Applied Respiratory Physiology by J. F. Nunn (Auth.)

By J. F. Nunn (Auth.)

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Example text

Work performed in overcoming frictional resistance is dissipated as heat and lost. Work performed in overcoming elastic resistance is stored as potential energy, and elastic deformation during inspiration is the usual source of energy for expiration during both spontaneous and artificial breathing. This chapter is concerned with the elastic resistance afforded by lungs and chest wall, which will be considered separately and then together. These factors govern the resting end-expiratory lung volume or functional residual capacity (FRC), and therefore lung volumes will be considered later in this chapter.

Dynamic compliance These measurements are made during rhythmic breathing, but compliance is calculated from pressure and volume measurements made when no gas is flowing, usually at end-inspiratory and end-expiratory 'no-flow' points. Two methods are in general use. Loops. The required pressure gradient and the respired volume are displayed simultaneously as X and Y co-ordinates. 14a, the 'no-flow' points being where the trace is horizontal. The dynamic lung compliance is the slope of the line joining these points when the pressure gradient is ambient/intrathoracic.

The driving pressure is proportional to the square of the required gas flow rate. 2. The driving pressure is proportional to the density of the gas and is independent of its viscosity. 3. The required driving pressure is, in theory, inversely proportional to the fifth power of the radius of the tube (Fanning equation). 3. Resistance, defined as pressure gradient divided by flow rate, is not constant as in laminar flow but increases in proportion to the flow rate. It is thus meaningless to use the Ohm's law concept of resistance when flow is turbulent or partly turbulent, and units such as c m H 2 0 per 1/s should be used only when flow is entirely laminar.

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