nekludova G.V., Chernyak A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/1512

В статье представлен обзор технических возможностей и обновленные стандарты проведения исследования диффузионной способности легких с помощью диагностических систем, использующих быстрореагирующие газоанализаторы (RGA-анализаторы — rapidly responding gas analysers) монооксида углерода и индикаторного газа, представленные совместной рабочей группой Европейского Респираторного Общества (ЕРО) и Американского Торакального Общества (АТО).

The article provides an overview of the technical capabilities and updated standards for the study of diffusion capacity of the lungs using diagnostic systems using rapidly responding gas analyzers (RGA analyzers — rapidly responding gas analyzers) of carbon monoxide and indicator gas, presented by a joint working group of the European Respiratory Society (ERC) and the American Thoracic Society (ATS).

диффузионная способность легкихбыстрореагирующие газоанализаторыновые стандарты измеренияlung diffusion capacityrapidly responding gas analysersnew measurement standardsReferencesOgilvie C., Forster R., Blakemore W., et al. A standardized breathholding technique for the clinical measurement of the diffusing capacity of the lung for carbon monoxide. // J. Clin Invest — 1957. — № 36. — P. 1–17.Ogilvie C., Forster R., Blakemore W., et al. A standardized breathholding technique for the clinical measurement of the diffusing capacity of the lung for carbon monoxide. // J. Clin Invest — 1957. — № 36. — P. 1–17.Graham B. L., Brusasco V., Burgos F., et al. 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung. // Eur Respir J. — 2017. — №49. — 1600016 [https://doi.org/10.1183/13993003.00016-2016].Graham B. L., Brusasco V., Burgos F., et al. 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung. // Eur Respir J. — 2017. — №49. — 1600016 [https://doi.org/10.1183/13993003.00016-2016].MacIntyre N., Crapo R., Viegi G., et al. Standardisation of the single-breath determination of carbon monoxide uptake in the lung. // Eur Respir J. — 2005. — № 26. — P. 720–735.MacIntyre N., Crapo R., Viegi G., et al. Standardisation of the single-breath determination of carbon monoxide uptake in the lung. // Eur Respir J. — 2005. — № 26. — P. 720–735.Hegewald M., Jensen R., Teeter J., et al. Long-term intersession variability for single-breath diffusing capacity. // Respiration. — 2012. — № 84. — P. 377–384.Hegewald M., Jensen R., Teeter J., et al. Long-term intersession variability for single-breath diffusing capacity. // Respiration. — 2012. — № 84. — P. 377–384.Salvador-Ong R., Dijkers E., van Steenwijk R., et al. Single-breath diffusion: comparison between helium and methane as tracer gases in COPD and healthy controls. // Eur Respir J. — 2014. — № 44. — Suppl. 58. — P. 1271.Salvador-Ong R., Dijkers E., van Steenwijk R., et al. Single-breath diffusion: comparison between helium and methane as tracer gases in COPD and healthy controls. // Eur Respir J. — 2014. — № 44. — Suppl. 