The impact of alveolar hemorrhage on lung function tests

Abstract

Introduction. Alveolar hemorrhage syndrome is a severe condition, with a high-risk of death. A timely diagnosis and therapy may be life-saving. The “gold-standard” method for diagnosing alveolar hemorrhage is bronchoscopy with bronchiolo-alveolar lavage. Pulmonary function tests are useful to appreciate the severity of alveolar hemorrhage. The objective of the study was to measure the impact of alveolar hemorrhage on lung function tests and to detect useful associations between Golde score value and the type of alveolitis with spirometry tests, lung diffusing capacity for carbon monoxide (DLCO) and carbon monoxide transfer coefficient (KCOc), and six minutes walking test (6MWT). Material and methods. We conducted a retrospective study on a sample of 60 patients diagnosed with alveolar hemorrhage syndrome, hospitalized in The National Institute of Pneumology “Marius Nasta” Bucharest, Romania, between June 2010 and February 2019. Results. The results of bronchiolo-alveolar lavage show that macrophage alveolitis is associated with moderate-severe alveolar hemorrhage syndrome, while neutrophilic and lymphocytic alveolitis are associated with mild to moderate alveolar hemorrhage syndrome. Pulmonary function tests (spirometry and complex respiratory tests) showed that only Tiffeneau index, maximal expiratory flow at 50% of vital flow capacity and DLCOc were influenced by the presence of moderate to severe alveolar hemorrhage. The degree of desaturation measured at the end of 6MWT did not correlate with the degree of alveolar hemorrhage severity. Conclusions. An abnormal gas transfer is common in alveolar hemorrhage, an increase of DLCOc value being a sensitive marker for the disease.

Keywords

• alveolar hemorrhage
• golde score
• functional lung tests