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The pulmonary diffusing capacity of normal persons increases during exercise, and has been measured by many investigators and by a variety of techniques (2-7). This increase in pulmonary diffusing capacity is probably caused by an increase in the size of the pulmonary capillary bed (8), but the mechanism by which it occurs is incompletely understood. It is independent of pulmonary blood flow (7, 9), but is related to the pressure across the walls of the pulmonary blood vessels (10). If the increase in pulmonary diffusing capacity in response to exercise is caused by enlargement of the pulmonary capillary bed, an increase in pulmonary diffusing capacity ought to be demonstrated regularly in persons with a normal capillary bed, and a failure to increase in a normal fashion ought to be demonstrated in some patients with a restricted vascular bed. The purpose of our investigation was 1) to determine the magnitude of increase in pulmonary diffusing capacity in normal subjects at various levels of exercise, 2) to ascertain the extent of exercise needed to give a predictable increase in pulmonary diffusing capacity in normal subjects, and 3) to study the exercise response of pulmonary diffusing capacity in subjects with a pulmonary capillary bed of normal size, as in pregnancy, patients with a large resting pulmonary capillary bed, as with atrial septal defect, and patients with a restricted pulmonary capillary bed, as in lung disease.

the journal of clinical investigation/the journal of clinical investigation

PULMONARY DIFFUSING CAPACITY DURING REST AND EXERCISE. A STUDY OF NORMAL PERSONS AND PERSONS WITH ATRIAL SEPTAL DEFECT, PREGNANCY, AND PULMONARY DISEASE*