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Diffusing lung capacity (DLCO) in cured asthmatic children

High percentage of uncured asthmatic children have the increased diffusion lung capacity (DLCO). One of the explanations is that asthma as a chronic inflammatory disorder of airways, by increasing the permeability of alveolocapillary membrane, can cause the increase of diffusion lung capacity. The Aim: To determine value of parameters obtained by the measurement of DLCO within the group of healthy children (Control) and in the asthmatic groups under the various therapies: Inhaled steroid (IS: fluticasone propionate 100-200 µg daily, Specific immunotherapy (SIT) and Sodium cromoglicate (SC: 60-80 µg daily) group. Subjects and Methods: In 161 children (96 boys and 65 girls) diagnosed as mild and moderate asthma and 40 healthy children (20 boys and 20 girls), we measured: DLCO (Single breath method with carbon monoxide, measured with Masterlab Jaeger), Residual volume (RV) and Residual volume percentage of the total lung capacity (RV%TLC). In Statistic Analysis: the Oneway analysis of variance, Mann-Whitney and Chi-square tests were used. The Results were as follows: Control IS SIT SC p No. of children (201) 40 86 48 25 Age (y) 11.1 ± 2.2 9.7 ± 3.2 10.8 ± 3.6 11.4 ± 3 Therapy (y) 0 1.6 ± 1.8 3.6 ± 1.6 2.3 ± 1.9 DLCO (%) 106 ± 20 118 ± 30 126 ± 34 134 ± 55 0.076 RV (%) 150 ± 70 267 ± 127 247 ± 175 255 ± 143 0.001 RV%TLC (%) 139 ± 47 184 ± 40 180 ± 59 184 ± 52 0.002 Results reported as average ± standard deviation. DLCO: expressed as percentage of predicted value according to Cotes, RV and RV%TLC: percentage of predicted value according to Zapletal. There were no statistically significant differences of DLCO values among the Control and other examined groups. IS, SIT and SC groups did not differ in parameters: RV and RV%TLC, while this difference was statistically significant in relation to the Control group. Conclusion: In cured asthmatic children the significant increase of DLCO was not proved. Parameter pointing to the hyperinflation (RV and RV%TLC) in comparison with the Control group were statistically significantly increased. RV and RV%TLC normalisation suggests the complete remission of disease.

DLCO; hyperinflation; asthma; children

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