Inflection points of lung pressure-volume curves using a three-balloon-catheter system

We measured the pressure-volume curves (PV curves) of the lung simultaneously at three levels in the esophagus below the tracheal bifurcation using the three-short-balloon-catheter system in 11 normal seated men and compared the inflection points (IP's) of three PV curves with the closing volume (CV) on the single-breath nitrogen washout curve. The mean pressure gradient from the top of the uppermost balloon to the top of the lowermost balloon (10 cm apart) was 0.58 +/- 0.06 cmH2O/cm at 60% total lung capacity (TLC). The IP was dependent on depth within the esophagus; i.e., the lung volume at IP (VIP) of the uppermost balloon was the smallest and the transpulmonary pressure (Ptp) at IP (PIP) of that balloon was the largest of the three IP's. VIP's were significantly larger than CV's and the mean absolute difference between the VIP of the uppermost balloon and the closing capacity (CC) was 0.9 liter. These results suggest that IP may not exactly reflect airway closure.