58. — P. 1271.Johnson D. C. Importance of adjusting carbon monoxide diffusing capacity (DLCO) and carbon monoxide transfer coeffi cient (KCO) for alveolar volume. // Respir. Med. — 2000. — № 94 (1). — P. 28–37. DOI: 10.1053/rmed.1999.0740.Johnson D. C. Importance of adjusting carbon monoxide diffusing capacity (DLCO) and carbon monoxide transfer coeffi cient (KCO) for alveolar volume. // Respir. Med. — 2000. — № 94 (1). — P. 28–37. DOI: 10.1053/rmed.1999.0740.Filley G. F., MacIntosh D. J., Wright G. W. Carbon monoxide uptake and pulmonary diffusing capacity in normal subjects at rest and during exercise. // J. Clin. Invest. — 1954. — № 33 (4). — P. 530–539. DOI: 10.1172/JCI102923.Filley G. F., MacIntosh D. J., Wright G. W. Carbon monoxide uptake and pulmonary diffusing capacity in normal subjects at rest and during exercise. // J. Clin. Invest. — 1954. — № 33 (4). — P. 530–539. DOI: 10.1172/JCI102923.Leech J. A., Martz L., Liben A., Becklake M. R. Diffusing capacity for carbon monoxide: the effects of different durations of breath-hold time and alveolar volume and of carbon monoxide back pressure on calculated results. // Am. Rev. Respir. Dis. — 1985. — № 132 (5). — P. 1127–1129.Leech J. A., Martz L., Liben A., Becklake M. R. Diffusing capacity for carbon monoxide: the effects of different durations of breath-hold time and alveolar volume and of carbon monoxide back pressure on calculated results. // Am. Rev. Respir. Dis. — 1985. — № 132 (5). — P. 1127–1129.McGrath M. W., Thomson M. L. The effect of age, body size and lung volume change on alveolar-capillary permeability and diffusing capacity in man. // J. Physiol. (Lond.). — 1959. — №. 146 (3). — P. 572–582.McGrath M. W., Thomson M. L. The effect of age, body size and lung volume change on alveolar-capillary permeability and diffusing capacity in man. // J. Physiol. (Lond.). — 1959. — №. 146 (3). — P. 572–582.Graham B. L., Dosman J. A., Cotton D. J. A theoretical analysis of the single breath diffusing capacity for carbon monoxide. // IEEE Trans. Biomed. Eng. — 1980. — № 27 (4). — P. 221–227.Graham B. L., Dosman J. A., Cotton D. J. A theoretical analysis of the single breath diffusing capacity for carbon monoxide. // IEEE Trans. Biomed. Eng. — 1980. — № 27 (4). — P. 221–227.Graham B. L., Mink J. T., Cotton D. J. Improved accuracy and precision of single-breath CO diffusing capacity measurements. // J. Appl. Physiol. Respir. Environ. Exerc. Physiol. — 1981. — №. 51 (1). — P. 1306–1313. DOI: 10.1152/jappl.1981.51.5. 1306.Graham B. L., Mink J. T., Cotton D. J. Improved accuracy and precision of single-breath CO diffusing capacity measurements. // J. Appl. Physiol. Respir. Environ. Exerc. Physiol. — 1981. — №. 51 (1). — P. 1306–1313. DOI: 10.1152/jappl.1981.51.5. 1306.Graham B. L., Mink J. T., Cotton D. J. Overestimation of the single-breath carbon monoxide diffusing capacity in patients with air-flow obstruction. // Am. Rev. Respir. Dis. — 1984. — №. 129 (3). — P. 403–408.Graham B. L., Mink J. T., Cotton D. J. Overestimation of the single-breath carbon monoxide diffusing capacity in patients with air-flow obstruction. // Am. Rev. Respir. Dis. — 1984. — №. 129 (3). — P. 403–408.Cotton D. J., Soparkar G. R., Graham B. L. Diffusing capacity in the clinical assessment of chronic airfl ow limitation. // Med. Clin. North. Am. — 1996. — № 80 (3). — P. 549–564.Cotton D. J., Soparkar G. R., Graham B. L. Diffusing capacity in the clinical assessment of chronic airfl ow limitation. // Med. Clin. North. Am. — 1996. — № 80 (3). — P. 549–564.Graham B. L., Mink J. T., Cotton D. J. Effect of breathhold time on DLCO (SB) in patients with airway obstruction. // J. Appl. Physiol. — 1985. — № 58 (4). — P. 