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Collateral ventilation and gas exchange in emphysema

N W Morrell1, B K Wignall, T Biggs

  • 1Department of Medicine, Charing Cross and Westminster Medical School, London, United Kingdom.

American Journal of Respiratory and Critical Care Medicine
|September 1, 1994
PubMed
Summary
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Collateral ventilation is significantly higher in emphysema patients compared to healthy individuals, indicating its increased role in gas exchange in this lung disease.

Area of Science:

  • Pulmonary Physiology
  • Respiratory Medicine
  • Emphysema Research

Background:

  • Collateral ventilation, the flow of gas through pathways other than airways, is thought to be altered in emphysema.
  • The precise contribution of collateral ventilation to gas exchange in emphysema remains incompletely understood.

Purpose of the Study:

  • To quantify the magnitude of collateral ventilation between bronchopulmonary segments in emphysema patients.
  • To compare collateral ventilation in emphysema patients with that of normal subjects.

Main Methods:

  • A balloon-tipped catheter was used to occlude segmental bronchi during fiberoptic bronchoscopy.
  • Helium (79%)/oxygen (21%) mixtures were used to measure the rate of helium concentration rise in occluded segments as an index of collateral ventilation.

Related Experiment Videos

  • Respiratory gas tensions (PO2, PCO2) were sampled from occluded segments.

    • Main Results:

    • The rate of helium concentration rise, indicating collateral ventilation, was approximately ten times greater in emphysema patients (9.5%/min) than in normal subjects (0.8%/min).
    • Mean PO2 in occluded segments was similar between groups (approx. 45 mm Hg).
    • Mean PCO2 was lower in emphysema patients (40.1 mm Hg) compared to normal subjects (46.4 mm Hg), likely due to ventilation-perfusion mismatches rather than collateral ventilation.

    Conclusions:

    • Emphysema is associated with significantly increased collateral ventilation compared to normal lungs.
    • Collateral ventilation may play a more substantial role in gas exchange in emphysema, although its exact impact requires further investigation.