[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-414776-105":59,"doc-detail-414776-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","the-search-for-the-ultra-elusive-can-computed-cardiopulmonography-enhance-early-detection-of-gas-exchange-abnormality","The search for the ultra-elusive: Can computed cardiopulmonography enhance early detection of gas exchange abnormality?","","Breathing control during exercise is often described as “ultra-secret,” yet diagnosing pulmonary gas-exchange abnormalities remains “ultra-elusive,” with many methods confined to physiology laboratories. Because lung disease may lack obvious symptoms until irreversible remodeling, there is a need for a simple, rapid, non-invasive approach with sufficient sensitivity and specificity to detect subtle gas-exchange changes and improve earlier diagnosis across obstructive, restrictive, fibrotic, and pulmonary vascular diseases. The text reviews inert gas washout history, limitations, and emerging computed cardiopulmonography.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-search-for-the-ultra-elusive-can-computed-cardiopulmonography-enhance-early-detection-of-gas-exchange-abnormality/414776/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-search-for-the-ultra-elusive-can-computed-cardiopulmonography-enhance-early-detection-of-gas-exchange-abnormality/414776.png","ImageObject",300,407,{"name":92,"@type":93},"River Wang","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-04","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",15,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is early detection of pulmonary gas-exchange abnormalities difficult?","Question",{"text":113,"@type":114},"Many diagnostic methods remain mostly in physiology laboratories, and lung conditions can progress without overt signs or symptoms until remodeling becomes irreversible.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What did classic inert gas washout work show about ventilatory distribution?",{"text":118,"@type":114},"N2 clearance during 100% O2 breathing showed that N2 persisted far longer in patients with conditions such as asthma, emphysema, or pulmonary fibrosis than in young healthy people, indicating uneven ventilatory distribution.",{"name":120,"@type":111,"acceptedAnswer":121},"What is computed cardiopulmonography (CCP) and what is its goal?",{"text":122,"@type":114},"CCP aims to quantify pulmonary function inhomogeneity contributing to V̇A/Q̇ inequalities using a 15-minute multiple breath washout test, with potential for clinical use due to relative simplicity and non-invasiveness.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},414776,1790794532,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":39,"preview_page_count":4},1099514067438,"https://ap-avatar.wpscdn.com/avatar/100002539ee87300030?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780474512215547542","DOI: 10.1113/EP092925  \nVIEWPOINT  \nThe search for the ultra-elusive: Can computed cardiopulmonography enhance early detection of gas exchange abnormality?  \nHarry B. Rossiter1   Yannick Molgat-Seon2, 3   \n1 Institute of Respiratory Medicine and Exercise Physiology, The Lundquist Institute for Biomedical Innovation at Harbor–UCLA Medical Center, Torrance, California, USA  \n2 Department of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, Manitoba, Canada  \n3 Centre for Heart and Lung Innovation, The University of British Columbia and St. Paul’s Hospital, Vancouver, British Columbia, Canada  \nCorrespondence  \nHarry B. Rossiter, Institute of Respiratory Medicine and Exercise Physiology, The Lundquist Institute for Biomedical Innovation at Harbor–UCLA Medical Center,  \nTorrance, CA, USA. Email: [hrossiter@lundquist.org](hrossiter@lundquist.org)  \nFunding information  \nHHS | NIH | National Heart, Lung, and Blood Institute (NHLBI), Grant/Award Numbers: R01HL166850, R01HL151452, R01HL153460, P50HD098593, R01DK122767; NSERC, Grant/Award Number: RGPIN-2020-06564; Tobacco Related Disease Research Program, Grant/Award Number: T31IP1666; Department of Defense / USAMRAA, Grant/Award Number: HT9425-24-1-0249; Research Manitoba, Grant/Award Number: 5049  \nHandling Editor: Ronan Berg  \nKEYWORDS  \npulmonary circulation, pulmonary function testing, pulmonary gas exchange, V/Q inequality  \nWhile the mechanisms that control breathing during exercise have been called the ‘ultra-secret’, the development of clinically useful methods to diagnose abnormalities in pulmonary gas exchange might be called the ‘ultra-elusive’. Although many methods have been developed over at least a century, most rarely make it out of the physiology laboratory. The lung is so exquisite in its role as a gas exchanger that many potentially devastating pulmonary conditions do not result in overt signs or symptoms, and therefore patients are not investigated with diagnostic testing, until they are advanced to the point that deleterious pulmonary remodelling is irreversible. The clinical utility of developing a simple, rapid, non-invasive method that is sufficiently sensitive and specific to determine subtle changes in pulmonary gas exchange could therefore make an important impact in earlier diagnosis and treatment of many obstructive, restrictive, fibrotic or pulmonary vascular diseases.  \nInert gas washout techniques have been extensively used to better understand heterogeneity of pulmonary deadspace, ventilation and perfusion. In his pioneering work from almost 75 years ago, Ward  \nFowler (Fowler et al., 1952) described N2 clearance characteristics from patients with cardiopulmonary diseases and compared them to those from healthy individuals. The efficiency of gas mixing within the lung was assessed while inhaling100%O2 and assessing the expired N2 concentration of subsequent exhalations. During 100% O2 breathing, Fowler et al. (1952) found that N2 remained detectible in the expirate of patients with asthma, emphysema or pulmonary fibrosis for 7–88 breaths – far greater than the 6–10 breaths observed in young healthy people – indicating unevenness in the ventilatory distribution of the inspired O2 within patients’ lungs. The technique, however, relied on cumbersome chemical gas analysis using the Van Slyke technique, and therefore was little appreciated until technological advances, such as automated computing and the respiratory gas mass spectrometer, became more widely available.  \nSingle breath washout, where deadspace and heterogeneity of lung gas distribution are inferred from the profile of N2 concentration over the course of a single expirate, and multiple breath washout techniques have seen a resurgence in the 21st century. Multiple  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \n© 2025 The A","cbCaiekpRIK1rRjf","https://ap.wps.com/l/cbCaiekpRIK1rRjf","pdf",141742,"English","# Viewpoint\n## Rationale for earlier, non-invasive diagnosis\n## Inert gas washout foundations and limitations\n## From laboratory to clinic: current alternatives\n## Computed cardiopulmonography (CCP) as a new approach","[{\"question\":\"Why is early detection of pulmonary gas-exchange abnormalities difficult?\",\"answer\":\"Many diagnostic methods remain mostly in physiology laboratories, and lung conditions can progress without overt signs or symptoms until remodeling becomes irreversible.\"},{\"question\":\"What did classic inert gas washout work show about ventilatory distribution?\",\"answer\":\"N2 clearance during 100% O2 breathing showed that N2 persisted far longer in patients with conditions such as asthma, emphysema, or pulmonary fibrosis than in young healthy people, indicating uneven ventilatory distribution.\"},{\"question\":\"What is computed cardiopulmonography (CCP) and what is its goal?\",\"answer\":\"CCP aims to quantify pulmonary function inhomogeneity contributing to V̇A/Q̇ inequalities using a 15-minute multiple breath washout test, with potential for clinical use due to relative simplicity and non-invasiveness.\"}]","The search for the ultra-elusive: Can computed cardiopulmonography enhance early detection of gas exchange abnormality? | PDF",1790598665]