Heterogeneous airway tone in asthmatic subjects.

We examined the effect of volume history on the dynamic relationship between airways and lung parenchyma (relative hysteresis) in 20 asthmatic subjects. The acoustic reflection technique was employed to evaluate changes in airway cross-sectional areas during a slow continuous expiration from total lung capacity to residual volume and inspiration back to total lung capacity. Lung volume was measured continuously during this quasi-static maneuver. We studied three anatomic airway segments: extra- and intrathoracic tracheal and main bronchial segments. Plots of airway area vs. lung volume were obtained for each segment to assess the relative magnitude and direction of the airway and parenchymal hysteresis. We also performed maximal expiratory flow-volume and partial expiratory flow-volume curves and calculated the ratio of maximal to partial flow rates (M/P) at 30% of the vital capacity. We found that 10 subjects (group I) showed a significant predominance of airway over parenchymal hysteresis (P < 0.005) at the extra- and intrathoracic tracheal and main bronchial segments; these subjects had high M/P ratios [1.53 +/- 0.27 (SD)]. The other 10 subjects (group II) showed similar airway and parenchymal hysteresis for all three segments and significantly lower M/P ratios (1.16 +/- 0.20, P < 0.01). We conclude that the effect of volume history on the relative hysteresis of airway and lung parenchyma and M/P ratio at 30% of vital capacity in nonprovoked asthmatic subjects is variable. We suggest that our findings may result from heterogeneous airway tone in asthmatic subjects.     

A model of constant-flow ventilation in a dog lung

A semiempirical model of constant-flow ventilation (CFV) is developed to test the hypothesis that a three-zone serial model with the following characteristics can explain the adequate CO2 transport observed during CFV: 1) a zone of jet recirculation immediately downstream of the catheter in which convection dominates; 2) a zone influenced by turbulence but with little or no bulk flow; and 3) a peripheral zone, free of turbulence, in which transport is governed by molecular and augmented diffusion. Interactions between turbulent eddies and cardiogenic oscillations are included using a modification of Taylor dispersion theory according to the formulation of Kamm et al. Predicted values for arterial PCO2 are reasonably similar to experimental results for He-O2, air, and SF6-O2 mixtures for catheter flow rates from 0.2 to 1.6 l/s. Specific impedance to gas exchange was found to be largest immediately proximal to the end of turbulent mixing zone, where transport is governed by low-level eddy mixing and molecular diffusion. Simulations suggest that, during CFV, cardiogenic oscillations augment gas exchange primarily by promoting turbulent eddy dispersion in the distal airways and by extending the length of the turbulent mixing zone. Even small displacements of the catheter are shown to have a dramatic effect on gas exchange.