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The aim of this study was to determine reference equations for the combined measurement of diffusing capacity of the lung for carbon monoxide (CO) and nitric oxide (NO) ( D  LCONO ). In addition, we wanted to appeal for consensus regarding methodology of the measurement including calculation of diffusing capacity of the alveolo-capillary membrane ( D  m ) and pulmonary capillary volume ( V  c ).   D  LCONO  was measured in 282 healthy individuals aged 18–97 years using the single-breath technique and a breath-hold time of 5 s (true apnoea period). The following values were used: 1) specific conductance of nitric oxide (θ NO )=4.5 mL NO ·mL blood  −1 ·min −1 ·mmHg −1 ; 2) ratio of diffusing capacity of the membrane for NO and CO ( D  mNO / D  mCO )=1.97; and 3) 1/red cell CO conductance (1/θ CO )=(1.30+0.0041·mean capillary oxygen pressure)·(14.6/Hb concentration in g·dL −1 ).  Reference equations were established for the outcomes of  D  LCONO , including  D  LCO  and  D  LNO  and the calculated values  D  m  and  V  c . Independent variables were age, sex, height and age squared.  By providing new reference equations and by appealing for consensus regarding the methodology, we hope to provide a basis for future studies and clinical use of this novel and interesting method.

Reference equations for pulmonary diffusing capacity of carbon monoxide and nitric oxide in adult Caucasians