DIFFUSING CAPACITY FOR LUNG CARBON MONOXIDE (DLCO) IN CHEMICAL LUNG INJURIES DUE TO THE USE OF MUSTARD GAS IN THE POISONED SOLDIERS OF IRAN-IRAQ WAR 2006

Objectives: To assess the Mustard gas exposure effects on pulmonary system, particularly on diffusing capacity for lung carbon monoxide (DLCO) and simple spirometry . Methodology: Sixty-five sulfur mustard- poisoned soldiers from Mostazafan and Janbazan organization were referred to our center in 2005. Complete history, physical examination, chest X ray, Echocardiography, Arterial blood gas, high – resolution computerized tomography, diffusion capacity for lung carbon monoxide and spirometry of these were performed and compared this result with normal value. Results: The mean value of indices in studied injured subjects was: Spirometry: forced expiratory volume in one second (FEV1) = 70.4, Forced vital capacity (FVC) = 66.5, EFE 25-75= 81.1, FEV1/FVC=101.9, Flow 25% = 28.7, Flow 50%= 72.9, Flow 75%= 100.1, Sample volume: Functional residual capacity of lungs (FRC) = 131.5, residual volume (RV) = 157.3, RV/TLC= 169.1, Total lung capacity (TLC) = 91.3, KCO= 131.6, TLCO= 116.3. No significant correlation was observed between TLCO values with HRCT, echocardiography, ABG and spirometry values (P 0.05). Conclusion: We recommend TLCO RV/TLV tests to assess severity of Injuries as there is no a suitable criterion to measure the real consequences of mustard gas on affected combatants. and Biological markers are also needed to determine cause- effect relations.