Importance of airway closure in limiting maximal expiration in normal man

To elucidate the importance of airway closure in limiting maximum expiration, two complementary plethysmographic techniques have been used to estimate the volume of and pressure within the trapped thoracic gas. Three young (19-23 yr) and three older (43-66 yr) subjects were studied. The first study defined the curve of possible pressure-volume relationships for the trapped gas; the second study attempted to estimate the volume of trapped gas. In the first study the subject in a Mead plethysmograph expired through a pneumotachograph and back into the box. A reduction in box volume greater than that caused by drying and cooling of expired gas implies gas compression due mainly to airway closure. In the second study a known volume of air was withdrawn from the mouth at full expiration and changes in box volume and mouth pressure were recorded. The apparent volume in pressure communication with the mouth (Vpc) was calculated using Boyle's law. In the young subjects we did not detect thoracic gas compression although there was evidence of trapped gas (RV-Vpc greater than 0). In the older subjects there was a larger volume of trapped gas that was compressed to pressures of more than 22 cmH2O. Airway closure appears to limit maximal expiration in older subjects.