Importance of the lower respiratory tract in oxygen transfer. Exercise testing in patients with interstitial and destructive lung disease

B. A. Keogh, E. Lakatos, D. Price, Ronald Crystal

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Evaluation of the gas exchange responses to steady state treadmill exercise of 176 patients with chronic disorders of the lower respiratory tract demonstrated that alveolar disease significantly affects O2 transfer with little effect on CO2 transfer. At exercise levels requiring oxygen delivery 2- to 3-fold above resting levels, patients with interstitial lung disease [idiopathic pulmonary fibrosis (IPF), sarcoidosis, histiocytosis-X (HX)] and 'pure' destructive lung disease [αI-antitrypsin (αIAT) deficiency] demonstrated no ventilation or cardiac limitation, but all exhibited marked reductions in O2 transfer. Strikingly, although resting values of Pa(O2) were normal or mildly reduced, the average estimated Pa(O2) at a V̇(O2) of 1 L/min was 47 mmHg in IPF, 65 mmHg in sarcoid, 54 mmHg in HX, and 41 mmHg in αIAT deficiency. Comparison of resting and exercise parameters revealed that: (1) exercise studies can uncover alveolar dysfunction in the presence of normal resting parameters, and (2) resting parameters cannot predict the magnitude of O2 related abnormalities induced by exercise. These observations suggest that exercise testing is a useful clinical tool in detecting alveolar disease and gauging the magnitude of abnormalities of O2 transfer.

Original languageEnglish
JournalAmerican Review of Respiratory Disease
Issue number2 SUPPL.
Publication statusPublished - 1 Jan 1984
Externally publishedYes


ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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