1319–1325. DOI: 10.1152/jappl.1985.58.4.1319.Graham B. L., Mink J. T., Cotton D. J. Effect of breathhold time on DLCO (SB) in patients with airway obstruction. // J. Appl. Physiol. — 1985. — № 58 (4). — P. 1319–1325. DOI: 10.1152/jappl.1985.58.4.1319.Jones R. S., Meade F. A theoretical and experimental analysis of anomalies in the estimation of pulmonary diffusing capacity by the single breath method. // Q. J. Exp.Physiol. Cogn. Med. Sci. — 1961. — № 46. — P. 131–143.Jones R. S., Meade F. A theoretical and experimental analysis of anomalies in the estimation of pulmonary diffusing capacity by the single breath method. // Q. J. Exp.Physiol. Cogn. Med. Sci. — 1961. — № 46. — P. 131–143.Chinn D. J., Harkawat R., Cotes J. E. Standardization of single-breath transfer factor (TLCO); derivation of breathholding time. // Eur. Respir. J. — 1992. — № 5 (4). — P. 492–498. Available at: https://erj.ersjournals.com/content/5/4/492?ijkey=cd3a5ea09782d695a9b84a6cb9f56925911e3f46&keytype2=tf_ipsecsha.Chinn D. J., Harkawat R., Cotes J. E. Standardization of single-breath transfer factor (TLCO); derivation of breathholding time. // Eur. Respir. J. — 1992. — № 5 (4). — P. 492–498. Available at: https://erj.ersjournals.com/content/5/4/492?ijkey=cd3a5ea09782d695a9b84a6cb9f56925911e3f46&keytype2=tf_ipsecsha.Ferris B. G. Epidemiology standardization project (American Thoracic Society). // Am. Rev. Respir. Dis. — 1978. — № 118 (6, Pt 2). — P. 1–120.Ferris B. G. Epidemiology standardization project (American Thoracic Society). // Am. Rev. Respir. Dis. — 1978. — № 118 (6, Pt 2). — P. 1–120.Welle I., Eide G. E., Bakke P., Gulsvik A. Applicability of the single-breath carbon monoxide diffusing capacity in a Norwegian Community Study. // Am. J. Respir. Crit. Care Med. — 1998. — № 158 (6). — P. 1745–1750. DOI: 10.1164/ajrccm.158.6.9712123.Welle I., Eide G. E., Bakke P., Gulsvik A. Applicability of the single-breath carbon monoxide diffusing capacity in a Norwegian Community Study. // Am. J. Respir. Crit. Care Med. — 1998. — № 158 (6). — P. 1745–1750. DOI: 10.1164/ajrccm.158.6.9712123.Fowler W. Lung function studies. II. The respiratory dead space. // Am J. Physiol. — 1948. — № 154 — P. 405–416.Fowler W. Lung function studies. II. The respiratory dead space. // Am J. Physiol. — 1948. — № 154 — P. 405–416.Yang J., Stanton J., Wang L. et al. Effect of salbutamol on the measurement of single-breath diffusing capacity. // Respirology. — 2013. — № 18 (8). — P. 1223–1229. DOI: 10.1111/resp.12125.Yang J., Stanton J., Wang L. et al. Effect of salbutamol on the measurement of single-breath diffusing capacity. // Respirology. — 2013. — № 18 (8). — P. 1223–1229. DOI: 10.1111/resp.12125.Baldi S., Fracchia C., Bruschi C. et al. Effect of bronchodilatation on single breath pulmonary uptake of carbon monoxide in chronic obstructive pulmonary disease. // Int. J. Chron. Obstruct. Pulmon. Dis. — 2006. — № 1 (4). — P. 477–483.Baldi S., Fracchia C., Bruschi C. et al. Effect of bronchodilatation on single breath pulmonary uptake of carbon monoxide in chronic obstructive pulmonary disease. // Int. J. Chron. Obstruct. Pulmon. Dis. — 2006. — № 1 (4). — P. 477–483.Zavorsky G. S. The rise in carboxyhemoglobin from repeated pulmonary diffusing capacity tests. // Respir. Physiol. Neurobiol. — 2013. — № 186 (1). — P. 103–108. DOI: 10.1016/j.resp.2013.01.001.Zavorsky