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Pathophysiological and Clinical Implication of Diffusing Capacity for CO (DLco) and Krogh Factor (Kco): How Do DLCO and KCO Differentiate Various Lung Diseases?

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Structure-Function Relationships in Various Respiratory Systems

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Abstract

The single-breath diffusing capacity of carbon monoxide (DLCO) provides independent measurements of kCO, the rate constant of removable CO from the alveolar gas during the breath-holding time, and accessible lung volume (VA) calculated by the dilution of helium (He), a nonabsorbable gas, in the lung at the time kCO is measured. Those two components of kCO and VA determines the value of DLco. DLco/VA, i.e., Kco is the rate constant for carbon monoxide uptake per unit barometric pressure, which is different from kCO in three constant factors: barometric pressure, 1000, and 1.2. Therefore, kCO and Kco are physiologically equivalent, and Kco does not correct DLco by lung volume. Changes in Kco is explained by changes in VA/the pulmonary capillary volume.(Vc), i.e., Vc/VA because VA/the membrane diffusing capacity (DMco) remains almost constant. Due to the pathogenesis, high, normal, or low Kco may be found together with low VA. Therefore, DLco should be in practical use, combined with the proper interpretation of Kco and VA.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan

    Kaoruko Shimizu

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Correspondence to Kaoruko Shimizu .

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  1. Department of Respiratory Medicine, Tokyo Medical University, Division of Respiratory Medicine, Tohto Clinic, Kenko-Igaku Association, Tokyo, Japan

    Kazuhiro Yamaguchi

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Shimizu, K. (2020). Pathophysiological and Clinical Implication of Diffusing Capacity for CO (DLco) and Krogh Factor (Kco): How Do DLCO and KCO Differentiate Various Lung Diseases?. In: Yamaguchi, K. (eds) Structure-Function Relationships in Various Respiratory Systems. Respiratory Disease Series: Diagnostic Tools and Disease Managements. Springer, Singapore. https://doi.org/10.1007/978-981-15-5596-1_12

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  • DOI: https://doi.org/10.1007/978-981-15-5596-1_12

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