Surface forces in lungs. II. Microstructural mechanics and lung stability

Recent lung microstructural models describing interactions between alveolar surface tension (gamma) and forces in structural elements of the alveolar duct predict that the component of lung recoil pressure due to gamma (P gamma) is proportional to gamma/V1/3, where V is the total lung volume. This relation is tested against experimental data obtained from pressure-volume measurements of excised rabbit lungs with different constant values of gamma. It is found that for values of gamma less than approximately 18 dyn/cm the data generally agree with the model predictions. With higher values of gamma, a mismatch between the data and predictions first occurs at low and high volumes and then spreads over the entire volume range. The mismatch at the lower volumes coincides with the appearance of nonuniformities of lung expansion. The nonuniformities are characterized by a coexistence of under- and overexpanded regions of the parenchyma referred to as a mixture of phases. These nonuniformities, as well as a pressure-volume curve with a shape similar to the shape of measured curves, are predicted from an analysis of lung stability. Results of this work indicate that if the lung expands uniformly, P gamma proportional to gamma/V1/3 is a good approximation over a wide range of volumes. The stability analysis indicates that the equilibrium configurations of the lung parenchyma when gamma is independent of interfacial area and elevated above normal values are nonuniform states of expansion, characterizable as a mixture of phases. This result confirms that a dependence of gamma on surface area is normally required to achieve stable, uniform states of lung expansion.