in this video we will show quality control for dlco on mgc diagnostics pulmonary function systems using asent software dlco quality control should be performed weekly per the ATS guidelines this test is performed with btps correction turned off this means you can add dlco test to the same patient visit that was used for syringe spirometry testing proceed to the dlco test screen prior to each dlco effort place the umbilical clip into the calibration port and perform a dlco gas calibration once the gas calibration has passed connect the umbilical clip to the prevent flow sensor the white dlco QC coupler should be used for dlco QC testing the coupler has a smaller internal diameter which allows better mixing of the gas inside the syringe the coupler is placed between the prevent flow sensor and the syringe connect the syringe and flow sensor to the head of the system have the syringe plunger pulled out to about the 1 L Mark click the the start button or press the space bar to begin the effort place your thumb at the 2 L mark on the syringe plunger perform three to four tidal breaths then push the plunger to exactly the 2 L Mark Press the space bar to close the distal shutter and pull back 2 lers of diffusion gas the system will automatically lock you out for 20 seconds to allow gas mixing in the syringe after 20 seconds the shutter will reopen and you can push the syringe plunger in all the way the effort will automatically stop and you can review the results looking at the data from the efforts verify that the IVC from each effort is between 1.90 to 2.10 L the measured value of dlco must be less than 0.5 milliliters a minute per millimet of mercury or less than 0166 moles a minute per kilopascals if using SI units using the IVC from each effort find the measured IVC in the second column in the mgc QC table the target VA along with the VA minimum and maximum will be to the right of the measured IVC verify that the measured VA is within the minimum and maximum values in this table if the IVC is not within range recalibrate the flow sensor and perform another dlco effort if the VA or dlco are not within range perform another gas analyzer calibration and repeat the effort the 2017 ATS ERS dlco guidelines also have a recommendation for quality control these recommendations can be used in place of the previous mgc specifications the guidelines state that each week or whenever problems are suspected a dlco QC check should be performed this check should be performed in a normal patient test mode meaning the btps correction is turned on from the ascent home screen select the ad patient icon click on the settings wheel and then select syringe btps on in the patient type drop-down menu this will leave the btps corrections on per the ATS only the ID and name need to be entered next click the save and create patient visit button press proceed to the dlco test screen then press F5 in the dlco F5 options ensure the fixed anatomical Dead Space box is checked and the dead space is correct for your syringe each syringe will have its dead space value printed on the syringe or on a label at the bottom of the syringe before each dlco effort place the umbilical clip into the calibration port and perform a dlco gas calibration once the gas calibration has passed connect the umbilical clip to the prevent flow sensor the white dlco QC coupler should be used for dlco QC testing the coupler has a smaller internal diameter which allows better mixing of the gas inside the syringe the coupler is placed between the prevent flow sensor and the syringe connect the syringe and flow sensor to the head of the system have the syringe plunger pulled out to about the 2 L Mark click the start button or press the space bar to begin the effort and perform 3 to four tital breaths then push the plunger all the way in press the space bar to close the distal shutter and pull back 3 l of diffusion gas the system will automatically lock you out for 20 seconds after the shutter reopens push the syringe plunger in all the way the effort will automatically stop and you can review the results the specifications from the ATS are that the VA must be within 300 mL of the target the VA Target is calculated by taking the syringe volume of 3 l times the atpd to btps correction factor in the example shown the room temperature is 72° f or 295° kelvin which is used in the equation and the barometric pressure is 740 the target VA is 3.26 l the measured value of dlco must be less than 0.5 millit per minute per millimet of mercury or less than 0.166 moles per minute per kilopascals if using SI units if the VA or dlco are not within range recalibrate the flow sensor per perform another gas analyzer calibration and repeat the effort note if any value in the dlco F5 option screen was changed prior to dlco testing they should be changed back to their original settings biologic QC should also be performed on a regular basis using subjects that are healthy and non-smoking refer to the ATS pulmonary function laboratory management and procedure manual which can be purchased at the ATS website www. thor. org thank you for watching this video information on quality control can be found in the mgc Diagnostics product bulletin part number 1 14255 d001 to obtain a copy of this bulletin or if you have any questions on quality control contact our technical support department at800 333 4137 or email us at support at mgc diagnostics.com