Abstract
The relation between pulmonary distensibility, lung volume, and elastic recoil pressure was examined in 45 patients (38 men) with cryptogenic fibrosing alveolitis (mean age 61 (SD 14) years). Exponential analysis of static pressure-volume data obtained during deflation of the lungs gave the exponent K, an index of the distensibility of the remaining inflatable lung tissue. Total lung capacity (TLC) was measured in a body plethysmograph or by nitrogen washout. The results were compared with values obtained in 147 healthy subjects (95 men), of mean age 39 (SD 16) years. Fibrosing alveolitis decreased K by 0.62 (SEM 0.04) kPa-1. This decrease was approximately equal to 2 SD of the regression of log K on age in healthy subjects. TLC was decreased to a mean of 70% (SD 14%) predicted in the patients with fibrosing alveolitis. Lung recoil pressure at maximum inspiration was about twice the expected value and regression analysis showed that most of this increase was related to the decreased K rather than to the decreased TLC. In the men with fibrosing alveolitis the regression of height standardised TLC (TLC/Ht3) on K was significant (p less than 0.02); the regression slope was similar to that for 95 healthy men, but was displaced to a smaller lung volume. The dependence of TLC/Ht3 on K is consistent with the close relation between K and peripheral airspace size found in normal lungs. In fibrosing alveolitis decreased pulmonary distensibility probably reflects a decrease in airspace size, whereas most of the decrease in lung volume reflects the loss of inflatable tissue in the fibrotic process.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Colebatch H. J., Greaves I. A., Ng C. K. Exponential analysis of elastic recoil and aging in healthy males and females. J Appl Physiol Respir Environ Exerc Physiol. 1979 Oct;47(4):683–691. doi: 10.1152/jappl.1979.47.4.683. [DOI] [PubMed] [Google Scholar]
- Colebatch H. J., Greaves I. A., Ng C. K. Pulmonary distensibility and ventilatory function in smokers. Bull Eur Physiopathol Respir. 1985 Sep-Oct;21(5):439–447. [PubMed] [Google Scholar]
- Colebatch H. J., Nail B. S., Ng C. K. Computerized measurement of pulmonary conductance and elastic recoil. J Appl Physiol Respir Environ Exerc Physiol. 1978 Apr;44(4):611–618. doi: 10.1152/jappl.1978.44.4.611. [DOI] [PubMed] [Google Scholar]
- Colebatch H. J., Ng C. K. A longitudinal study of pulmonary distensibility in healthy adults. Respir Physiol. 1986 Jul;65(1):1–11. doi: 10.1016/0034-5687(86)90002-2. [DOI] [PubMed] [Google Scholar]
- Colebatch H. J., Ng C. K., Nikov N. Use of an exponential function for elastic recoil. J Appl Physiol Respir Environ Exerc Physiol. 1979 Feb;46(2):387–393. doi: 10.1152/jappl.1979.46.2.387. [DOI] [PubMed] [Google Scholar]
- Crystal R. G., Fulmer J. D., Roberts W. C., Moss M. L., Line B. R., Reynolds H. Y. Idiopathic pulmonary fibrosis. Clinical, histologic, radiographic, physiologic, scintigraphic, cytologic, and biochemical aspects. Ann Intern Med. 1976 Dec;85(6):769–788. doi: 10.7326/0003-4819-85-6-769. [DOI] [PubMed] [Google Scholar]
- Finucane K. E., Prichard M. G. Mechanical properties of the lung in diffuse interstitial lung disease. Aust N Z J Med. 1984 Oct;14(5 Suppl 3):755–761. [PubMed] [Google Scholar]
- Fulmer J. D., Roberts W. C., von Gal E. R., Crystal R. G. Morphologic-physiologic correlates of the severity of fibrosis and degree of cellularity in idiopathic pulmonary fibrosis. J Clin Invest. 1979 Apr;63(4):665–676. doi: 10.1172/JCI109349. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gibson G. J., Pride N. B., Davis J., Schroter R. C. Exponential description of the static pressure-volume curve of normal and diseased lungs. Am Rev Respir Dis. 1979 Oct;120(4):799–811. doi: 10.1164/arrd.1979.120.4.799. [DOI] [PubMed] [Google Scholar]
- Gibson G. J., Pride N. B. Pulmonary mechanics in fibrosing alveolitis: the effects of lung shrinkage. Am Rev Respir Dis. 1977 Oct;116(4):637–647. doi: 10.1164/arrd.1977.116.4.637. [DOI] [PubMed] [Google Scholar]
- Goldstein R. H., Lucey E. C., Franzblau C., Snider G. L. Failure of mechanical properties to parallel changes in lung connective tissue composition in bleomycin-induced pulmonary fibrosis in hamsters. Am Rev Respir Dis. 1979 Jul;120(1):67–73. doi: 10.1164/arrd.1979.120.1.67. [DOI] [PubMed] [Google Scholar]
- Greaves I. A., Colebatch H. J. Elastic behavior and structure of normal and emphysematous lungs post mortem. Am Rev Respir Dis. 1980 Jan;121(1):127–136. doi: 10.1164/arrd.1980.121.1.127. [DOI] [PubMed] [Google Scholar]
- Greaves I. A., Colebatch H. J. Large lungs after childhood asthma: a consequence of enlarged airspaces. Aust N Z J Med. 1985 Aug;15(4):427–434. doi: 10.1111/j.1445-5994.1985.tb02765.x. [DOI] [PubMed] [Google Scholar]
- Haber P. S., Colebatch H. J., Ng C. K., Greaves I. A. Alveolar size as a determinant of pulmonary distensibility in mammalian lungs. J Appl Physiol Respir Environ Exerc Physiol. 1983 Mar;54(3):837–845. doi: 10.1152/jappl.1983.54.3.837. [DOI] [PubMed] [Google Scholar]
- Hance A. J., Crystal R. G. The connective tissue of lung. Am Rev Respir Dis. 1975 Nov;112(5):657–711. doi: 10.1164/arrd.1975.112.5.657. [DOI] [PubMed] [Google Scholar]
- Pierce J. A. Tensile strength of human lung. J Lab Clin Med. 1965 Oct;66(4):652–658. [PubMed] [Google Scholar]
- Scadding J. G., Hinson K. F. Diffuse fibrosing alveolitis (diffuse interstitial fibrosis of the lungs). Correlation of histology at biopsy with prognosis. Thorax. 1967 Jul;22(4):291–304. doi: 10.1136/thx.22.4.291. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stromberg D. D., Wiederhielm C. A. Viscoelastic description of a collagenous tissue in simple elongation. J Appl Physiol. 1969 Jun;26(6):857–862. doi: 10.1152/jappl.1969.26.6.857. [DOI] [PubMed] [Google Scholar]
- Turner-Warwick M., Burrows B., Johnson A. Cryptogenic fibrosing alveolitis: clinical features and their influence on survival. Thorax. 1980 Mar;35(3):171–180. doi: 10.1136/thx.35.3.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yernault J. C., de Jonghe M., de Coster A., Englert M. Pulmonary mechanics in diffuse fibrosing alveolitis. Bull Physiopathol Respir (Nancy) 1975 Mar-Apr;11(2):231–244. [PubMed] [Google Scholar]