What is it about?
At lower lung volumes DLCO becomes smaller as expected from lower surface area for diffusion, and DLCO/VA higher. DACO - adjusting predicted DLCO for lung volume - provides a better indication of diffusion.
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Why is it important?
DACO is an excellent measure of the lung's diffusion capacity. While KCO (DLCO/VA) can be low, normal or elevated in patients with interstitial lung disease, DACO will be low. While KCO can be very elevated in patients with restrictive lung disease and normal lung parenchyma, DACO will be near 100% predicted. For example with pectus excavatum having VA of 50%, DLCO will be near 80%, KCO near 160%, and DACO near 100% predicted.
Perspectives
When initially published, many promoted KCO as the best measure of diffusion. It is now widely recognized that lung volume affects diffusion and that should be accounted for when interpreting DLCO.
Dr Douglas Johnson
baystate medical center
Read the Original
This page is a summary of: Importance of adjusting carbon monoxide diffusing capacity (DLCO) and carbon monoxide transfer coefficient (K CO) for alveolar volume, Respiratory Medicine, January 2000, Elsevier,
DOI: 10.1053/rmed.1999.0740.
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