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. 1971 Nov;26(6):727–733. doi: 10.1136/thx.26.6.727

Pulmonary ventilation and gas exchange in bronchiectasis

J N Pande 1, B P Jain 1, R G Gupta 1, J S Guleria 1
PMCID: PMC472389  PMID: 5144652

Abstract

The subdivisions of the lung volume, pulmonary mechanics, and resting steady state pulmonary transfer factor were measured in 31 patients with bronchographically proven bronchiectasis. In seven patients the process of gas exchange was further investigated by fractionating the total alveolar-arterial oxygen tension gradient into diffusion, distribution, and true shunt components.

A restrictive type of ventilatory defect with varying degrees of airway obstruction was observed in a majority of the patients; the airway obstruction was partially reversed by a bronchodilator. Dynamic compliance was usually decreased and the pulmonary resistance increased.

Pulmonary transfer factor was decreased in proportion to the number of segments involved. Vital capacity, maximum breathing capacity, and dynamic compliance bore a less significant correlation with the extent of disease. The degree of airway obstruction, as judged by pulmonary resistance, was independent of the extent of disease.

All the patients were hypoxaemic and some had hypercapnia as well. The alveolar-arterial oxygen tension gradient was widened primarily because of distributional abnormalities and, to some extent, by the presence of true right-to-left shunts. The latter amounted to 13·6% of the total cardiac output.

Surgical resection of the affected lobe or segments resulted in a further deterioration of all the parameters of pulmonary function tested.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ANDERSON L. L., BELL J. C., BLOUNT S. G., Jr An evaluation of factors affecting the alveolar-arterial oxygen tension gradient in chronic pulmonary disease. Am Rev Tuberc. 1954 Jan;69(1):71–77. doi: 10.1164/art.1954.69.1.71. [DOI] [PubMed] [Google Scholar]
  2. AYRES S. M., CRISCITIELLO A., GRABOVSKY E. COMPONENTS OF ALVEOLAR-ARTERIAL O2 DIFFERENCE IN NORMAL MAN. J Appl Physiol. 1964 Jan;19:43–47. doi: 10.1152/jappl.1964.19.1.43. [DOI] [PubMed] [Google Scholar]
  3. BATES D. V., BOUCOT N. G., DORMER A. E. The pulmonary diffusing capacity in normal subjects. J Physiol. 1955 Aug 29;129(2):237–252. doi: 10.1113/jphysiol.1955.sp005350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. BATES D. V., WOOLF C. R., PAUL G. I. A report on the first two stages of the co-ordinated study of chronic bronchitis in the Department of Veterans Affairs, Canada. Med Serv J Can. 1962 Apr;18:211–303. [PubMed] [Google Scholar]
  5. Bass H., Henderson J. A., Heckscher T., Oriol A., Anthonisen N. R. Regional structure and function in bronchiectasis. A correlative study using bronchography and 133Xe. Am Rev Respir Dis. 1968 Apr;97(4):598–609. doi: 10.1164/arrd.1968.97.4.598. [DOI] [PubMed] [Google Scholar]
  6. Bhargava R. K., Woolf C. R. Changes in diffusing capacity after bronchography. Am Rev Respir Dis. 1967 Oct;96(4):827–829. doi: 10.1164/arrd.1967.96.4.827. [DOI] [PubMed] [Google Scholar]
  7. CHERNIACK N., VOSTI K. L., SAXTON G. A., LEPPER M. H., DOWLING H. F. Pulmonary function tests in fifty patients with bronchiectasis. J Lab Clin Med. 1959 May;53(5):693–707. [PubMed] [Google Scholar]
  8. CHRISTOFORIDIS A. J., NELSON S. W., TOMASHEFSKI J. F. Effects of bronchography on pulmonary function. Am Rev Respir Dis. 1962 Jan;85:127–129. doi: 10.1164/arrd.1962.85.1.127. [DOI] [PubMed] [Google Scholar]
  9. Cherniack N. S., Carton R. W. Factors associated with respiratory insufficiency in bronchiectasis. Am J Med. 1966 Oct;41(4):562–571. doi: 10.1016/0002-9343(66)90218-x. [DOI] [PubMed] [Google Scholar]
  10. FRASER R. G., MACKLEM P. T., BROWN W. G. AIRWAY DYNAMICS IN BRONCHIECTASIS; A COMBINED CINEFLUOROGRAPHIC-MANOMETRIC STUDY. Am J Roentgenol Radium Ther Nucl Med. 1965 Apr;93:821–835. [PubMed] [Google Scholar]
  11. GOLDMAN H. I., BECKLAKE M. R. Respiratory function tests; normal values at median altitudes and the prediction of normal results. Am Rev Tuberc. 1959 Apr;79(4):457–467. doi: 10.1164/artpd.1959.79.4.457. [DOI] [PubMed] [Google Scholar]
  12. Guleria J. S., Chitkara R. K. Natural history of broncho-pulmonary suppuration with emphasis on symptomatology. Indian J Chest Dis. 1966 Apr;8(2):54–61. [PubMed] [Google Scholar]
  13. Guleria J. S., Pande J. N., Markose M. M., Gupta R. G., Jain B. P. Pulmonary function in chronic severe anaemia. Clin Sci. 1971 Apr;40(4):317–325. doi: 10.1042/cs0400317. [DOI] [PubMed] [Google Scholar]
  14. Guleria J. S., Sharma M. P., Pande J. N., Ramchandran K. Pulmonary diffusing capacity in normal Indian subjects. Indian J Physiol Pharmacol. 1970 Oct;14(4):245–251. [PubMed] [Google Scholar]
  15. Guleria J. S., Talwar J. R., Malhotra O. P., Pande J. N. Effect of breathing cold air on pulmonary mechanics in normal man. J Appl Physiol. 1969 Sep;27(3):320–322. doi: 10.1152/jappl.1969.27.3.320. [DOI] [PubMed] [Google Scholar]
  16. KAMENER R., BECKLAKE M. R., GOLDMAN H., McGREGOR M. Respiratory function following segmental resection of the lung for bronchiectasis. Am Rev Tuberc. 1958 Feb;77(2):209–220. doi: 10.1164/artpd.1958.77.2.209. [DOI] [PubMed] [Google Scholar]
  17. LIEBOW A. A., HALES M. R., LINDSKOG G. E. Enlargement of the bronchial arteries, and their anastomoses with the pulmonary arteries in bronchiectasis. Am J Pathol. 1949 Mar;25(2):211–231. [PMC free article] [PubMed] [Google Scholar]
  18. MARSHALL R. The physical properties of the lungs in relation to the subdivisions of lung volume. Clin Sci. 1957 Aug;16(3):507–515. [PubMed] [Google Scholar]
  19. Pande J. N., Jain B. P., Guleria J. S. Reversibility of airway obstruction in chronic obstructive lung disease. Am Rev Respir Dis. 1970 Mar;101(3):371–376. doi: 10.1164/arrd.1970.101.3.371. [DOI] [PubMed] [Google Scholar]
  20. ROOSENBURG J. G., DEENSTRA H. Bronchial-pulmonary vascular shunts in chronic pulmonary affections. Dis Chest. 1954 Dec;26(6):664–671. doi: 10.1378/chest.26.6.664. [DOI] [PubMed] [Google Scholar]
  21. SMITH G. A., SIEBENS A. A., STOREY C. F. Preoperative and postoperative cardiopulmonary function studies in patients with bronchiectasis. Am Rev Tuberc. 1954 Jun;89(6):869–914. doi: 10.1164/art.1954.69.6.869. [DOI] [PubMed] [Google Scholar]

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