Effects of Increasing Carboxyhemoglobin on the Single Breath Carbon Monoxide Diffusing Capacity
Bibliographic record
Abstract
Although carboxyhemoglobin (COHb) is often increased in smokers, American Thoracic Society recommendations for adjusting the single breath carbon monoxide (CO) diffusing capacity (DL(CO)(SB)) for COHb remain optional. Using a previously described 3-equation technique, we measured DL(CO)(SB) and an index of diffusion inhomogeneity (DI) in 10 healthy, nonsmoking subjects who performed DL(CO)(SB) maneuvers both before and after increasing COHb. CO backpressure (FA(CO)) was measured from the exhaled gas of a standardized deep breath of room air that immediately preceded each DL(CO)(SB) and was validated by measurement of FA(CO) from an identical "sham" maneuver without inhaling CO. Without adjustments for FA(CO) or COHb, DL(CO)(SB) decreased with increasing COHb. This effect persisted when DL(CO)(SB) was adjusted only for FA(CO), but it was eliminated with further adjustment for the anemia effect of increasing COHb. The anemia adjustment was proportional to the fractional COHb. DI, adjusted for FA(CO), was unaffected by increasing COHb. We conclude that DL(CO)(SB) must be adjusted for both the buildup of CO backpressure and the anemia effect of increasing COHb. Adequate corrections of DL(CO)(SB) can be implemented using FA(CO) measured during a standardized deep breath immediately preceding the DL(CO)(SB) maneuver. Current American Thoracic Society recommendations for DL(CO)(SB) standardization do not adequately compensate for COHb.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".