What is complete pulmonary function testing?
Complete pulmonary function tests are a group of tests that include spirometry, diffusion capacity (DLCO), and lung volumes that are used in detecting, characterizing, and quantifying the severity of lung disease.
In addition to the benefits of spirometry, DLCO and lung volumes provide more detailed information about how the lungs are performing. A DLCO test assesses the ability of the lungs to transfer oxygen to the blood. Lung volumes refer to the volume of air in the lungs at different phases of the respiratory cycle. A combination of spirometry, DLCO, and lung volumes can help identify lung disease, measure the effects of medication on the lungs, and provide a better assessment of lung disease severity.
What is a DLCO test?
It's well understood that the most accurate method of diagnosing Chronic Obstructive Pulmonary Disease (COPD) is via Pulmonary Function Testing or a PFT examination. The ability to measure total lung capacity (TLV) or functional residual volume (FRC) gives a pulmonologist a strong baseline of data. However, the transfer factor – or diffusing capacity of the lungs for carbon monoxide (DLCO) -- is just as crucial for diagnosing and tracking overall lung health.
DLCO is a measurement that helps to determine the lung's ability to transfer gas from inspired air through the bloodstream. It measures the uptake of carbon monoxide (CO) per unit time / per mm of driving pressure of CO (or cc of CO/sec/mm of Hg).
Why expand on spirometry with DLCO and lung volumes?
- DLCO is the most powerful predictor of survival in patients with COPD.Ref.
- DLCO is used as an indicator of lung disease severity.Ref.
- DLCO can show a comorbidity of COPD in heart failure in patients.Ref.
- Assess the hospitalization risk in a COPD patient.Ref.
- DLCO is helpful in detecting drug-induced lung disease.Ref.
- DLCO is useful as an early indicator for detecting interstitial lung disease before lung volumes become decreased.Ref.
- Monitor disease progression in CF patients with Lung Clearance Index (LCI).Ref.
How are quality grading standards determined for DLCO?
The 2017 ATS/ERS DLCO guidelines for single-breath carbon monoxide uptake in the lungs specified changes to the acceptability and repeatability standards used to determine technical acceptability. As part of the development of these guidelines, a quality control grading system was proposed that would determine if a DLCO test was acceptable.
Quality grading for DLCO measurements include:
- VI/VC 90% or VI/VC greater than 85% and VA within 0.2 L or 5% of the largest VA from another acceptable maneuver.
- A breath-holding time of 8-12 seconds.
- A sample collection of fewer than 4 seconds.
These variables assign a 'grade A' test and are the only ones that meet all ATS/ERS acceptance criteria. For outdated or older PFT devices, these results are manually determined only after completing the exam. As such, the DLCO exam requires more time to analyze testing results and determine if a quality grade has been achieved.
How the EasyOne Pro and Easy One Pro Lab streamline DLCO tests
DLCO testing is one of the multiple tests offered by the EasyOne Pro and EasyOne Pro Lab PFT devices. These potent solutions offer Portable DLCO, Lung Volume, and Spirometry tests– allowing respiratory professionals to have an all-inclusive, lightweight, and extremely accurate solution for all lung function testing solutions.
The EasyOne® Pro and EasyOne Pro Lab have been designed with NDD Medical Technologies TrueFlow™ and TrueCheck™ technology. The inclusion of these solutions removes the need for continual calibration, saves time, and is infused with multiple tools that streamline PFT and DLCO testing. The EasyOne® Pro and EasyOne Pro Lab's compact design makes them a functional PFT for offices of any size and includes features that streamline the PFT process – without compromising the quality of results.
No more constant calibration
- Most DLCO testing equipment requires calibration to be completed in-between individual cycles. This not only extends the time between tests but inconveniences and frustrates patients – who are already stressed while completing these exams.
- When you activate the EasyOne Pro and EasyOne Pro Lab, the system is calibrated and ready to use. This system can provide the technician with DLCO results in three minutes. These features are possible due to NDD's patented TrueCheck® technology – which takes care of the essential quality control needed for gas analysis testing.
- Both devices are equipped with an integrated commentator that allows medical professionals to streamline the patient data entry process. You can easily define and assign standard comments or quickly select and amend them with customized notes.
- EasyOne Pro® and EasyOne Pro Lab® are the only devices proven to be accurate for a lifetime for DLCO measurements. They are user-friendly, can be used in multiple locations, and produce robust results that ensure accurate diagnosis and continual monitoring of respiratory disease.
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