G. S. The rise in carboxyhemoglobin from repeated pulmonary diffusing capacity tests. // Respir. Physiol. Neurobiol. — 2013. — № 186 (1). — P. 103–108. DOI: 10.1016/j.resp.2013.01.001.Frey T. M., Crapo R. O., Jensen R. L., Elliott C. G. Diurnal variation of the diffusing capacity of the lung: is it real? // Am.Rev. Respir. Dis. — 1987. — № 136 (6). — P. 1381–1384. DOI: 10.1164/ajrccm/136.6.1381.Frey T. M., Crapo R. O., Jensen R. L., Elliott C. G. Diurnal variation of the diffusing capacity of the lung: is it real? // Am.Rev. Respir. Dis. — 1987. — № 136 (6). — P. 1381–1384. DOI: 10.1164/ajrccm/136.6.1381.American Thoracic Society. Single-breath carbon monoxide diffusing capacity (transfer factor). Recommendations for a standard technique: 1995 update. // Amer. J. Respir. Crit. Care Med. — 1995. — № 152. — P. 2185–2198.American Thoracic Society. Single-breath carbon monoxide diffusing capacity (transfer factor). Recommendations for a standard technique: 1995 update. // Amer. J. Respir. Crit. Care Med. — 1995. — № 152. — P. 2185–2198.Cotes J, Chinn D, Quanjer P, et al. Standardization of the measurement of transfer factor (diffusing capacity). // Eur Respir J. — 1993. — № 6. — Suppl. 16. — P. 41–52.Cotes J, Chinn D, Quanjer P, et al. Standardization of the measurement of transfer factor (diffusing capacity). // Eur Respir J. — 1993. — № 6. — Suppl. 16. — P. 41–52.Cinkotai F. F., Thomson M. L. Diurnal variation in pulmonary diffusing capacity for carbon monoxide. // J. Appl. Physiol. — 1966. — № 21 (2). — P. 539–542.Cinkotai F. F., Thomson M. L. Diurnal variation in pulmonary diffusing capacity for carbon monoxide. // J. Appl. Physiol. — 1966. — № 21 (2). — P. 539–542.Sansores R. H., Abboud R. T., Kennell C., Haynes N. The effect of menstruation on the pulmonary carbon monoxide diffusing capacity. // Am. J. Respir. Crit. Care Med. — 1995. — № 151 (1). — P. 381–384. DOI: 10.1164/ajrccm.152.1.7599851.Sansores R. H., Abboud R. T., Kennell C., Haynes N. The effect of menstruation on the pulmonary carbon monoxide diffusing capacity. // Am. J. Respir. Crit. Care Med. — 1995. — № 151 (1). — P. 381–384. DOI: 10.1164/ajrccm.152.1.7599851.Peavy H. H., Summer W.R., Gurtner G. The effects of acute ethanol ingestion on pulmonary diffusing capacity. // Chest. — 1980. — № 77 (4). — P. 488–492.Peavy H. H., Summer W.R., Gurtner G. The effects of acute ethanol ingestion on pulmonary diffusing capacity. // Chest. — 1980. — № 77 (4). — P. 488–492.Simeone F., Wiese J., Glindmeyer H., Lasky J. The effects of ethanol ingestion on the accuracy of pulmonary diffusing capacity measurement. // Chest. —2005. — № 128 (6). — P. 3875–3880. DOI: 10.1378/chest.128.6.3875.Simeone F., Wiese J., Glindmeyer H., Lasky J. The effects of ethanol ingestion on the accuracy of pulmonary diffusing capacity measurement. // Chest. —2005. — № 128 (6). — P. 3875–3880. DOI: 10.1378/chest.128.6.3875.Punjabi N. M., Shade D., Patel A. M., Wise R. A. Measurement variability in single-breath diffusing capacity of the lung. // Chest. — 2003. — № 123 (4). — P. 1082–1089. DOI: 10.1378/chest.123.4.1082.Punjabi N. M., Shade D., Patel A. M., Wise R. A. Measurement variability in single-breath diffusing capacity of the lung. // Chest. — 2003. — № 123 (4). — P. 1082–1089. DOI: 10.1378/chest.123.4.1082.

The authors declare that there are no conflicts of interest present.